Cervical cancer Flashcards
what is the peak age of cervical cancer?
44-45
what are the RF of cervical cancer?
HPV related (16 & 18), Multiple partners, Early age at first intercourse, Older age of partner, Cigarette smoking
what is the main vaccination for primary prevenetion of hpv?
HPV 16 and 18 vaccine
40f para 3 attends gp with heavy irregular periods, smoker, hasn’t had a cervical screen since 2005, what should the gp do?
refer as an irgent cancer referral as a suspected cancer patient
what are the symptoms of cervical cancer?
abnormal vaginal bleeding, postcoital bleeding, intermenstrual bleeding, discharge, sometimes pain if it is advanced
how is cervical cancer diagnosed?
clinically, screening, biopsy
what is the purpose of screening?
to detect precancerous disease NOT cancer
what does histopathology look to pickup?
CIN (1, 2 or3 ) - cervical interepithelial neoplasia - abnormal proliferation of squamous epithelial cells.
what abnormalities are seen?
cytological atypia, in CIN 1 there is atypia effecting the lower part of the epithelium, 2 and 3 progress onto atypia effecting further up the epithelium
what type of cancer is picked up in histopathology?
squamous cell carcinoma (80%), adenocarcioma (20%)
what is FIGO staging?
Cervical cancer staging is the assessment of cervical cancer to decide how far the disease has progressed. Cancer staging generally runs from stage 0, which is pre-cancerous or non-invasive, to stage IV, in which the cancer has spread throughout a significant part of the body
what are the criteria of FIGO staging?
1a1, 1a2, 1b. 2 is vagina, 3 lower vagina, 4 distant mets
what other modalities are used to stage cervical cancer?
PET-CT, MRI
what is the Tx of cervical cancer?
hysterectomy, combination of chemotherapy and radiotherapy. External beam radiotherapy, chemo (5 cycles of cisplatin), caesium insertion.
what is lletz?
Large loop excision of the transformation zone (LLETZ)LLETZis the most common treatment for removing abnormal cells from the cervix
