Public Health Issues in O&G Flashcards
What is the most common cancer in women <35?
Cervical cancer
Why is screening done for cervical cancer?
Aims to reduce the incidence on invasive cancer of the cervix
What are the advantages of screening?
Reduces disease incidence and mortality
Allows for less radical treatment due to early detection
Cost effective and has overall population benefit
What does cervical screening identify?
Cell changes which may develop to be pre-cancerous = beneficial as women may otherwise have no symptoms
What women should receive diagnostic testing for cervical cancer instead of screening?
Those with symptoms = unusual vaginal discharge or bleeding, bleeding after sex or between periods, dyspareunia
What women are offered cervical screening?
Those aged between 25-64
How often is cervical screening performed?
Age 25-49 = every 3 years
Age 50-64 = every 5 years
What examination is performed during cervical screening?
Speculum examination = visual examination of cervix, brush samples of cells, primary HPV testing
Where are brush samples taken from during cervical screening?
Transformation zone of cervix
How is the coverage of a screening programme calculated?
Screened population/eligible population x100
How is the usage of a screening programme calculated?
Screened population/invited population x100
What are the challenges of optimising the coverage a screening programme
Minority ethnic groups, immigrants, travellers, prisoners, students
What are the challenges of optimising the uptake of a screening programme?
Change of address, communication, health literacy, deprivation, vulnerable groups
What are some ways to increase coverage and uptake of a screening programme?
Promotion of screening programme, GP incentives, material in variety of languages, local and national incentives
How many types of HPV are there?
More than 80 types have been identified = about 40 are known to infect the genital tract
What can HPV infection cause?
Low risk types cause genital warts
High risk types cause invasive cervical cancer
What types of HPV are covered by the vaccine?
Quadrivalent vaccine (gardasil) = cover types 16 and 18, plus types 6 and 11 (so protects against genital warts)
What is responsible for most cases pf cervical cancer?
HPV types 16 and 18 = cause about 70% of cervical cancers
Who gets the HPV vaccine?
Girls in S1-S3, male/male sex, boys in S1
Why is cervical screening still important even though there is a vaccine for HPV?
Vaccine doesn’t protect against 30% of cervical cancers
What are some public health issues related to O & G?
Teenage pregnancy, female genital mutilation, obesity, exercise, smoking, substance use, infertility, breastfeeding, increasing maternal age
What is female genital mutilation defined as?
All procedures that involve partial or total removal of external female genitalia, or other injury to female genitalia for non-medical reasons
What is female genital mutilation recognised as internationally?
A violation of human rights
Who tends to suffer from female genital mutilation most commonly?
Nearly always carried out on minors
What are some O & G cancers that are related to obesity?
4% of ovarian cancers and 38% of womb cancers could be prevented if everyone was a healthy weight
What are the impacts of obesity on O & G?
Increased subfecundity and infertility
Decreased IVF effectiveness
Increased risk of miscarriage and pregnancy complications
How does smoking cessation improve O & G outcomes?
Decreased risk of complications in pregnancy and birth
Reduces risk of stillbirth, premature birth and SIDS
Reduced risk of developing cervical cancer
Improved prognosis following diagnosis of cervical cancer
What are the medical impacts of teenage pregnancy on the mother?
UTI, STD complications, premature death, preterm birth, pre-eclampsia/eclampsia, anaemia, depression
What are the social impacts of teenage pregnancy on the mother?
Social isolation, lack of qualifications, not completing education, receiving welfare benefits, not living independently
What are the impacts of teenage pregnancy on the child?
Reduced birth weight, higher risk of death, growth restriction, not breastfed, infection, SIDS, more likely to become teenage mother
What are some of the benefits to the child of breastfeeding?
Reduced risk of developing diabetes, fewer and less severe URTIs, lower cholesterol as adult, less risk of Crohn’s and UC in later life, fewer UTIs, decreases risk of childhood cancers, higher visual acuity
What protective benefit does folic acid offer?
Helps prevent neural tube defects, including spina bifida
How much folic acid should be prescribed during pregnancy?
400mg daily pre-conception until 12 weeks gestation
What are some foods that contain folate?
Green leafy veg, fortified bread and cereals
