Cervical conditions

Question 1

Cervical cancer screening

Answer 1

Offered to women age 25-49 3 yearly and those 50-64 5 yearly.
Sample tested for high risk HPV types 16, 18 and 33. If positive then invite for colposcopy and cytological examination. Results can show borderline changes, low or high grade dyskaryosis, invasive SCC or glandular neoplasia.

Question 2

Interpreting results

Answer 2

If hrHPV + but cytology normal - recheck in 12 months. If now HPV - then return to normal recall.
If still positive but normal cytology, check in another 12 months.
If still HPV + at 24 months then invite for colposcopy.

If sample inadequate- repeat within 3 months, if still inadequate invite for colposcopy.

Question 3

Cervical cancer- staging

Answer 3

50% is in the under 45s. Either SCC or adenocarcinoma.
Staging:
IA- confined to cervix, microscopic, <7mm
IB- confined to cervix but >7mm
II- extension beyond cervix
III- extension to pelvic wall
IV- beyond pelvis to bowel or bladder

Question 4

Cervical cancer-treatment

Answer 4

For stage IA hysterectomy and node clearance. Knife cone biopsy to retain fertility (increases risk of preterm birth)
RT and chemotherapy for higher stages.