Revision

Question 1

What is the main cause of cervical cancer?

Answer 1

Human papilloavirus:

• 16, 18, 31 and 33 high
• 6, 11 being low risk

Other risk factors:

• Smoking
• Early first intercourse
• Oral contraceptive pill
• HIV

Question 2

Which viral proteins of HPV increase the risk of cervical cancer

Answer 2

E6 - Decrease p53, which usually regulates G1 to S phase of cell cycle

E7 - Decrease retinoblastoma, which usually inhibits E2F stopping progression into S1

Question 3

Where does HPV invade?

Answer 3

The squamocolumnar junction between the endocervix (columnar) and exocervix (squamous) = Transformation zone

Question 4

Which type of cancers occur in the cervix?

Answer 4

1) Squamous cell carcinoma (85-90%)

2) Adenocarcinoma (10-15%)

Question 5

What is cervical intraepithelial neoplasia characterised by?

Answer 5

1) Koilocytic changes
2) Disorder cellular maturation
3) Nuclear atypic
4) Increased mitotic activity

Question 6

How do we screen for cervical cancer?

Answer 6

Pap smear and cytology

Question 7

If on Pap smear

Answer 7

Mild