Cytopathology ServicesAugust 2013

� Melbourne Pathology offers a full range of cytopathology services

� All patients are linked to the Victorian Cervical Cytology Register (VCCR) on an opt- off basis

� All scientific staff involved with screening, participate in the RCPA Quality Assurance Program (QAP)

Led by Drs Vanessa Obers and Val Surtees, Melbourne Pathology offers a full range of cytopathology services including Pap test screening, exfoliative cytology and fine needle aspiration. These tests are performed in- house at our Collingwood laboratory.

Gynaecological CytologySuppliesMelbourne Pathology supply three types of Pap test collection kits. Cervex ‘Broom’ kit (blue), spatula and endocervical brush kit (blue) and Cervex Brush® – Combi kit (red), all pictured below. Liquid based cytology is also offered at Melbourne Pathology; the ThinPrep® vial and Cervex ‘Broom’ are used for this collection.Chlamydia, gonorrhoea and HPV PCR can be performed on the same ThinPrep® vial as is used for the Pap test.

ReportsAll patients are linked to the Victorian Cervical Cytology Register (VCCR) on an opt-off basis. Reports are available in all formats; electronic, fax and hardcopy A4 with a tear-off acknowledgement and reminder to be sent to the patient.

Melbourne Pathology provides: � Six-monthly cervical cytology analysis reports with the number of Pap tests and a breakdown of endocervical component, ThinPrep® and abnormalities compared to the laboratory average

� Monthly abnormal list: A list of patients who require early follow-up for either abnormal or unsatisfactory results

� Monthly Pap test reminder list and letters (optional): A monthly list of all patients who are due for a repeat Pap test in the next month. This is sent mid-month for the following month, allowing time to notify patients and make appointments. This report is based on the last Pap test report at Melbourne Pathology. The reminder letters are addressed to the patient on behalf of the doctor. These letters are sent to the patient by the clinic. We do not send any correspondence directly to the patient.

Please note: Reminders will also be sent from the VCCR to the patient if they have not had a repeat Pap test three months after their due date.

Cervical cytology analysis report

Cervex ‘Broom’ kit (blue)Order no. 03888

Spatula and endocervical brush kit – (blue) Order no. 03882

ThinPrep® vial and Cervex ‘Broom’Order no. Vial – 01922, ‘Broom’ within kit – 03888. (Order both numbers)Cervex Brush® – Combi

kit (red)Order no. 07113

QualityAll scientific staff involved with screening, participate in the RCPA Quality Assurance Program (QAP) and are also monitored quarterly as to their Pap test reporting profile.

The laboratory fulfils all requirements of the RCPA QAP performance measures.

All Pap tests are primarily screened by qualified scientific staff. All negative Pap tests are rapidly re- screened and authorised by an independent scientist.

Symptomatic or high risk patients have their Pap test fully re- screened by an independent scientist and may also have analysis and authorisation by a Cytopathologist. All abnormal cases are seen and authorised by a Cytopathologist.

Dr Val Surtees is Melbourne Pathology’s onsite dedicated gynaecological Cytopathologist. Melbourne Pathology employs numerous Cytopathologists to support queries. Pap test reports are correlated with concurrent HPV DNA and cervical biopsy reports to produce a complete result.

Melbourne Pathology participates in internal and external quality control. All staff have the opportunity to participate in monthly gynae multiheader microscope sessions and other continuing education activities. Melbourne Pathology uses a paperless reporting system to reduce transcription errors and provide accountability.

Exfoliative CytologyMelbourne Pathology offers a range of exfoliative cytology services including analysis of urine, sputum, bronchial washings and brushings, gastric brushings, effusions, CSF and nipple discharge samples.

Exfoliative specimens are screened by quality scientific screeners, and reported by a specialist Cytopathologist.

Fine Needle Aspiration (FNA) CytologyThe laboratory receives a range of fine needle aspirates for reporting with a large proportion being of thyroid and breast origin. Fine needle aspirates are received from clinicians from palpable lesions and from radiology for deeper lesions, including endoscopic ultrasound assisted FNAs.

The Bethesda standardised reporting format is used for thyroid FNAs. All FNAs are primary screened by a scientist and are then reported by a specialist Cytopathologist.

An onsite FNA service for palpable lesions can be provided by arrangement with Dr Vanessa Obers, at our Collingwood main laboratory.

Reports are available in all formats; electronic, fax and hardcopy A4. Melbourne Pathology has internal and external quality control activities and participate in RCPA QAP General and FNA modules.

Relevant publications available: � High-Risk HPV Test (June 2013) � May 2013 HPV DNA collection letter � Taking Better Pap Tests (July 2012) � Moving toward structured reporting for thyroid cytology (July 2011)

� How to get the best out of an FNA (July 2011)

Courier pick upsMelbourne Pathology couriers travel far and wide to pick up and deliver a range of pathology samples, including cytopathology samples. The Melbourne Pathology courier network services metropolitan Melbourne, as well as many regional areas including Bendigo, Ballarat, Shepparton, Moe, Warrnambool, Warragul, Wangaratta, Euroa, Colac and the Mornington and Bellarine Peninsulas. To arrange a courier pick-up, please call 9287 7788.

Dr Vanessa ObersMBBCh, FFPath, FIAC, FRCPA

Director of Cytopathology

Dr Obers completed a Bachelor of Medicine and Bachelor of surgery in 1985 at the University of Witwatersrand,

Johannesburg, South Africa. She went on to complete her Pathology Fellowship Examination at the College of Medicine of South Africa in 1991 and in 1995, completed her fellowship Examination of the International Academy of Cytology. During this time, Dr Obers held several appointments at a number of medical instituitions.

From 1986 – 87, she was a Registrar in the Cytology Unit at the Department of Anatomical Pathology, School of Pathology of the South African Institute of Medical Research (SAIMR) and the University of Witwatersrand. She went on to become Head of the Cytology Unit at Baragwanath Branch Laboratory, School of Pathology, SAIMR and the University of Witwatersrand. Dr Obers was appointed Practising Pathologist in 1994 at Lancet Laboratories in Johannesburg where she remained until 2009, heading up the Cytopathology Unit.

Dr Obers moved to Australia in February 2009 and joined Melbourne Pathology as a full time Histo and Cytopathologist. She became a fellow of the Royal Australasian College of Pathologists in 2010.

Cytopathology Services cont.

Melbourne Pathology ABN 63 074 699 139. A subsidiary of SONIC HEALTHCARE LIMITED

103 Victoria Parade Collingwood, Victoria 3066 | Switchboard 9287 7700 www.mps.com.au August 2013