Gynae cancers

Question 1

Which gynae cancers are hereditary

Answer 1

1. Ovarian
2. Endometrial

Note: cervical cancer has no familial link

Question 2

Which gynae cancers are more common in younger people

Answer 2

• Cervical cancer

- Ovarian germ cell tumours

Question 3

Which gynae cancers are more common in older people

Answer 3

• Endometrial cancer

- Ovarian Epithelial tumours

Question 4

Most common type of cervical cancer

Answer 4

Squamous cell carcinoma

Question 5

Risk factors for CIN/ cervical cancer

Answer 5

• Smoking
• Immunodeficiency
• HPV 16, 18, 31, 33;
• Multiple partners
• > 8 years combined pill use

Question 6

Early signs of cervical cancer

Answer 6

• Abnormal vaginal bleeding (PC, IM, PM)

- Offensive vaginal discharge

Question 7

Late signs of cervical cancer

Answer 7

• uraemia (urea in blood)
• haematuria
• PR bleeding
• pelvic pain

Question 8

Investigations for cervical cancer

Answer 8

• BIOPSY: Diagnosis
• PV & PR: for staging
• CYSTOSCOPY: detects bladder involvement
• MRI: detects size, spread, LN involvement

Question 9

Common sits of mets for cervical cancer

Answer 9

• lung
• liver
• bone
• bowel

Question 10

Most common type of ovarian cancer overall

Answer 10

Epithelial carcinoma
(serous cystadenoma is most common type of epithelial cancer)

Question 11

Most common type of ovarian cancer in women under 30

Answer 11

Germ cell tumour

Question 12

Which gynae cancer has the poorest prognosis

Answer 12

Ovarian (as it presents late)

Question 13

Generally, what is the main risk factor for

• cervical cancer
• ovarian cancer
• endometrial cancer

Answer 13

Cervical: HPV infx

Ovarian: incessant ovulation

Endometrial: high oestrogen levels

Question 14

3 different types of primary ovarian cancers

Answer 14

1. Epithelial (most common)
2. Germ cell
3. Sex cord

Question 15

Most common type of ovarian epithelial tumour

Answer 15

Serous cystadenoma

Question 16

Most common type of ovarian germ cell tumour

Answer 16

Dermoid cyst (benign)

Teratoma is malignant version of dermoid cyst

Question 17

Which 3 cancers are associated with BRCA1 and BRCA 2

Answer 17

1. Breast
2. Ovarian
3. Pancreatic

Question 18

Between BRCA1 and BRCA2, which is more likely to cause ovarian cancer

Answer 18

BRCA1

Question 19

Which 3 cancers are associated with HNPCC (Lynch syndrome)

Answer 19

1. Colorectal
2. Endometrial
3. Ovarian

Question 20

In terms of menstrual and childbearing factors, what are risk factors for ovarian and endometrial cancer

Answer 20

1. Early menarche
2. Late menopause
3. Nulliparity

(but breastfeeding is protective)

Question 21

Are malignant ovarian tumours more likely to be

• hard/ soft
• large/ small

Answer 21

Malignant:

• Hard
• Small

Question 22

Which gynae cancers is Ca125 a marker for

Answer 22

1. Ovarian + fallopian tube

2. Endometrial

Question 23

What 2 blood tests can be done to differentiate ovarian germ cell tumour from epithelial tumour

Answer 23

1. Alpha fetoprotein
2. hCG

(indicate germ cell tumour)

Question 24

Most common gynae cancer

Answer 24

Endometrial

Question 25

Most common endometrial cancer

Answer 25

Adenocarcinoma

Question 26

1st line investigation for endometrial cancer

Answer 26

Transvaginal USS

• Assess thickness of endometrium
• Pipelle biopsy + hysteroscopy if endometrial is 5mm or more

Question 27

Which gynae cancer does PCOS increase the risk of

Answer 27

Endometrial Ca

not ovarian Ca

Question 28

Which gynae cancer may respond to progesterone

Answer 28

Endometrial Ca

Question 29

Why is nulliparity a risk for endometrial/ ovarian cancer

Answer 29

Women have NOT been exposed to high progesterone levels (which are protective)