cervical cancer screening Flashcards
HPV infxn typically clears in
6-12 mo
CIN 2,3 typically takes __ yrs to turn into invasive CA
10-13 yrs?
major contributing factor to most cervical CA deaths..
being rarely or never screened
4 at risk groups for lack of cervical screens
- minorities
- low SES
- foreign born (less than 10 yr in US)
- no usual health care
cervical cancer in the world is the ___ most common and __ most deadly CA
4th most common and deadly worldwide
when columnar cells from uterus merge with squamous cells on cervix
ectropion
aka transformation zone
what could ectropian be result of?
taking OCP
this is a variant of normal
never given birth vaginally
nulliparous
has had 1+ kids vaginally
multiparous
RF for cervical CA
Under 20 first sex experience multiple partners young at first preg high parity low SES Smoker
gravidity
number times women has been pregant
parity
number of pregnancies carried full term
a pap smear is less sensitive for___
glandular neoplasia OR
adenocarcinoma of the cervix
HPV strain __ and __ responsible for 70+% of cervical cancer
16 and 18
hpv 6 and 11
genital warts
HPV persistenet over ___ yrs = cancer
5 .. higher risk for ca development
4 screen rules for HPV
- no one under 21
- 21-29 pap q3yrs
- 30+ pap tst plus HPV q5yrs
- no screen after age 65, with at least 3 consecutive - pap tests or with a pap in last 10 yrs
unsatisfactory pap
no endocervical component
atypical squamous cells
ASC-US
low grade squamous intraepithelial lesions
LGSIL
ascus cannot exclude a high grade lesion
ASC-H
high grade squamous intraepithelial lesion
HGSIL or HSIL
atypical glandular cell
AG
carcinoma in situ
CIS
cotesting
testing for HPV only or for the high riks 16 and 18
cervical intraepithelial neoplasia
CIN
if unsatisfactory pap…
repeat cytology in 2-4mo
if contesting is HPV + test agin in 2-4mo
if cotest shows 16,18 = colposcopy
if pap 2x unsat, then colposcopy
colposcopy
microscopic thing to look at vagina and cervix
__ is the most common and most benign form of cervical intraepithial neoplasia spontaneously
CIN I
usually resolves in 2 yrs
how tx CIN I lesion
LEEP, cryosurgery, cone biopsy or laser ablation
HSIL indicates what?
a moderate to severe neoplasia of the cervical cells
high grade squamous lesions can lead to
invasive cancer of the cervix
CIS
carcinoma in situ
cis TX
must have some typye of ablative tx regardless of age
