Cervical Cancer OXCOG podcast Flashcards
UK Stats for cervical cancer
Cases per year in UK
Case per 100
3200 in UK
3rd most common gynae cancer in developed (Endometrial, Ovarian)
lifetime risk of developing cervical 7 in 1000 women UK
In developing countries 2nd most common cancer, 3rd most common cancer death (most common gnar cancer worldwide)
HPV is detected in what % cervical cancers?
99.7%
What are the most common types of cervical cancer?
Squamous Cell carcinoma 70%
Adenocarcinoma 25%
RF cervical cancer
HPV related
- Early onset sexual activity
- Multiple sexual partners
- High risk sexual partner
- Hx STIs
- immunosupression
Non HPV related
- Low socioeconomic status
- COCP > 5years, background after 10 years
- Cigarette smoking - squamous cell not adenocarcinoma
- Genetics
How many HPV are oncogenic
15 of the 40 HPV
HPV 16&18 in 70% of cervical cancers
How many sexual active patient have HPV at some point
75-85%, most people clear the virus
Squamous cell carcinoma - HPV subtypes
16 60%
18 13%
58/33 5%
Adenocarcioma cell carcinoma - HPV
16 36%
18 37%
45 5%
Presenting Sx cervical cancers
Asymptomatic
IMB/PCB/PMB
Dyspareuniria
Abnormal vaginal discharge
Abnormal speculum
Haematuia
Urinay incontince
Loin pain (hydronephrosis)
Weight loss
Change bladder/bowel
Peak age incidence of cervical carcinoma
25-29yrs
rare <25yrs
Cervical cancer %
localised/regional/mets at diagnosis
44% localised
34% regional
15% distant mets
How to Dx cervical cancer
Colposcopy and biopsy (punch Bx, multiple or LLETZ)
Where does cervical cancer spread locally
Vagina
Parametrium
Uterosacral ligaments
Bladder/rectum/para aorta lymph nodes
Where does cervical cancer spread distantly
Bone, liver, lungs
FIGO Stage 1a
1a1
1a2
1a Microscopic <5mm
1a1 Stromal <3mm
1a2 Stromal 3-5mm