Cervical Cancer Flashcards
what is the most important risk factor for developing cervical cancer?
human papilloma virus (HPV)
what HPV types are carcinogenic?
- 16
- 18
- 33
what HPV subtypes are associated with genital warts and are non-carcinogenic?
- 6
- 11
how does HPV affect cervical cells?
infected endocervical cells undergo changes resulting in the development of koliocytes
what are the characteristics of koilocytes?
- enlarged nucleus
- irregular nuclear membrane contour
- nucleus stains darker than normal (hyperchromasia)
- perinuclear halo may be seen
what is the most common types of cervical cancer?
- squamous cell carcinoma (80%)
- adenocarcinoma
how does HPV increase the risk of developing cancer?
- HPV produces E6 and E7 proteins
- these proteins inhibit tumour suppressor genes (p53 and pRb)
- promotes the development of cancer
are are the risk factors for catching HPV?
- early sexual activity
- increased number of sexual partners
- sexual partners who have had more partners
- not using condoms
other than HPV, what are the risk factors for developing cervical cancer?
- smoking
- HIV
- COCP
- pregnancy
- family history
- exposure to diethylstilbestrol during foetal development
what symptoms can cervical cancer present with?
- abnormal vaginal bleeding
- pelvic pain
- dyspareunia
what can be seen on cervical examination which raises the suspicion of cancer?
- ulceration
- inflammation
- bleeding
- visible tumour
what is CIN I?
cervical intraepithelial neoplasia
- mild dysplasia
- 1/3 thickness of the epithelial layer
what is CIN II?
cervical intraepithelial neoplasia
- moderate dysplasia
- 2/3 thickness of the epithelial layer
- likely to become cancerous is not treated
what is CIN III?
cervical intraepithelial neoplasia / cervical carcinoma in situ
- severe dysplasia
- very likely to become cancerous
what ages is the cervical screening undertaken?
- 25-49 every 3 years
- 50-64 every 5 years
what are the exceptions to the cervical screening program?
- HIV screened annually
- previous CIN
- immunocompromised
- wait until 12 weeks post-partum
why is acetic acid used in colposcope?
- causes abnormal cells to appear white
- acetowhite
why is iodine solution used in colposcope?
schiller’s iodine test
- stain health cells a brown colour
- abnormal will not stain
what is large loop excision of the transformation zone (LLETZ)?
- performed under local
- diatheramy used to remove abnormal cells
what are possible complications following LLETZ?
- bleeding
- abnormal discharge
- infection
- preterm labour
what is a cone biopsy?
- treatment for CIN
- general anaesthetic
what are the main risks of a cone biopsy?
- pain
- bleeding
- infection
- scar formation with stenosis of the cervix
- increased risk of miscarriage and premature labour
what are stage IA cervical cancer tumours managed?
- hysterectomy +/- lymph node clearance
- maintain fertility = cone biopsy
how is stage IB-IIA cervical cancer managed?
- B1 tumours = radiotherapy + chemotherapy
- B2 tumours = radical hysterectomy + pelvic node dissection
