Cervical cancer & screening Flashcards

1
Q

what is CIN?

A

disordered growth & development of epithelial cells lining the transformation zone

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2
Q

aetiology of CIN?

A

HPV infection (16 & 18) most common cause

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3
Q

who is vaccination for and for what subtypes?

A
  • >12 years old
  • for subtypes 6,11, 16 & 18
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4
Q

what else is HPV infection linked to?

A

anal, vaginal, throat, mouth, penis and vulval cancer

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5
Q

how does HPV work?

A

infects cells and inhibits tumour suppressor genes p53 and pRb

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6
Q

how is HPV transmitted?

A

sexually

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7
Q

where is smear test taken from and why

A
  • transition zone of cervix & squamous epithelium of ectocervix
  • because this is where HPV infects
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8
Q

outline the screening programme

A
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9
Q

what happens during colposcopy?

A
  • magnification w light to see cervix
  • use acetic acid and iodine to stain
  • cone biopsy may be taken for degree of CIN
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10
Q

every how often do women participate in screening?

A
  • 25-49–> every 3 years
  • 50-65–> every 5 years
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11
Q

what other indications are there for referral to colposcopy? (apart from dyskaryosis on smear)

A
  • 3 consecutive inadequate smear samples
  • 3 borderline smears (squamous)
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12
Q

describe CIN I-3

A
  • CIN1
    • Mild dysplasia, affects lower 1/3 of cervical epithelium
  • CIN2
    • moderate dysplasia, affects lower 2/3 of cervical epithelium
  • CIN3
    • severe dysplasia, affects full thickness of cervical epithelium ie carcinoma in situ
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13
Q

treatment options for CIN 1-3?

A
  • CIN1
    • likely to return to normal w/o treatment - conservative Mx
  • CIN 2/3
    • 2- likely to progress to cancer w/o treatment
    • 3-will progress to cancer if untreated
    • both treated w LLETZ
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14
Q

cervical cancer epidemiology?

A
  • young women in peak reproductive years
  • elderly women (80s)
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15
Q

histological types?

A

80% squamous cell carcinoma, 20% adenocarcinoma

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16
Q

aetiology of cervical cancer?

A
  • HPV (16, 18, 31 + 33)
  • COCP
  • smoking
  • early sexual activity w many sexual partners
17
Q

presentation of cervical cancer?

A
  • asymptomatic
  • abnormal vaginal bleeding (IM/PC/PM)
  • vaginal discharge
18
Q

Ix?

A
  • colposcopy + biopsy
  • MRI/CT
19
Q

Staging of cervical cancer?

A

stage 1: confined to cervix

stage 2: invades uterus / upper 2/3 of vagina

stage 3: invades pelvic wall/ lower third of vagina

stage 4: invades bladder/ rectum / beyond pelvis

20
Q

Mx of cervical cancer?

A

stage 1–> surgery (radical hysterectomy + removal of lymph nodes)

stage 2+ –> chemoradiotherapy