Cervical Cancer Flashcards
1
Q
What is the aetiology of cervical cancer?
A
- HPV causes 99% of cases
2
Q
Describe the epidemiology of cervical cancer (rank, age group, incidence change over time)?
A
- 10th most common cancer in woman in Scotland
- Peak age 45-55 years
- Incidence is decreasing (due to immunisation of HPV and screening)
3
Q
What are risk factors for cervical cancer?
A
- HPV infection
- Causes 99% of cases
- Multiple sexual partners
- Older partner
- Smoking
- Deprived
4
Q
What is the presentation of cervical cancer?
A
- Abnormal vaginal bleeding
- Post coital bleeding
- Intermenstrual bleeding/PMB
- Discharge
- Pain – unusual though unless advanced cancer that has spread and is causes neuropathic pain
5
Q
How is cervical cancer diagnosed?
A
- Clinical
- Screen detected
- Biopsy
6
Q
What investigations are done for cervical cancer?
A
- Biopsy with histology
- Majority squamous carcinoma (80%)
- Adenocarcinoma (endocervical)
- PET CT, MRI to stage
7
Q
What histological type of cancer is most common for cervical cancer?
A
- Majority squamous carcinoma (80%)
- Adenocarcinoma (endocervical)
8
Q
How is cervical cancer staged?
A
- Done by PET-CT and MRI
- IA
- Invasive cancer identified only microscopically
- IA1 <=3mm depth and <=7mm diameter
- IA2 <=5mm depth and >7 diameter
- IB
- Clinical tumours confined to cervix
Spread:
- Locally (more common than metastases spread)
- Stage 2 – vagina (upper 2/3)
- Stage 3 – lower vagina, pelvis
- Stage 4 – bladder, rectum
- Metastases
- Lymphatic – pelvic nodes
- Blood – liver, lung, bone
9
Q
Explain the staging of cervical cancer?
A
- IA
- Invasive cancer identified only microscopically
- IA1 <=3mm depth and <=7mm diameter
- IA2 <=5mm depth and >7 diameter
- IB
- Clinical tumours confined to cervix
10
Q
Where does cervical cancer often spread?
A
- Locally (more common than metastases spread)
- Stage 2 – vagina (upper 2/3)
- Stage 3 – lower vagina, pelvis
- Stage 4 – bladder, rectum
- Metastases
- Lymphatic – pelvic nodes
- Blood – liver, lung, bone
11
Q
What lymph nodes does cervical cancer spread to?
A
Pelvic nodes
12
Q
Describe the management of cervical cancer?
A
- IA1
- Type 3 excision of cervical transformation zone or hysterectomy
- IB-IIA
- Radical hysterectomy (removal of uterus, cervix, upper vagina, parametria, pelvic nodes, ovaries are conserved in pre-menopausal woman) or chemo-radiotherapy
- IIB-IV
- Chemo-radiotherapy
13
Q
What improves the prognosis of cervical cancer?
A
- Good cure rate if detected early