Gynaecological tumours

Question 1

When are smear tests offered in England?

Answer 1

25-49 years: 3-yearly screening

50-64 years: 5-yearly screening

Question 2

Which types of cervical cancer are most common?

Answer 2

Squamous cell carcinoma (80-85%)

Adenocarcinoma (15-20%)

Question 3

What are the early symptoms of cervical cancer?

Answer 3

Abnormal bleeding:

• postcoital
• inter-menstrual
• persistent

Question 4

What is the transformation zone of the cervix?

Answer 4

The point at which the inner, soft columnar epithelium meets the outer, hard squamous epithelium.

It is where malignancies arise.

Question 5

What does CIN stand for?

Answer 5

Cervical intraepithelial neoplasia

Question 6

What is HPV test of cure?

Answer 6

all women who have been treated for CIN (usually with a Loop excision) will have a test for HPV 6 months following their treatment.

If this is negative, they need no further follow up and can return to routine recall.

If this test is positive they will need further follow up with colposcopy.

Question 7

What % of CIN stage will progress to invasive cervical cancer?

Answer 7

1. CIN 1 - 1%
2. CIN 2 - 5%
3. CIN 3 - <12%

Question 8

What does this show?

Answer 8

CIN stage 1

Question 9

If boarderline / mild dyskaryosis is found with smear test, what should happen next?

Answer 9

Test for high risk HPV (16, 18, 33)

Negative - back to routine smear

Positive - refer for colposcopy

Question 10

How is CIN managed?

Answer 10

LLETZ

Large loop excision of the transformation zone (ie get rid of the cancer-prone bit)

NB / avoid sex, tampons, and swimming for 4 weeks after

+ Cone biopsy / hysterectomy for CIN 3