Neoplasia Flashcards
HPV Subtypes Responsible for Cervical Cancer?
15 high risk oncogenic subtypes of HPV, most common being 16, 18, 31 and 33
HPV 16 and 18 account for 71% of cervical cancer cases
Risk Factors for Cervical Cancer?
Primary/Secondary Prevention of Cervical Cancer?
Primary prevention- Gardasil 9
* single dose for those aged 9 to 24 years of age.
* two dose schedule at an interval of 0 and 6-12 months for those 25-45
Secondary prevention- Screening
* offered to all sexually active women aged 25 to 60-65 years
* HPV Testing => Cytology => Colposcopy of TZ after aceitic acid added => Punch Biopsy
Management of CIN
Complications?
Histologic Subtypes of Cervical Cancer
Squamous cell carcinoma (85-90%)
Adenocarcinoma (10-15%)
Cervical Cancer Staging/Treatment
Stage 1 – local excision, or lymphadenectomy plus hysterectomy
Stage 2 or 3 – chemoradiotherapy
Stage 4 – palliation
Complications of Hysterectomy
haemorrhage
infection
DVT and PE
ureteric fistula
bladder dysfunction
lymphoedema
Risk Factors for Endometrial Cancer?
Age
Obestity
Estrogen only HRT/Tamoxifen
Nulliparity
PCOS
Early Menarche/Late Menopause
Protective Factors for Endometrial Cancer?
High parity – high levels of progesterone during pregnancy
COCP – progesterone content decreases risk by 50% with 4 years of use, and 72% with 12 years of use
Smoking (do not recommend smoking to the patient)
Diet, such as consumption of coffee and increased animal fat intake
Post menopausal Bleeding Differential?
Atrophic vaginitis (50% of cases)
Endometrial hyperplasia (30%)
Benign polyps (10%)
Adenocarcinoma (10%)
Surgery for Endometrial Cancer?
Total hysterectomy with bilateral salpingo-oophrectomy
Risk Factors for Ovariuan Cancer
Risk increases with the number of ovulations
* nulliparity
* early menarche
* late menopause
BRCA1 – lifetime risk of ovarian malignancy is 40-60%
BRCA2 – lifetime risk of ovarian malignancy is 10-30%
Protective Factors for Ovarian Cancer?
Suppression of ovulation is protective – the COCP, pregnancy
