Cervical CA Screening

Question 1

what system failures lead to cervical cancer?

Answer 1

1. women don’t come for screen
2. Providers don’t screen
3. colposcopy for abnormal screen isn’t done
4. pt doesn’t get proper therapy

Question 2

(Persistent/Transient) HPV puts a woman at risk for cancer?

Answer 2

Persistent

Question 3

the area where the columnar cells and the squamous cells of the cervix meet is called the ______ zone

what virus really likes this zone?

Answer 3

Transformation

HPV

Question 4

are liquid pap test better or worse than cervical smears

Answer 4

better!!

Question 5

liquid pap preps are (lower/higher cost)

you can test ___, ____, and ____
you can test during ____ or after ____

Answer 5

higher cost

HPV, gonorrhea, chlamydia

Menses, coitus

Question 6

Pap smears are less sensitive for ___ neoplasia

Answer 6

glandular

Question 7

GUIDELINES!!!

1. NO pap for who?
2. how often should 21-29 y.o. get pap?
3. 30+ yrs should get pap + HPV e. ___ yrs

Answer 7

1. 65 (with 3 normal paps in last 10 yrs)
2. e. 3 years (if normal)
3. 5

Question 8

if a pap comes back “unsatisfactory”, what is your next step?

Answer 8

repeat in 2-4 months

if + for HPV–> colposcopy

Question 9

If a pt’s pap comes back with CIN I, what are the chances is progresses to cancer?

Answer 9

12-16% chance

Question 10

___% of patients with HSIL have invasive cancer, however up to __% with HSIL will develop cancer if it is left untreated

Answer 10

2%

20%

Question 11

Carcinoma in Situ Must have some type of ____ treatment regardless of age

Answer 11

ablative

Question 12

what pap results need colposcopy?

Answer 12

LGSIL
HGSIL
ASCUS-H

Question 13

what f/u tx should you perform is a pap is Normal cytology with HPV +

Answer 13

repeat in 1yr

Question 14

what f/u tx should you perform is a pap is ASCUS HPV-

Answer 14

Repeat in 1yr

new recommendation is can repeat in 3 yrs

Question 15

what f/u tx should you perform is a pap is ASCUS HPV +

Answer 15

repeat in 1 yr

HPV typing or colposcopy

Question 16

How should the following CIN stages be treated?
I-____
II- ____
III- ___

Answer 16

I: just watch may not turn to cancer for 20 years or very high rate of regression

II: even here observation is preferred but treatment is acceptable

III: treatment is recommended

Question 17

for a woman who is 21-24 y.o. with Low risk for invasive cervical cancer, but HIGH risk for HPV exposure and HPV associated lesions…. what should be the approach?

Answer 17

OBSERVE

Question 18

what do the following mean? 
Unsatisfactory\_\_\_
ASC-US  \_\_\_
LSIL  \_\_\_
ASC-H  \_\_\_
HGSIL or HSIL  \_\_\_
AGUS \_\_\_
CIS  \_\_\_\_

Answer 18

Unsatisfactory-no endocervical component
ASC-US atypical squamous cells
LSIL -low grade squamous intraepithelial lesion
ASC-H ascus cannot exclude a high grade lesion
HGSIL or HSIL high grade squamous intraepithelial lesion
AGUS atypical glandular cells
CIS carcinoma in situ

Question 19

You can get HPV by having___, ___ or ___ with someone who has the virus. Anyone who is ____ can get HPV, even if you have had sex with only one person.

Answer 19

vaginal, anal, oral sex

sexually active

Question 20

HPV is most commonly spread during ___ or ___ sex

Answer 20

vaginal or anal sex

Question 21

___ is the most common STI

Answer 21

HPV

Question 22

T/F: HPV is so common that nearly all sexually active men and women get it at some point in their lives.

Answer 22

T

Question 23

T/F: HPV can be passed only when an infected person has symptoms.

Answer 23

F: HPV can be passed even when an infected person has no signs or symptoms.

Question 24

how long after infection can you develop symptoms?

Answer 24

years after you have sex with someone who is infected

makes it hard to know when you first became infected.