Cervical Dysplasia

Question 1

Current screening guideline for cervical cancer

Answer 1

Screening starts at age 21

Question 2

Age 21-29 cervical cancer screening

Answer 2

Recommend pap test q3 years

Question 3

> 29 cervical cancer screening.

Answer 3

Pap test q3yr OR pap test + HPV q5yr.

Question 4

When can cervical cancer screening stop?

Answer 4

Age 65, if h/o consistent screening. Or If hysterectomy was performed for benign reasons.

Question 5

(+) LSIL (CIN-I) 21-24yo

Answer 5

Repeat pap in 1yr

Question 6

(+) LSIL (CIN-I) 25-29

Answer 6

Colposcopy

Question 7

(+) LSIL (CIN-I) > 30

Answer 7

HPV testing. If (-): repeat pap and HPV testing in 1 yr. If (+) proceed w/ colposcopy

Question 8

HSIL 21-24

Answer 8

Colposcopy

Question 9

HSIL > 24

Answer 9

LEEP

Question 10

21-24

Atypical Squamous cells of Undetermined Significance (ASCUS)

Answer 10

Repeat pap in 1 yr. If (+) at repeat pap proceed to colposcopy

Question 11

> 25

Atypical Squamous cells of Undetermined Significance (ASCUS)

Answer 11

HPV testing. If (+) proceed w/ colposcopy

Question 12

Atypical Squamous Cells: high risk (ASC-H)

Answer 12

Regardless of age all get colposcopy

Question 13

Atypical glandular cells (AGC)

Answer 13

endocervical sampling, Colposcopy, Endometrial Bx (>35 or high risk)

Question 14

Invasive cervical cancer Pt

Answer 14

irregular vaginal bleeding, post-coital bleeding, vaginal discharge, pelvic/back pain, urinary/bowel symptoms.

Question 15

Invasive cervical cancer diagnosis

Answer 15

If lesion is visible, then Bx lesion.

If not visible: pap test, colposcopy (if pap is abnormal)

Question 16

Treatment for invasive cervical cancer

Answer 16

< 3mm invasion = conization or hysterectomy
Confined to cervix - radical hysterectomy, LAD, +/- chemo.
Local spread: chemoradiation.
Metastatic - chemotherapy.