Cervical and Endometrial Cancer Flashcards
Incidence rates for cervical cancer in the UK are highest in what age group?
25-29 years
(>50% women are <45 years)
Most cervical cancers are adenocarcinomas. TRUE/FALSE?
FALSE
squamous cell cancer (80%)
adenocarcinoma (20%)
Are patients with cervical cancer always symptomatic?
No may be detected during routine screening
Symptoms may include:
- abnormal vaginal bleeding
- postcoital, intermenstrual or postmenopausal bleeding
- vaginal discharge
Name some risk factors for the development of cervical cancer
HPV infection
smoking
HIV
Early first intercourse
Many sexual partners
High parity
Lower socioeconomic status
COCP
What subtypes of HPV put patients more at risk of cervical cancer?
16,18 & 33
HPV is the most important risk factor in the development of cervical cancer. TRUE/FALSE?
TRUE
How does the HPV virus cause cervical cancer?
- HPV 16 & 18 produces the oncogenes E6 and E7 genes respectively
- E6 inhibits p53
- E7 inhibits RB suppressor gene
Risk factors for development of endometrial cancer
- nulliparity
- early menarche+late menopause
- unopposed oestrogen
- metabolic syndrome
- obesity
- diabetes mellitus
- PCOS
- Tamoxifen
- HNPCC
What are some “protective” factors against endometrial ca?
- multiparity
- COCP
- smoking (reasons unclear)
How do patients normally present with endometrial ca?
- postmenopausal bleeding
> premenopausal women may develop menorrhagia or intermenstrual bleeding
What investigations can be completed to assess post-menopausal bleeding and look for endometrial ca?
- TVUS for endometrial thickness (normally <4mm)
- hysteroscopy with endometrial biopsy
How is endometrial cancer normally managed?
- Surgery
> total abdominal hysterectomy with bilateral salpingo-oophorectomy
If high-risk disease
=> postoperative radiotherapy
Progestogen therapy if not suitable for surgery
