Cervical and Endometrial Cancer Flashcards
Pap smears reduce incidence of cervical cancer by 70%.
Cerivcal cancer is the #2 cause of cancer death in women.
Freebie! There was no question. Good way to start off a new deck. =)(FYI, It’s a true statement)
T/F: Getting a HPV infection means that you will get cervical cancer in the future.
False. Getting HPV infection doesn’t mean you’ll get cervical cancer. HPV infection is VERY prevalent but will resolve within 2 years in young immunocompetant patients.
All of the following are risk factors for oncogenic HPV EXCEPT: A. Smoking B. Immunocompetance C. Early age at 1st time sex D. Low socioeconomic status
B. Immunocompromisedis most important risk factor
Most common histological type of cervical cancer
Squamous cell carcinoma (80%)Adenocarcinoma = #2 most common
Which HPV strain(s) seen in 90% of adenocarcinoma cerival neoplasia?
HPV 16 and 18
What is the recommendation of immunization against HPV?
vaccinate w/ nonavalent aged 11-12 for girls AND boys, catch up to 26
What is the cervical cytologic screening recommendation?
Initial screening start at 21 y/o
Repeat cytology q 3 years b/w 21-65 y/o
T/F: HPV testing is indiciated in adolescents.
False. Unnecessary since 90% of HPV infections naturally resolve within 2 years.
T/F:1-2 year persistence of HPV 18predicts 20-30% of CIN 3+ over 10years
False. HPV 16
5 years
Initial presenting symptoms of cerival cancer (2)
Abnormal bleeding
Unusual vaginal discharge
T/F: A diagnosis of cervical cancer is made by a positive cervical cytology.
False. Must confirm with biopsy.Cervical cytology is used for screening. When tumor is clinically visible, only need biopsy.
Most common histological type of cervical cancer
Pattern of spread?
Squamous cell carcinoma
Local invasion, lymphatic spread
Types of cervical cancer that spreads hematogenously (3)
Adenocarcinoma
Neuroendocrine
Small cell tumors
= worse prognosis
T/F: Staging of cervical cancer is based on surgical evaluation.
False.Exclusively based on clinical evaluation
Does NOT change based on findings post surgery
Allows staging to occur in low resource settings
Treatment of early stage cervical cancer
Radical hysterectomy w/ pelvic lymph node dissection (PLND)
OR
Primary chemotherapy
Treatment of locally advanced stage cervical cancer
Primary chemoradiation
Treatment of distant metastases (4B) cervical cancer
Systemic chemotherapy
Radical trachelectomy =
Used when?
Removal of cervix alone
Used to preserve fertility in women with cervical cancer
Post cervical treatment follow-up schedule
PAP yearly CXR yearly Clinical evaulation: Q 3 months x 2 years --> Q 6 months x 3 years --> Annually
T/F: Endometrial cancer is the most common gynecologic cancer and has a high mortatality.
False. Most common buthigh surivivald/t early diagnosis
T/F: Endometrial cancer is most common young white women.
False. White old women
Black women also at (lesser) risk
Peak age: 60-70
Type 1 endometrial cancer =
Estrogen dependent
Endometrioid adenocarcinomas
Better prognosis
Type 2endometrial cancer =
Non-estrogen dependent
Papillary serous
Clear cell
Worseprognosis
Most common clinical symptom of endometrial cancer
Post menopausal bleeding
T/F:Endometrial Hyperplasia/Endometrial Intraepithelial Neoplasia (EIN) is precursor to endometrial cancer. The highest risk is with complex atypical hyperplasia.
True
Highly sensitive work up for endometrial cancer
Endometrial biopsy +/ transvaginal US
T/F:Staging of endometrialcancer is based on surgical evaluation.
True
T/F: Postiive nodes changes staging from 2 to 3 in endometrial cancer.
True
Unlike cervical cancer where staging does not change post surgery
Most important prognostic factor of endometrial cancer
Lymph node metastasis
Treatment of primary endometrial cancer
Hysterectomy +/- Pelvic and paraortic lymph node dissection (PPLND)
Post endometrial treatment follow-up schedule
Clinical exam Q 3-4 months x 2 years Clinical exam Q 6 months x 3 years Yearly after 5 years CXR yearly Pap smear not required
T/F: Endometrial cancers are more likely to reoccur than cervical cancer within 2 years.
False. Cervical cancer more likely to recur (80%) than endometrial cancer (50%)
T/F: Cervical cancer recurrence is harder to treat than endometrial cancer recurrence.
True. 80% of endometrial cancer recurrence are treatable vs 20% in cervical cancer
