gynaecological cancers Flashcards
a) when is peak incidence of ovarian cancer?
b) prognosis?
a) 60 years old
b) poor, due to vague presentation
risk factors for ovarian cancer?
- FHx
- early menarche
- late menopause
- nulliparity
- (last 3 all increase number of ovulations)
presentation of ovarian cancer?
- abdominal distension, bloating
- abdominal and pelvic pain
- urinary urgency
- early satiety
- diarrhoea
investigations in ovarian cancer?
- CA125
- if this >35IU/ml, then USS of abdo/pelvis
- diagnostic laparotomy
why is CA125 not used for screening of ovarian cancer?
it gets falsely raised by:
- endometriosis
- menstruation
- benign ovarian cysts
age of presentation for endometrial cancer?
- 75% are post-menopausal
- 25% before then
risk factors for endometrial cancer?
- obesity
- nulliparity
- early menarche
- late menopause
- unopposed oestrogen (add a progesterone to HRT)
- diabetes
- tamoxifen
- PCOS
- HNPCC
features of endometrial cancer?
- post-men bleeding
- intermenstrual bleeding
investigations of endometrial cancer?
- if >55 with post-men bleed, refer to suspected cancer pathway
- TVUSS is first line
- hysteroscopy with endometrial biopsy
management of endometrial cancer?
- total abdominal hysterectomy with bilateral salpingo-oophorectomy
- if frail, progestogen therapy
protective factors for endometrial cancer?
- COCP
- smoking
peak age for cervical cancer incidence?
25-29 years old
when is cervical cancer often picked up?
on routine screening
features of cervical cancer?
- vaginal discharge
- abnormal bleeding:
- postcoital
- intermenstrual
- postmen
a) which virus is biggest risk factor for cervical cancer?
b) which serotypes?
a) HPV
b) 16, 18, 33
risk factors for cervical cancer?
- HPV
- smoking
- HIV
- early first intercourse
- many sexual partners
- high parity
- lower socioeconomic status
- COCP
how often are 25-49 year olds screened for cervical cancer?
3-yearly
how often are 50-64 year olds screened for cervical cancer?
5-yearly
pros of liquid-based cytology over pap smear?
- fewer inadequate samples
- more sensitive
- more specific
when is the cervical smear most accurate?
mid-cycle
how is a negative hrHPV result managed?
return to normal recall
how is a positive hrHPV result managed?
- sample examined cytologically
- if normal, repeat at 12 months
- if abnormal, then colposcopy
how is an inadequate sample for cervical smear managed?
- repeat within 3 months
- if this is inadequate too, colposcopy
how is cervical cancer classified?
FIGO staging
strains of HPV that cause genital warts?
- 6
- 11
when is HPV vaccinated against?
- boys and girls aged 12-13
- MSM <45
