Cervical Cancer Flashcards
Aetiology
Unprotected sexual intercourse
HPV types 16 and 18
When does cervical screening begin?
24
What changes are common in the sexually active adult women?
Viral changes
Dysplasia
CIN 1 and 2
Staging
FIGO staging system
Stage Ia
Micro-invasive disease
Stage Ib
Clinical disease confined to the cervix
Stage IIa
Disease involves the upper third of the vagina, but no the parametrium
Stage IIb
Disease involves the parametrium but does not extend to the pelvic wall
Stage III
Disease involves the lower two thirds of the vagina and/or the pelvic wall
Stage IV
Involvement of the bladder, rectum or distant organs
Presentation
CIN and micro-invasive carcinoma usually have no symptoms
Earliest symptoms of invasive carcinoma
-Vaginal discharge
-Post-coital bleeding
-intermenstrual or post-menopausal bleeding
-backache from hydronephrosis and nodal spread
Investigations for Asymptomatic patients
CIN 1, 2, 3 or micro-invasive carcinoma do not require further investigation prior to treatment
Investigation for symptomatic patients
Examination under anaesthetic for staging, cystoscopy, sigmoidoscopy
Management of CIN 3 disease localised to the ectocervix
Colposcopy
Loop diathermy
Cryoprobe
Laser
Management of CIN 3 disease extending into the endocervical canal or micro-invasion
Cone biopsy
