BAC Webinar 'The Borderline Challenge' 26th October 2023

Webinar Details

England fully converted to primary HPV screening in late 2019. Approximately 15% of all cervical tests detect the presence of high risk HPV and require a reflex cytology test to confirm the presence or absence of a morphological abnormality Approximately 50% of cytology tests are expected to show no cellular changes and will be repeated in 12 months.

Data (Q3 2022/2023) from English laboratories show the reporting rate for borderline and low grade dyskaryosis to be about 27.5% with individual providers ranging from 18.6 to 42.8% showing a marked variation in standards. Over reporting of borderline (ASCUS /AGUS) samples can lead to increased pressures and cost in colposcopy as well as unnecessary anxiety for patients. Many cell changes relate to a transient HPV infection which will clear the immune system and revert to normal. In the new era of HPV primary testing some cytologists and cytopathologists will air on the side of caution rather than issue a negative cytology result.

The borderline category has always been a difficult and subjective one. Most common areas for overcalling are inflammation, degeneration and metaplasia changes including repair, atrophy and iatrogenic effects. The aim of this workshop is to revisit the criteria for borderline in squamous and glandular cells and consider areas where the borderline category is being used inappropriately. It will also cover the use of sensitivity and specificity and the value of workplace tutorials and multiheader microscopy sessions.

It is hoped this workshop will help cytologists to examine their own threshold and reinforce application of cytological criteria to correctly grade a sample.

Our speaker

Maggie Morgan is a Consultant Biomedical Scientist with 21 years of reporting experience and a cytologist for 37 years. She has represented the profession on numerous committees and advisory boards.

She is a practising Consultant Biomedical Scientist and Cervical Screening Provider Lead for Health Services Laboratories who became the sole provider of cervical screening in London in December 2019.