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A visit to Scotland: the Hologic Annual Medical Education Conference

Recently, Hologic hosted its eighth HAMEC meeting, this year held in Ayrshire, which attracted an audience of 160 delegates from hospitals and laboratories across Europe. The first day was chaired by Dr Amanda Herbert (consultant cytopathologist and histopathologist, St Thomas’ Hospital, London), and the second day by Professor Heather Cubie (consultant clinical scientist, Edinburgh Royal Infirmary). A variety of topical debates relevant to cytology and molecular pathology were presented by eminent guest speakers to an audience representing 13 countries across Europe.

Automated cell block system
Immunocytological applications on samples produced by Hologic’s Cellient automated cell block instrument were discussed by Dr Henryk Domanski (consultant cytopathologist, University Hospital of Lund, Sweden). Dr Domanski argued that there had been historic issues in obtaining sufficient material from fine-needle aspiration (FNA) samples for ancillary studies. Lund University Hospital had, until recently, been using the Shandon kit to create cell blocks since 1997. Although it had its limitations as a manual process with variable quality, it did provide good results in experienced hands. However, last year the university’s Department of Pathology obtained Hologic’s Cellient automated cell block system, which now provides an automatic and standardised process for every sample. Dr Domanski concluded that the department has been using Cellient for almost a year and the main advantage is its automation and provision towards standardisation in the country.

Focus on Scotland
Dr Louise Smart (consultant cytopathologist, Aberdeen Royal Infirmary) followed with a discussion on the modernisation of cervical cytology in Scotland. With a population of 5.2 million, there are 14 Scottish Health Boards, each of which manages its own budget. The Scottish Cervical Screening Programme was introduced in 1989 to women aged 20–60 years with three-yearly screening intervals. Eleven laboratories across Scotland report approximately 400,000 cervical samples every year, with the smallest laboratory processing 17,000 samples and the largest processing 77,000 samples.

Liquid-based cytology (LBC) was implemented throughout Scotland in 2003/04 following a pilot study showing improved productivity, fewer inadequate results and increased pick-up of abnormal cells. Since then nearly four million ThinPrep LBC samples have been reported. Further introduction of the Scottish Cervical Call and Recall System (SCCRS) in 2007, where a single Scotland-wide database for the Cervical Screening Programme was developed, has led to a more efficient electronic system for the management of cervical screening and treatment. Other advancements include the introduction of human papillomavirus (HPV) vaccination in a school-based programme for 12–13-year-old children, with a ‘catch-up’ for those in the 13–17 age group; and a soon to be implemented HPV ‘test of cure’ at one test centre in Edinburgh and the development of a Cervical Cytology Review Group that addresses laboratory organisation, coordination of service delivery, manpower planning, technology changes as well as assessing whether or not an imaging system will benefit cervical cytology in Scotland.

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