Cervical cancer

Question 1

Etiology of cervical cancer

Answer 1

HPV infection - 12/ 100+ subtypes cause cervical cancer - mostly 16 + 18

Question 2

Risk factors of cervical cancer?

Answer 2

Risk factors for HPV infection

Early age of first intercourse
multiple sex partners
Immunodeficiency
smoking

Question 3

Types of cervical cancer?

Answer 3

Squamous cell carcinoma - most common

Adenocarcinoma - rare

Question 4

Symptoms of Cervical cancer?

Answer 4

Light vaginal bleeding (spotting)
vaginal bleeding, especially post coital
Pelvic pain
Dysuria

Question 5

Diagnosis of Cervical cancer?

Answer 5

Screening - PAP smear (Papanicolau)
If precancerous cells seen (Dysplasia) -> colposcopy

Colposcopy allows viewing and biopsy.

Question 6

Stages of cervical cancer?

Answer 6

Stage 0 - carcinoma in situ 
Stage 1 - confined to cervix 
A - Microscopic 
B - Macroscopic 
Stage 2 - Spreads beyond the cervix but not to pelvic wall
A - upper 2/3 of vagina 
B - parametrial involvement 
Stage 3 - Spreads to pelvic wall
A - Lower 1/3 of vagina 
B - Hydronephrosis 
Stage 4 - Distant metastasis and invasion
A - Bladder and rectum involvement 
B - Distant metastasis

Question 7

Treatment of cervical cancer?

Answer 7

Conization/total hysterectomy - Stage 0, Stage 1A
Radical hysterectomy - Stage 1B, Stage 2A
Radiation and adjuvant chemotherapy - Stage 2B -> Stage 4A
Chemotherapy only - Stage 4B