cervical cancer Flashcards
around 50% of cervical CA occur in women…
under age of 45 years
which age group has the highest incidence rates of cervical CA?
25-29 year olds
what can cervical CA be divided into?
- squamous cell cancer (80%)
- adenocarcinoma (20%)
what are the features of cervical CA?
- may be detected during routine cervical CA screening
- abnormal vaginal bleeding: PCB / IMB / PostMB
- vaginal d/c
what is the most important factor in the development of cervical CA?
Human PapillomaVirus (HPV) serotypes 16, 18 and 33
what are the other risk factors in developing cervical CA?
- smoking
- HIV
- early 1st intercourse, many sexual partners
- high parity
- lower socioeconomic status
- COCP
what is the mechanism of HPV causing cervical CA?
HPV 16 and 18 produces oncogenes E6 and E7 respectively
→ E6 inhibits p53 tumour suppressor gene
→ E7 inhibits RB suppressor gene
what is the mx of cervical CA determined by?
FIGO staging and wishes of the pt to maintain fertility
what are the FIGO stages?
IA, IB, II, III and IV
*prognosis also depends on FIGO staging
what is meant by FIGO stage IA?
confined to cervix, only visible by microscopy and <7mm wide
what is meant by FIGO stage IB?
confined to cervix, clinically visible / >7mm wide
what is meant by FIGO stage II?
extension of tumour beyond cervix but not to pelvic wall
what is meant by FIGO stage III?
extension of tumour beyond cervix and to pelvic wall
what is meant by FIGO stage IV?
extension of tumour beyond pelvis / involvement of bladder/rectum
how do you manage stage IA tumours?
gold standard: hysterectomy +/- lymph node clearance