Cervical

Question 1

Outline cervical cancer screening

Answer 1

25 to 49 = every 3 years
50 to 64 = every 5 years
65 or older = only if 1 of your last 3 tests was abnormal

Speculum into the vagina - cervical brush to collect cells

Question 2

What are the risk factors for cervical Ca

Answer 2

HPV 16, 18, 33 (unprotected sexual intercourse)

Immune system def

Herpes

Smoking

Age

OCP

Question 3

How does cervical Ca present

Answer 3

Screening

Abnormal PV bleeding, usually postcoital

Vaginal discomfort

Malodorous discharge

Dysuria

Question 4

How is cervical Ca investigated ?

Answer 4

Screening

Chlamydia screen

Colposcopy + biopsy

Staging

• Cystoscopy + Protosigmoidoscopy (rule out invasion of bladder/colon)
• CXR
• CT
• MRI
• PET
• Bloods

Question 5

Outline how cervical Ca is managed

Answer 5

Very early stage = large loop excision of the transformation zone, cone biopsy

Early stage = surgery to remove the cervix + some/all of the womb, +/- RT

Advanced = RT, +/- chemo, +/- surgery

Question 6

Outline the histology of cervical Ca

Answer 6

Cervical intraepithelial neoplasia