Cervical Cancer

Question 1

Pap smear age & screening intervals

Answer 1

25- 65yrs

• Every 3yrs if done alone
• Every 5 years as co-testing

Question 2

Pap smear contraindications

Answer 2

Hysterectomy for non-malig. dz

Endometrial Cancer

Question 3

Screening interval for HPV test

Answer 3

Every 5 years (with primary & co test)

Question 4

Colposcopy indications

Answer 4

• Abnormal findings on gross exam and
• Abnormal results on cervical screening tests
• ASC-H result in Pap smear
• Positive primary HPV 16, 18
• Two consecutive inconclusive cytology results in HPV positive pt. >25

Question 5

Most common subtype of invasive cervical cancer

Answer 5

Squamous cell carcinoma (80%)

Question 6

FIGO IA & IB

Answer 6

Tumor strictly confined to cervix

IA: deepest invasion = 5mm

IB: > 5mm depth

Question 7

FIGO IIA & IIB

Answer 7

Invasion beyond uterus but not into pelvic wall or lower 1/3 of vagina

IIA: upper 2/3 of vagina, no parametrial inv.

IIB: parametrial invasion

Question 8

FIGO III

Answer 8

• Tumor invaded pelvic wall 
and/or
• Lower 1/3 of vagina
and/or 
• causes hydronephrosis or nonfunctioning kidney

Question 9

FIGO IVA & IVB

Answer 9

Tumor extends beyond true pelvis or (on biopsy) spread to vesicular or rectal mucosa

IVA: spread to adjacent organs

IVB: spread to distant organs

Question 10

FIGO 0(Tis)

Answer 10

Carcinoma in situ (CIN III)

Question 11

Primary mode of tx for stages (IB, IIA, IIB, III) invasive cervical cancer

Answer 11

Concurrent chemoradiation

Other: Radiotherapy alone

Question 12

Invasive Cervical ca:

Indication for simple extrafascial hysterectomy WITHOUT lymphadenectomy

Answer 12

FIGO IA1

Question 13

Recommend age for HPV vaccine

Answer 13

9 -26 yrs

Question 14

High risk HPV strains__

Answer 14

16, 18, 31, 33

Question 15

HSIL Or ASC-H? …Colposcopy

Other premalignant changes

Answer 15

… directed Surface Biopsy at site

Question 16

Directed Surface biopsy in non-pregnant patient >24 years is

Answer 16

…LEEP rather than Colposcopy

Question 17

For women (25 - 65) years, ACOG recommends either..

Cotesting or primary Pap every 5 years

Answer 17

Or solitary Pap every 3 years

Question 18

USPSTF says..

• women (30 - 65) = Contest every 5 years
• women (21- 29) = Solitary Pap every 3 years

Answer 18

…yeah

Question 19

Women 21- 24 with LSIL on Pap smear?

• Repeat smear

Answer 19

..twice, at 12 month intervals

Question 20

In women 25 and up, LEEP is used to treat…

Answer 20

HSIL 
and CIN (I to III)