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Cervical cancer and cervical screening Flashcards

1
Q

What other cancers can high-risk HPV cause?

A 
Cervical
Penis
Vulva/vagina
Anus
Mouth
Oropharynx
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2
Q

What is the peak age for cervical cancer?

A

45-55

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3
Q

Which HPVs are high risk for cervical cancer?

A

16 & 18

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4
Q

What are the risk factors for cervical cancer?

A

Multiple partners
Early age at first intercourse
Older age of partner
Smoking

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5
Q

What are cervical cancer symptoms?

A 
Abnormal vaginal bleeding
Post coital bleeding
Intermenstrual bleeding/PMB
Discharge
Pain
Often asymptomatic
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6
Q

How is cervical cancer diagnosed?

A

Screen detected

Biopsy

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7
Q

What does screening aim to detect?

A

Pre-cancerous disease NOT cancer

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8
Q

What are the two types of cervical cancer?

A

Squamous cell carcinoma

Adenocarcinoma

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9
Q

What type of cervical cancer are the majority?

A

Squamous carcinoma

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10
Q

What is the staging for cervical cancer?

A

1A - 4B

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11
Q

What is stage 1A1 cervical cancer?

A

Invasive cancer identified only microscopically

<3mm depth and <7mm diameter

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12
Q

What is stage 1A2 cervical cancer?

A

<5mm depth

<7mm diameter

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13
Q

What is stage 1B cervical cancer?

A

Confined to cervix

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14
Q

What is stage 2 cervical cancer?

A

Upper 2/3 vagina

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15
Q

What is stage 3 cervical cancer?

A

Lower vagina, pelvis

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16
Q

What is stage 4 cervical cancer?

A

Bladder, rectum

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17
Q

What is the lymphatic metastasis of cervical cancer?

A

Pelvic nodes

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18
Q

What is the systemic metastasis of cervical cancer?

A

Liver, lungs, bone

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19
Q

What investigations are used for cervical cancer staging?

A

PET-CT

MRI

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20
Q

What is the treatment for stage 1A cervical cancer?

A

Hysterectomy

Excision of cervical TZ

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21
Q

What is the treatment for stage 1B-2A cervical cancer?

A

Radical/total hyseterectomy
OR
Chemoradiotherapy

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22
Q

What is the treatment for stage 2B-4 cervical cancer?

A

Chemoradiotherapy

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23
Q

What does radical hysterectomy involve?

A

Removal of: uterus, cervix, upper vagina, parametria, pelvic nodes
Ovaries conserved
Exploration of pelvic and para-aortic space

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24
Q

What is the radiotherapy treatment for cervical cancer?

A

External beam x 20 fractions

25
Q

What is the chemotherapy for cervical cancer?

A

5 cycles cisplatin

26
Q

What are the options for cervical cancer treatment?

A 
Hysterectomy
Radiotherapy
Chemotherapy
Chemoradiotherapy
Caesium insertion
27
Q

What is the most important cause of cervical cancer?

28
Q

What less common cancers can HPV cause,?

A 
Cervix
Penis
Vulva/vaginal
Anus
Mouth
Oropharynx
29
Q

Who has been vaccinated against HPV?

A

Girls born after 1 September 1990

30
Q

What type of cancers are cervical cancers mainly?

A

Squamous cell carcinoma

31
Q

What is the SCCRS?

A

Scottish Cervical Call Recall System (SCCRS)

32
Q

If there are minor changes on cervical screening what is the next step?

A

Colposcopy

33
Q

What age group is cervical screening aimed at?

34
Q

How often do you have a cervical screening?

A

Every 5yrs

35
Q

What type of test is cervical screening?

A

Liquid based cytology (LBC)

36
Q

Where are the cells taken from in the cervix?

A

Transformation zone

37
Q

What does abnormal cells on cervical screening mean?

A

Cervical intraepithelial neoplasia (CIN)

38
Q

What type of epithelium is typically in the endocervix?

A

Columnar epithelium

39
Q

What type of epithelium is typically in the ectocervix?

A

Squamous epithelium

40
Q

What type of epithelium is typically in the transformation zone?

A

Squamo-columnar as is junction between two

41
Q

What method stains cervical samples?

A

Papanicolaou method (PAP)

42
Q

What is it called when the cytology of the cervix is abnormal?

A

Dyskaryosis

43
Q

What does the grading of dyskaryosis mean?

A

Degree of underlying CIN

  • low grade
  • high grade
44
Q

What cells reflect HPV infection?

A

Koilocytes

45
Q

Which test is more sensitive HPV test or cytology?

46
Q

What is used in colposcopy to identify limits of lesion?

A

Acetic acid

47
Q

What is done to make diagnosis of cervical cancer/CIN?

A

Punch biopsy

48
Q

What cells does HPV infect in the transformation zone?

A

Basal layer cells

49
Q

What does koilocytosis look like?

A

Cells with wrinkled nuclear and perinuclear halo

50
Q

What are low risk types of HPV?

A

6, 11, 42, 44

51
Q

What are high risk types of HPV?

A

16, 18, 31, 45

52
Q

What are low grade types of HPV?

A

Genital warts and low grade CIN

53
Q

What are high grade types of HPV?

A

High grade CIN

Cancer

54
Q

How does HPV cause high grade CIN?

A

Deregulation of host cell cycle

55
Q

What are the 3 grades of CIN?

A

CIN 1: low grade dysplasia
CIN 2: moderate dysplasia
CIN 3: severe dysplasia - unlikely to regress

56
Q

What is cervical intraepithelial neoplasia (CIN)?

A

Disorganised proliferation of abnormal cells in squamous epithelium

57
Q

What is the treatment for CIN?

A

LLETZ
Thermal coagulation
Laser ablation

58
Q

What are the risks of CIN?

A

Increased risks of cervical cancer compared with normal population

Reproductive (20 decks)

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