Cervical Cancer Flashcards

1
Q

What is the aetiology of cervical cancer?

A
  • HPV causes 99% of cases
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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)
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3
Q

What are risk factors for cervical cancer?

A
  • HPV infection
    • Causes 99% of cases
  • Multiple sexual partners
  • Older partner
  • Smoking
  • Deprived
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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
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5
Q

How is cervical cancer diagnosed?

A
  • Clinical
  • Screen detected
  • Biopsy
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6
Q

What investigations are done for cervical cancer?

A
  • Biopsy with histology
    • Majority squamous carcinoma (80%)
    • Adenocarcinoma (endocervical)
  • PET CT, MRI to stage
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7
Q

What histological type of cancer is most common for cervical cancer?

A
  • Majority squamous carcinoma (80%)
  • Adenocarcinoma (endocervical)
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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
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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
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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
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11
Q

What lymph nodes does cervical cancer spread to?

A

Pelvic nodes

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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
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13
Q

What improves the prognosis of cervical cancer?

A
  • Good cure rate if detected early
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