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Business of science > Lecture 10 > Flashcards

Lecture 10 Flashcards

1
Q

hpv 16 and 18 account for how many % of cases

A

70%

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2
Q

true or false: once you get hpv, you will get cancer for sure

A

nah usually it is persistent infections that cause cancer

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3
Q

true or false: most hpv infections spontaneously regress

A

true

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4
Q

true or false: grade 3 hpv infection is cancer

A

nah it is still pre-cancer but still very close to cancer

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5
Q

what is a colposcopy

A

-done after a weird pap test
-insert a vaginal speculum and then you insert a beam of light to see the cervix

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6
Q

what does a high grade hov infection looks like

A

-it looks super red and looks swollen

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7
Q

what is mostly used to see the state of the basal membrane in cervix

A

histology to see the fucked up cells

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8
Q

CIN grade 1: regression, persistence, progression to CIN 3 and progression towards cancer

A

-regression: 57%
-Persistence: 32%
-progression to cin3: 11%
-Progression towards invasive cancer: 1%

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9
Q

CIN grade 2: regression, persistence, progression to CIN 3 and progression towards cancer

A

-regression: 43%
-Persistence: 35%
-progression to cin3: 22%
-Progression towards invasive cancer: 5%

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10
Q

CIN grade 3: regression, persistence, progression to CIN 3 and progression towards cancer

A

-regression: 32%
-Persistence: <56%
-progression to cin3: we dunno %
-Progression towards invasive cancer: >12%

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11
Q

treatment of cervical pre-cancer: less invasive

A

-loop electrocautery: excisitional procedure; basically you take off what is the weird cells
-cold knife conization: you make a weird cone and you take off what is fucked up: more invasive

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12
Q

treatment of cervical pre-cancer: more invasive

A

-radical hysterectomy
-intensity modulated radiotherapy; basically targetted

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13
Q

what is the 4th common female malignancy wolrdwide

A

cervical cancer

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14
Q

how many deaths and new cases of cervical cancer a year

A

-570 000 cases per year
-311 000 deaths anually

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15
Q

where do cervical cancer deaths happen

A

mostly in poor countried 90%

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16
Q

what is the goal for elimination as a public health problem: cervical cancer

A

4 per 100 000 women-years for
elimination as a public health problem;

17
Q

cervical cancer: 90-70-90 targets by 2030:

A
  • 90% of girls fully vaccinated with HPV vaccine by age 15 years.
  • 70% of women are screened with a high- performance test by 35 years of age and again by 45 years of age
  • 90% of women identified with cervical disease receive treatment (90% of women with precancer treated, and 90% of women with invasive cancer managed).
18
Q

Screening reduced cervical cancer incidence by

A

80%

19
Q

true or false: pap smear has low sensitivity

A

yeah, a lot of false negatives

20
Q

US spends more than $… on cervical cancer screening annually.

A

7 billion

21
Q

hpv: Three screening options

A
  • HPV with cytology (cotesting)
  • HPV testing with genotyping and reflex cytology (primary HPV testing)
  • Cytology alone
22
Q

Primary hrHPV Testing: advantages

A
  • Improved sensitivity for CIN3+ over cytology alone (↑detection by 50%)
  • Potential for self-collection
  • Improve access: you can do it at home
23
Q

Primary hrHPV Testing: disadvantages

A
  • Lack of specificity (↑colposcopy referral by ~50%)
  • Requires change in infrastructure
  • Requires healthcare provider and patient education
24
Q

What happens after a positive HPV test result?

A

cytology and genotype to see which type of hpv

25
Q

which hpv strain is the most dangerous

A

16

26
Q

The positivity of p16/ki-67 strongly indicates the presence of ……

A

high-grade dysplasia.

27
Q

ki 67 is a marker of what

A

cell proliferation

28
Q

P16 is a marker of….

A

loss of cell cycle regulation- a hallmark of neoplastic transformation.

29
Q

True or false: under normal physiologic conditions,
staining of p16 and Ki-67 should not show expression in the same cells.

A

true

30
Q

Summary of current challenges: hpv edition

A
  1. Accessibility
  2. Low specificity of HPV DNA testing
  3. Limited biomarker detection capabilities
31
Q

hpv: self sampling

A
  • Not yet Health Canada or FDA-approved
  • Multiple effectiveness studies and patient acceptability studies have shown
    that self-sampling is effective, is cost-effective and is acceptable to women,
    especially among under-screened populations
  • Sensitivity comparable to clinician-obtained samples with PCR-based HPV
    tests.
32
Q

what is mnbc

A

online platform to have the self sampling for hpv peeps

33
Q

Indigenous women have a …… higher incidence of cervical cancer (27.7/100000) and …. more likely to die from cervical
cancer

A

-3.5x
-4 x

34
Q
A

Business of science (21 decks)

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