105. Cervical Smearing and Cancer Flashcards
What age range of women are invited for a cervical smear?
Those aged between 20 and 60 years old
What factors may predispose to cervical cancer?
Earl sexual activity/Multiple partners Vaginal or vulval warts Previously abnormal result OCP use Heavy smoking
What does a severely dyskaryotic smear usually mean?
Cervical intra epithelial neoplasia
A pre cancerous neoplasia
Describe the appearance of a dyskaryotic histology slide?
Enlarged nuclei, darkly stained and have an irregular margin
What is the most common age group to get cervical cancer?
30-55
What causes 99.7% cases of cervical cancers?
Human Papilloma virus,
Strains 16&18 cause 70% of those cases
What is the role of cervical screening?
Aims to pick up Cervical intraepithelial neopalsias- a pre cancerous change
Where does the cervical cancer screening test sample from
The epithelium in the transition zone
What are the symptoms of cervical cancer
Intermenstrual bleeding
Vaginal discharge (bloodstained)
Post menopausal bleeding
Abnormal appearance of the cervix on examination
What must be ruled out in pre menopausal women before referring to gynae
Chlamydia
What further tests are done when cervical cancer is suspected
biopsy
radiological imaging and staging
What is the FIGO classification of cervical cancer?
Based on rectal and vaginal examination to stage the cancer
What are the treatment options for the various FIGO stages of cervical cancer
1a- Local excisions if fertility required. Hysterectomy
1b- 2a- radical hysteorectomy or chemotherapy
2-4- Chemo/radiotherapy
What chemotherapy options are given?
Cisplatin based chemo
When must radio/chemotherapy be considered
Greater than 1/3 stromal invasion
Lymphovascular space invasion
Tumour diameter>4cm