Exam 2 - Cervical cancer Flashcards Preview

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Flashcards in Exam 2 - Cervical cancer Deck (18)
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1
Q

Which populations are most at risk for cervical cancer?

A

African Americans, hispanics, poor individuals

2
Q

What is the key preventative measure to prevent cervical cancer?

A

Early detection because early lesions can be removed

  • Take average of 10-12 years (latent period) for HPV to progress to full blown cervical cancer
3
Q

What are the two main types of cervical cancer, and which type is most common?

A
  • Squamous cell carcinoma (SCC) - most common
  • Adenocarcinoma
4
Q

SCC vs adenocarcinoma - which cell type is found in the ectocervix?

A

Squamous cell carcinoma (SCC)

5
Q

SCC vs adenocarcinoma - which cell type is found in the endocervix?

A

Adenocarcinoma

6
Q

Which strain of HPV is associated with SCC?

A

HPV 16

7
Q

Which strain of HPV is associated with adenocarcinoma?

A

HPV 18

8
Q

What tissue type is associted with adenocarcinomas?

A

Columnar epithelial glandular cells

9
Q

Cervical cancer risk factors

A
  • Persistent high risk HPV infection that does not clear
  • Sexually active at an early age (younger than 18 years)
  • Multiple or high risk sexual partners
  • Smoking
  • Weakened immune system
  • COC use for 5+ years
  • High parity (3+ full term pregnancies)
  • Genetic predisposition
  • DES (diethylstilbestrol) exposure
10
Q

Cervical cancer clinical manifestations

A
  • Mostly asymptomatic in early disease process
  • Vaginal discharge
  • Abnormal vaginal bleeding (between menses, postcoital, postmenopausal)
  • Late symptoms - bladder obstruction, back pain, pelvic pain, leg swelling
11
Q

Physical exam findings

A

Should perform pelvic exam, abdominal, inguinal lymph nodes, rectal exam

Cervix appears normal in early disease

  • Friable, lesions/growths, hard, immobile, inguinal lymph node swelling
12
Q

Should women be screened annually for cervical cancer?

A

No

13
Q

When should routine screening for cervical cancer begin?

A

Starting at 21 years through 65 years

  • Pap recommended every 3-5 years based on age (conventional slide or liquid based cytology)
  • >30 years, include high-risk HPV cotest
14
Q

Screening recommendations: 21-29 years

A
  • Cytology (pap smears) every 3 years
  • Most HPV resolves without intervention
15
Q

Screening recommendations: ages 30-64 years

A

Cytology (pap smear) + HPV cotest every 5 years

  • Increased detection of CIN 3, adenocarcinoma
  • Minimizes number of colposcopies and harm
16
Q

Screening recommendations: ages 65+ years

A

Stop screening with…

  • History of 3 consecutive negative pap tests OR two consecutive negative HPV tests
  • No CIN 2, or higher, results within last 20 years
  • Hysterectomy
17
Q

Under was circumstances should the provider NOT stop screening for cervical cancer?

A

History of CIN 2/3 or adenocarcinoma

  • Continue screening for at least 20 years (even after age 65)
18
Q

How would the provider manage sexual parters of patients with cervical cancer?

A
  • Partners do not need to be tested for HPV (will share HPV so partner most likely has it too)
  • Encourage condom use

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