CERVICAL CANCER Flashcards
WHAT AGE RANGE DOES 50% OF THE CASES OCCUR IN?
women under the age of 45 years,
AGES FOR HIGHEST INCIDENCE RATES?
25-29 YEARS
2 TYPES
squamous cell cancer (80%)
adenocarcinoma (20%)
FEATURES
- may be detected during routine cervical cancer screening
- abnormal vaginal bleeding:
postcoital, intermenstrual or postmenopausal bleeding - vaginal discharge
RISK FACTORS
smoking
human immunodeficiency virus
early first intercourse, many sexual partners
high parity
lower socioeconomic status
combined oral contraceptive pill*
CAUSATIVE ORGANISM
HPV 16, 18 AND 33
MECHANISM OF HPV CAUSING CERVICAL CANCER
HPV 16 & 18 produces the oncogenes E6 and E7 genes respectively
E6 inhibits the p53 tumour suppressor gene
E7 inhibits RB suppressor gene
WHAT IS HPV FIRST SYSTEM
sample is tested for high-risk strains of human papillomavirus (hrHPV) first and cytological examination is only performed if this is positive.
NEGATIVE HRHPV
RETURN TO NORMAL RECALL
POSITIVE hrHPV
Proceed to cytology
if cytology abnormal then colposcopy
cytology normal then repeat in 12 months - if negative normal recall, if still positive further repeat in 12 months
- if still positive after 24 months - colposcopy
What do you do if the sample is inadequate?
repeat the sample within 3 months
if two consecutive inadequate samples then → colposcopy
What do you do if the sample is inadequate?
repeat the sample within 3 months
if two consecutive inadequate samples then → colposcopy
follow up of patients with previous CIN
individuals who’ve been treated for CIN1, CIN2, or CIN3 should be invited 6 months after treatment for a test of cure repeat cervical sample in the community.
treatment of CIN
Large loop excision of transformation zone (LLETZ)
cryotherapy
