cervical screening and cancer Flashcards
which HPV virus is associated with cervical cancer?
16 and 18
which HPV is associated with genital warts?
6 and 11
how can HPV virus be treated?
- there is no cure- most resolve within 2 years
what is the pathophysiology of HPV causing cervical cancer?
- the virus releases proteins e6 and e7 which inhibit the tumour suppressor genes p53 and prb
what are the risk factors for cervical cancer?
- those that increase your risk of catching HPV:
- early sexual activity
- increased number of partners
- sexual partners with more than one partner
other risk factors:
- smoking
- HIV
- COCP> 5 yrs
- increased number of full term pregnancies
- family history
how does cervical cancer present?
- abnormal bleeding- mostly post coital, but also intermenstural and post menopausal
- discharge
- pelvic pain
- deep dyspareunia
what is the cervical intraepithelial neop[lasia grading system?
CIN1- mild dysplasia- 1/3 of the epithelial thickness, will resolve without treatment
CIN2- moderate and affects 2/3 thickness-> likely to progress
CIN3- Severe dysplasia- cervical carcinoma in situ
–>
beyond CIN 1 can be treated with large loop excision of transformational zone or cone biopsy
what type of cancer is cervical cancer?
- squamous cell carcinoma= the majority
- adenocarcinoma
what tests are performed at colposcopy?
acetic acid-> makes abnormal cells appear white and suggests increased nuclear to cytoplasm ratio
scholars iodine test-> iodine stains healthy cells brown, unhealthy cells won’t stain
what are the stages of actual cervical cancer (beyond CIN)?
1- confined to cervix
2- invades uterus and upper 2/3 of vagina
3- pelvic wall and lower 2/3 vagina
4- bladder rectum and beyond pelvis
what is the treatment for stage 1b-2a cervical cancer?
- radical hysterectomy and lymph node removal
what is the management of 2b-4a cervical cancer?
chemotherapy and radiotherapy
what is the treatment beyond 4b cancer?
- radiotherapy, chemotherapy, palliative care
