Newcastle Laboratories

Cytology

Each request received by the laboratory is considered an agreement between the laboratory and the sender. The obligations of both parties to that agreement are detailed on this site. If an organisation external to the Newcastle upon Tyne NHS Foundation Trust, wishes to procure our services, to a value in excess of £10,000 per annum then a Service Level Agreement will be drawn up between the two organisations.

To provide a Cervical Screening service:

The NHS Cervical Screening Programme invites all women between the ages of 25-49 and 50-64 to have a cervical screening test every three years and five years respectively.

Cervical screening is a method of preventing cervical cancer by detecting and treating abnormal changes in the cervix of women who are healthy and asymptomatic.

Specimens are received from all GPs and hospitals within the Newcastle, North Tyneside and Northumberland areas, the RVI processes about 50,000 specimens every year.  (In the event that there are problems with the ICE electronic ordering, the attached CYGO015 form can be used for cervical screening cytology requests).

The specimens are taken directly from the cervix with a plastic brush, which is immediately placed into a vial containing SurePath preservative.

Sample vials and brushes, request forms and specimen bags, tracking forms and transport bags can be ordered by telephone: 0191 2824437 (08:30AM – 05:00PM) or by e-mail CytologyOrder@nuth.nhs.uk. Please state GP address, the type of form needed (ICE form from GP’s or HMR101’s) and location (Newcastle, North Tyneside or Northumberland).

The lab receives the specimens, where they are processed in batches of 48 using Liquid Based Cytology methods.

Processing involves enrichment (which removes excess blood and mucus) and homogenisation. A random sample of cells, which is representative of the cells from the woman’s cervix, is transferred to the slide, which is then stained.

The samples are then analysed microscopically by qualified cytoscreeners and biomedical scientist for any dyskaryotic (pre-cancerous) cells.

Any samples that contain possible abnormalities are referred to, and interpreted by a Pathologist.

Any low grade abnormalities are triaged with a PCR test for High Risk HPV

Patients who do have abnormal samples will be monitored and/or treated accordingly.

Patients who have received treatment for dyskaryosis will have a Test Of Cure for HR HPV.

Your Guide to Cervical Screening Smear Test

Jo’s Cervical Cancer Trust

NHS Cervical Screening Program

Information for Sample Taker Training

To provide a diagnostic service:

The cytology laboratory also receives samples from symptomatic patients who are suspected to have cancer, or to rule out malignancy.

Specimens are usually fresh fluids that can be collected relatively rapidly, painlessly and simply, these include urines, bladder washes, CSF, sputum, bronchial washes, serous fluids and fine needle aspirates.

Fresh fluids are received in universal containers, and are spun down to concentrate any cells in the fluid that are then transferred via cytocentrifugation to glass slides (fine needle aspirate samples can be spread directly onto slides).

Non-gynae specimens can also be processed using Liquid-Based Cytology methods.

The specimens are then stained with Papanicolou and May Grunwald Giemsa so that the Pathologists can interpret them microscopically. The Pathologists may then request further special stains and/or immunocytochemistry to help them reach a diagnosis.

 

Post Vasectomy Semen Analysis:

This is a screening test only, checking for the absence of sperm after a vasectomy. It is not to be used for fertility assessment (number and vitality of spermatozoa). If this is required please refer the patient to Newcastle Fertility Centre for Life.

How to collect a semen sample for post-vasectomy sperm count:

2015 Sperm

Before you collect your sample:

  • You should have ejaculated at least 20 times prior to submitting your first sample
  • Samples should be collected after a minimum of two days but no longer than seven days of sexual abstinence.

To collect your sample:

  • Use only the container provided for your sample. Do not use a condom to collect your specimen as these are harmful to sperm.
  • It is very important that the entire specimen goes into the container and none is lost. If some sample is lost, select ‘N’ for the Complete Sample? Question.
  • Ensure that the container is securely closed.

Please label the specimen container with:

  • Your full name and date of birth
  • The type of specimen (semen)
  • The date and time the specimen was produced

Please ensure that the request form provides the following information:

  • Your full name, address and date of birth
  • Your GP’s name and surgery OR referring clinician.
  • The date of your vasectomy
  • The date and time the specimen was produced
  • Consent (or not) for the use of surplus sample for training and validation.
  • NB: Samples without complete labels or forms may not be accepted

Delivering your specimen to the hospital:

  • Keep the specimen at room temperature or as near to body temperature as possible (for example, by transporting it in your pocket)
  • Your specimen must be delivered within 2 hours of production to the Cellular Pathology Department, Cytology Reception at the Royal Victoria Infirmary (in the New Victoria Wing, Level 3) on any week day (Monday to Friday) 8:30am to 3:30pm.  Please ensure the sample is handed to a member of staff.
  • If your sample is more than four hours old on receipt in the laboratory and sperm are identified within it, you will be asked by your clinician to produce a repeat sample at the hospital

 

Please note that this service is not accredited by UKAS to CPA or ISO 15189:2012

 

Sending us samples – acceptance & rejection criteria

New criteria for the acceptance of cervical screening samples were introduced by Public Health England in April 2017.

Cervical samples will only be accepted by the laboratory if they have been taken appropriately. Patients are invited to have samples taken at intervals determined by their previous history following protocols issued by the NHSCSP.

  • First invitations are sent out at age 24.5. The laboratory will not accept first samples on patients younger than this. It may be the case that the patient has already entered the screening program in Scotland where first invite is at age twenty. If this is the case, please indicate this on the request form.
  • The laboratory will not accept samples on patients over age of 65 unless:
    • The patient has never had a sample before(unscreened)
    • The patient has missed their last invitation
    • The patient is in follow up for previous abnormal
  • In cases where patients are on routine recall(three or five yearly), samples will be accepted which have been taken up to six months before the actual recall date. Samples taken more than six months prior to the recall date will be rejected.
  • In cases where patients are on early repeat (three, six or twelve month recall), samples taken before the actual recall date will be rejected.
  • Vault samples on women with total hysterectomy for benign conditions or non-cervical malignancy will be rejected if the patient was on routine recall prior to the hysterectomy.

Regarding the sample and request form:

  • Samples in out-of-date vials will be rejected.
  • Samples without requests forms (or forms without samples) will be rejected.
  • Unlabelled samples will be rejected.
  • Samples will be rejected if requests forms do no have valid sample take codes. These codes are issued by the Cercical Sample Taker Database (CSTD) and are in the format of a letter followed by four numbers.

Cervical samples are not diagnostic tests and should not be taken on symptomatic patients e.g. abnormal bleeding unless the sample is due anyway. These patients should be referred to colposcopy.

Please ensure that the brush head is placed in the vial and that all the fluid is present. Check also that there are no cracks in the lid of the vial. If samples are received without brush heads and/or fluid which has leaked in transit they will be reported as unsatisfactory.