Cervical cancer Flashcards
What is the peak incidence of cervical cancer?
Between the ages of 25 and 29
What are the 2 types of cervical cancer and which is more common?
Squamous cell carcinoma (80%) Adenocarcinoma (20%) –> worse prognosis
What are 5 risk factors for development of cervical cancer
Immunosuppression i.e HIV, kidney transplant Multiple sexual partners COCP use High-grade HPV infection Lower socioeconomic background Smoking
How does HPV cause cervical cancer?
HPV 16 & 18 produces the oncogenes E6 and E7 genes respectively E6 inhibits the p53 tumour suppressor gene E7 inhibits RB suppressor gene
What virus is associated with the development of cervical cancer?
HPV
Give 2 histological observations of cervical dyskaryosis
Hyperchromasia Increased mitotic activity Multinucleation Irregular nuclear chromatin
Who is screened in cervical cancer screening and how often?
25 - 49 years of age: every 3 years 50 - 64 years of age: every 5 years
Cervical screening cannot be offered to women over the age of 64
Contraindications for cervical cancer screening (pap smear)?
o Is menstruating. o Is less than 12 weeks postnatal. o Is less 12 weeks after a termination of pregnancy, or miscarriage. o Has a vaginal discharge or pelvic infection — treat the infection and take the sample on another occasion.
What are 3 subtypes of high-risk HPV?
HPV 16, 18 and 33
What is the name given to epithelial cells infected with HPV?
Koilocytes (halo cells)
Give 4 characteristics of koilocytes
Enlarged nucleus
Irregular nuclear contour
Hyperchromasia - nucleus stains darker than normal
Perinuclear halo may be seen
What is the staging classification used for cervical cancer and what is the description for each stage?
What are the different steps to take for the different cervical cancer screening results (dyskaryosis): borderline/mild, moderate/severe/suspected cancer and undetermined
Treatment for moderate/severe CIN?
LLETZ
Cone biopsy
Treatment for borderline/mild CIN
Watch and observe –> return to screening programme
