16: Cervical cancer

Question 1

Important points to explain to someone with HSIL

Answer 1

• Abnormal smears does not equal cancer
• Infection can remain dormant for many years
• Must attend specialist appointment due to high risk

Question 2

When is referral for colposcopy necessary?

Answer 2

LSIL: 1 abnormal smear in last 5 years or >30 and HrHPV +ve

HSIL: all women

Question 3

How would you explain what to expect during colposcopy?

Answer 3

• Will look at your cervix under a microscope and use a stain
• Abnormal areas -> sample-
• 10-20 mins

Question 4

What is a LLETZ?

Answer 4

Lower loop excision of TZ

- Use of an electric loop wire to remove abnormal cells under local anaesthetic assisted by colposcopic vision

Question 5

What is a cone biopsy?

Answer 5

Cone shaped sample of the cervix to remove abnormal cells, usually under GA

Question 6

of deaths from CC worldwide

incidence of CC in NZ

Without screening __ would develop CC

Answer 6

300,000 annually worldwide

160 develop and 60 die

without screening 1/40 would develop

Question 7

Risk factors for cervical cancer

Answer 7

Epidemiology: women >40, Maori, Pacific, obese, porvery
Obs Hx: multiple full term pregnancies, young age at first full term
Gynae: HPV, chlamydia
PMHx: immunosuppression, COC
FHx: cervical ca
SHx: smoking, diet

Question 8

How does a woman with cervical cancer typically present

Answer 8

• Asymptomatic
• PCB/IMB
• Unusual discharge
• Signs of spread e.g. change in bowel/bladder function, leg/bone pain
• Constitutional: weight loss, malaise