Cervical + vulval cancers Flashcards
Cervical cancer risk factors
HPV (human papilloma virus types 16,18,31,33,35)
sexual behaviour - multiple partners, STDs, early age of SI
smoking
immunosuppression - HIV, transplant patients
What effect does HPV have on the cell cycle?
pRb = tumour suppressor protein
pRb prevents the cell from replicating damaged DNA
HPV E7 preferentially binds to pRb
maintain damaged cells in a hyper-proliferative state
effect on E6 to immortalise cells with unrepaired DNA damage
How is HPV infection prevented?
health education
barrier contraception
vaccination against high risk HPV
Who is offered cervical screening and how often?
25-64 year olds
3 yearly 25-49
5 yearly 50-64
screening to detect pre-cancer
How are smear test specimens tested?
liquid based cytology
Presentation of cervical cancer
through screening: asymptomatic
post-coital bleeding
inter-menstrual bleeding
pelvic pain
discharge
Types of cervical cancer
squamous cell carcinoma
(cervical intraepithelial neoplasia (CIN))
adenocarcinoma or adenosquamous carcinoma (cervical glandular intraepithelial neoplasia (CGIN))
What is the least common gynaecological malignancy?
vulval cancer
Causes of vulval cancer
HPV
chronic skin conditions - lichen sclerosis, Paget’s
Risk factors for vulval cancer
smoking
immunosuppression
Most common types of vulval cancer
most common = squamous carcinoma
others:
- melanoma
- sarcoma
- adenocarcinoma
How does vulval cancer spread?
by lymphatics
inguinal + femoral chain –> pelvic nodes
