cervical cancer

Question 1

features of cervical cancer

Answer 1

detected during screening
abnormal vaginal bleeding: post-coital, intermenstrual or post menopausal
vaginal discharge

Question 2

risk factors for cervical cancer

Answer 2

HPV types 16, 18, 33
smoking
HIV
early first intercourse, many sexual partners
high parity
lower socioeconomic status
COCP

Question 3

who is screened for cervical cancer and how often

Answer 3

scotland: 25-64 every 5 years
pregnancy delay until 3 months post-partum

Question 4

management if patient has negative hrHPV

Answer 4

return to normal recall
unless test of cure pathway or untreated CIN pathway

Question 5

management of hrHPV positive result

Answer 5

samples examined cytologically if abnormal sent for colposcopy

Question 6

management if hrHPV positive and cytology is normal

Answer 6

repeat test at 12 months
if neg: return to normal recall
if positive: repeat at another 12 months

Question 7

treatment of CIN

Answer 7

large loop excision of transformation zone
cryotherpy

Question 8

staging used for cervical cancer

Answer 8

FIGO

Question 9

management of IA cervical tumour
(confined to cervix, less than 7mm wide)

Answer 9

hysterectomy
- clearance for A2 tumours
cone biopsy with negative margins for patients wanting to maintain fertility
close follow up

Question 10

management of stage 1B cervical tumours
(confined to cervix, clinically visible, larger than 7mm)

Answer 10

B1: radiotherapy with concurrent chemotherapy
cisplatin (chemo)
B2: radical hysterectomy with pelvic lymph node dissection

Question 11

management of stage II and III cervical tumours

Answer 11

radiation with concurrent chemo