Cervical cancer Flashcards
Cervical cancer peak incidence
Age 25-29
Cervical cancer Sx
- Coital bleeding
- Post-coital bleeding
- Intermenstrual bleeding
- Dyspareunia
Abnormal Uterine Bleeding
Smear result HR-HPV with low-grade cytology
Colposcopy within 6 wks
Smear HR-HPV with normal cytology
Repeat smear in 12 months
Cervical cancer Risk Factors
- HPV 16/18
- Smoking
- Long term (> 8yrs) COCP use
- Immunodef.
- STIs
What does cervical screening detect
pre-invasive disease (i.e Cervical Intraepithelial Neoplasia, CIN)
which HPV strains are high risk to cervical cancer
HPV 16/18
Cervical cancer staging system
FIGO staging
Smear result HR-HPV with High grade cytology
Refer colposcopy within 2 wks
Surgical options for early cervical cancer + fertility preservation
Radical Trachelectomy
Surgical options for early cervical cancer + NO fertility preservation
- Laparoscopic hysterectomy
- Pelvic Lymphadenectomy
Surgical options for advanced cervical cancer
Radical hysterectomy
(Wertheim’s)
what do radical hysterectomy involves
removal of the
uterus
vagina
cervix
parametrial tissues up to the pelvic sidewall
lymph nodes
Surgical options for late/recurrent cervical cancer
Anterior/posterior/total pelvic extenteration
Cervical cancer palliative Tx
Chemo - Cisplatin based
An alternative to surgery for early cervical cancer
Chemoradiation therapy
when to book smear post-partum, TOP, miscarriage
12 weeks after
where is mutation most liekyl to occur in the cervix
squamocolumnar junction (Transfarmation zone)
why is mutation more liekly to occur in the squamocolumnar junction
Cells are already ‘transforming’ form squamous to columnar
Smear 3-yearly screen age group
25-49
Smear 5-yearly screen age group
50-64
Age > 65 smear screening indication
- not had recent smear
- recent abnormal smear
CIN II / III (high-grade dysplasia) Tx
LLETZ biopsy during colposcopy
when is Cone biopsy indicated
Dysplasia abnormal area extends into the cervical canal
