Cervical cancer

Question 1

How does cervical cancer present?

Answer 1

Vaginal bleeding, most commonly post coital.

There may be an offensive vaginal discharge. Pain is not an early feature. Speculum examination usually reveals an ulcer or a mass on the cervix.

Question 2

Post coital bleeding is due to cervical cancer until proven otherwise (T/F)?

Answer 2

True

Question 3

What are the investigations for cervical cancer?

Answer 3

1. Biopsy - required to confirm the diagnosis. It will give the type and grade. NB: a smear is a screening test for asymptomatic women and is not appropriate in symptomatic women.
2. Staging investigations: examination under anaesthesia, abdominal/pelvic CT.

Question 4

What staging system is used to stage cervical cancer?

Answer 4

The FIGO system.

Question 5

What is the pathology of cervical cancer?

Answer 5

• 80% of cervical cancers are invasive squamous cell carcinoma, the precursor lesion is CIN.
• 20% are adenocarcinomas, arising from the endocervical epithelium in the cervix. High risk HPV is also important in causing cervical adenocarcinoma. The precursor lesion is CGIN (cervical glandular intraepithelial neoplasia).

Question 6

What age group is cervical cancer most common in?

Answer 6

18-35yrs