Cervical Cancer Flashcards
What is cervical cancer?
Cervical cancer is a malignant tumour of the cervix, most commonly arising from the transformation zone.
What are the two main histological types of cervical cancer?
The two main types are squamous cell carcinoma (most common) and adenocarcinoma.
What is cervical intraepithelial neoplasia (CIN)?
CIN is a premalignant condition of the cervix characterised by abnormal changes in cervical epithelium.
How is CIN classified?
CIN is graded based on the extent of abnormal cell changes: CIN 1 (mild), CIN 2 (moderate), and CIN 3 (severe or carcinoma in situ).
What is the primary cause of cervical cancer?
The primary cause is persistent infection with high-risk types of human papillomavirus (HPV), particularly types 16 and 18.
What are the risk factors for cervical cancer?
Risk factors include early sexual activity, multiple sexual partners, smoking, immunosuppression, and lack of regular cervical screening.
How is cervical cancer screened for in the UK?
Screening involves cytology (Pap smear) and HPV testing as part of the National Cervical Screening Programme.
What are the symptoms of cervical cancer?
Symptoms include postcoital bleeding, intermenstrual bleeding, vaginal discharge, pelvic pain, and, in advanced cases, urinary or bowel symptoms.
What is the role of HPV in cervical cancer?
HPV integrates into the host genome, causing the overexpression of oncogenes E6 and E7, which disrupt tumour suppressor pathways.
What investigations are used to diagnose cervical cancer?
Investigations include cervical cytology, colposcopy, biopsy, and HPV testing.
What is colposcopy?
Colposcopy is a procedure to visually examine the cervix using magnification and apply acetic acid to identify abnormal areas.
How is CIN managed?
Management depends on the grade: CIN 1 often resolves spontaneously, while CIN 2/3 may require excisional procedures like LLETZ or cold knife cone biopsy.
What is LLETZ?
LLETZ (Large Loop Excision of the Transformation Zone) is a procedure to remove abnormal cervical tissue using a heated wire loop.
How is early-stage cervical cancer treated?
Treatment involves surgery (e.g., hysterectomy or trachelectomy) or radiotherapy, depending on the stage and patient factors.
How is advanced cervical cancer treated?
Treatment includes a combination of radiotherapy and chemotherapy, typically with cisplatin.
What is the role of HPV vaccination in cervical cancer prevention?
HPV vaccination prevents infection with high-risk HPV types and is offered to adolescents before sexual activity begins.
At what age is HPV vaccination offered in the UK?
It is routinely offered to boys and girls aged 12-13 as part of the national immunisation programme.
What are the complications of untreated cervical cancer?
Complications include local invasion (e.g., bladder, rectum), lymph node metastases, and systemic spread to distant organs.
What are the stages of cervical cancer?
Staging is based on the FIGO system: Stage I (confined to the cervix), Stage II (local extension), Stage III (pelvic wall/vagina), Stage IV (distant spread).
What is the prognosis for cervical cancer?
Prognosis depends on the stage at diagnosis, with early-stage disease having a much higher survival rate compared to advanced disease.
What are the side effects of radiotherapy for cervical cancer?
Side effects include fatigue, diarrhoea, bladder irritation, and long-term complications like fistulas or pelvic fibrosis.
How does smoking increase the risk of cervical cancer?
Smoking reduces immune function in the cervix, increasing susceptibility to HPV infection and progression to malignancy.
What is the transformation zone of the cervix?
The transformation zone is the area where the columnar epithelium of the endocervix meets the squamous epithelium of the ectocervix, a common site for cervical dysplasia.
How is recurrent cervical cancer managed?
Management may include palliative chemotherapy, radiotherapy, or pelvic exenteration in selected cases.
What is the importance of regular cervical screening?
Screening detects precancerous changes (CIN) and early cervical cancer, significantly reducing mortality rates.
What psychological support might women with cervical cancer need?
Support includes counselling, support groups, and addressing concerns about fertility, body image, and sexual health.
How does immunosuppression increase the risk of cervical cancer?
Immunosuppression (e.g., HIV, immunosuppressive therapy) impairs the ability to clear HPV infections, increasing the risk of CIN and cervical cancer.
