Cervical Cancer

Question 1

What is the most common type of cervical cancer?

Answer 1

Squamous cell

Question 2

What are risk factors for cervical cancer?

Answer 2

HPV
Multiple sexual partners
Smoking
Long term COCP use
Immunosuppression

Question 3

What are the high risk HPV subtypes for cervical cancer?

Answer 3

16

18

Question 4

How do those HPV subtypes cause cervical cancer?

Answer 4

Produce E6 + E7 proteins that inhibit p53 and pRb tumour suppressor genes

Question 5

What is CIN?

Answer 5

Cervical intraepithelial neoplasia

Pre-malignant lesion

Question 6

What are the types of CIN?

Answer 6

CIN 1 = mild dysplasia affecting 1/3 thickness

CIN 2 = moderate dysplasia affecting 2/3 thickness

CIN 3 = severe dysplasia

Question 7

What are features of cervical cancer?

Answer 7

Post-coital bleeding
PMB
Dyspareunia

Question 8

How is suspected cervical cancer investigated?

Answer 8

Screening via smear

Colopscopy + biopsy

Question 9

What happens in colposcopy?

Answer 9

Speculum + colposcope used to magnify cervix

Stains

• acetic acid - abnormal cells = white
• iodine - normal cells = dark

Question 10

How can cervical cancer be managed?

Answer 10

Surgery

• LLETZ (large loop excision of transformation zone)
• hysterectomy

Chemo

RT

Question 11

How is cervical cancer prevented?

Answer 11

HPV vaccination to boys + girls aged 14

Subtypes

• 6
• 11
• 16
• 18

Given before they are sexually active to prevent HPV spread