Cervical Carcinoma
Definition
Risk Factors
Aetiology
Clinical Features
Symptoms
Vaccination
Screening (Australia)
Pap smear
Investigation
Bedside:
Others:
Treatment
Source
A/Prof Amanda Dennis 2014
- Neoplastic transformation of cervical squamous cells
- N --> CIN --> Ca
- LSIL = CIN 1
- HSIL = CIN II, III and carcinoma in situ
Risk Factors
- Exposure to HPV
- Not using barrier contraceptives
- Smoking
- Immunosuppression
- FHx
Aetiology
- HPV (6, 11 - Benign; 16, 18 - Malignant)
- 6, 11 responsible for >90% of genital warts, but can still cause cancer that is more likely to regress
- 16, 18 responsible for 70% of cancer, less likely to regress
Clinical Features
Symptoms
- Abnormal vaginal bleeding, usually postcoital
- Malodorous vaginal discharge
- Dysuria
- PV exam: Mass
- Metastasis
- Lymph nodes
Vaccination
- 12-13y
- Male catch up 14-15y
Screening (Australia)
Pap smear
- Looks for CIN, not Ca in transformation zone
- Start: 18y or 2y after 1st intercourse, whichever is later
- 1 smear Q2Y
- End: 70y if last 2 smears over 5 years -ve
- LSIL: Monitor yearly (pap smear)
- HSIL: Colposcopy --> Biopsy --> Treatment listed below
Investigation
Bedside:
- Colposcopy
Others:
- Biopsy
Treatment
- Low grade Squamous Intraepithelial Lesion (LSIL) monitored, not treated in women who want to give birth
- Surgical
- LLETZ
- Radical diathermy
- Laser ablation
- Laser cone
- Cold knife cone
- Hysterectomy
Source
A/Prof Amanda Dennis 2014