4.1 Cervical Pathology and Cervical Screening Flashcards Preview

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Flashcards in 4.1 Cervical Pathology and Cervical Screening Deck (17)
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1
Q

What is a colposcopy?

A

procedure to closely examine the cervix, vagina and vulva for signs of disease - may be done is results of pap test were abnormal

2
Q

What strains of HPV are most commonly associated with cervical cancer?

A

16 and 18

3
Q

Why is HPV16 so potent?

A

occurs earlier and after shorter incubation period

HPV 16 CIN2 will not regress at all

4
Q

What are the classifications of HPV

A

Low grade squamous intraepithelial lesion (LSIL) = CIN1

High grade squamous intraepithelial lesion (HSIL) = CIN2 and 3

5
Q

What are the 10 principles of screening

A
  1. Condition should be important
  2. There should be an accepted treatment
  3. facilities for diagnosis and treatment should be available
  4. there should be a recognisable latent or early symptomatic stage
  5. There should be a suitable examination
  6. The test should be acceptable to the population
  7. Natural history of the condition ,including development from latent to declared disease should be adequately understood
  8. There should be an agreed policy on who to treat
  9. The cost of case finding should be economically balanced in relation to expenditure on medical care as a whole
  10. Case finding should be a continuing process not a one off project
6
Q

What are the four key components of cervical screening?

A
  1. Population coverage
  2. Screening interval
  3. Test sensitivity
  4. Age of commencement
7
Q

What is the screening age of cervical cancer in Australia?

A

20-69

8
Q

What is the recommended screening interval for cervical cancer in Australia?

A

2 years

9
Q

Define sensitivity

A

True positives/ (true positives + false negatives)

10
Q

Define specificity

A

True negatives / (true negatives + false positives)

11
Q

What is the impact on testing with a high sensitivity?

A

The higher the sensitivity the more chance there is of identifying the precursors
- The more sensitive the test the lower the proportion of false negatives

12
Q

Define negative predictive value

A

True negatives/ (true negatives + False positives)

13
Q

Define positive predictive value

A

True positives/ (true positives + False positives)

14
Q

What is the impact on NPV with a higher sensitivity?

A

It will be higher

15
Q

What is the alternative testing to Pap smear?

A

HR-HPV testing

16
Q

What is the sensitivity and specificity of HR-HPV testing compared with pap smear?

A

More sensitive less specific

17
Q

What happens if there is a negative/positive HR-HPV test?

A

Negative - sent away for 5 years as there is a high NPV

Positive - further testing (cytology/genotyping)