Cervical Dysplasia Flashcards
(4 cards)
What is Cervical dysplasia?
Abnormal growth of the cells that line the surface of the cervix, usually caused by the human papillomavirus (HPV). Mild cervical dysplasia: the majority (65-70%) will regress by themselves
Have different categories of this condition
Human papillomavirus (HPV)
* High percentage of the adult population is thought to be exposed (75% in the U.S.).
* Most women with HPV never get dysplasia.
* 100 HPV sub-types, Some more aggressive, such as HPV 16 and HPV 18 can develop into cancer within 18 months (exceptions rather than the norm).
What are the risk factors?
Risk factors for cervical dysplasia and cervical cancer
* Chlamydia infection: cofactor to HPV in the development of cervical cancer
* Diethylstilbestrol exposure: daughters of women who took (DES) - medication taken to prevent miscarriages used in the 70s
* Oral contraceptives.
* CIN 2 and 3: higher 16-alpha hydroxyestrone and fewer 2- hydroxyestrogen metabolites
* Pregnancy: Three or more full-term pregnancies seem to increase the risk, as well as giving birth before age of 22.
* Other: Multiple partners, non-condom use, Obesity, Smoking, Chronic stress, a diet low in fruits and vegetables.
What are the symptoms?
Symptoms typically Asymptomatic
* Occasionally; menorrhagia, abnormal bleeding, spotting, watery vaginal discharge.
* Advanced cervical cancer: pelvic pain, difficulty with urination and oedema, along with signs of advanced malignancy
What are the common diagnostic tests and treatment?
Investigations:
* Papanicolaou (Pap) test
* CIN I and CIN II: 40-50% of abnormal smear tests spontaneously revert to normal. Can be within two years. Can work with patient with this if mild and have time, using herbs but at times it may be more aggressive.
* CIN III or HSIL: in severe dysplasia or carcinoma in situ, spontaneous regression is unlikely
There has been a Prevention Vaccination programme
* 90% protection against HPV infection, cervical dysplasia, and cancer.
* Cervarix vaccine against HPV 16, 18
* Gardasil (Silgard) against HPV 16, 18, 6, 11
* Gardasil 9 against nine HPV types 6, 11, 16, 18, 31, 33, 45, 52, 58, supposed to protect
against 90% of cervical cancer
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