Gynaecological oncology Flashcards
(42 cards)
Which types of HPV are responsible for cervical cancer?
Types 16 and 18
What types of HPV cause genital warts?
Types 6 and 11
What types of HPV does the current Gardasil vaccine protect against?
Types 6, 11, 16 and 18
Describe how the cervical screening programme is triaged?
- Intial screening for HPV
- If HPV+ve, cytology
- If abnormal cells: send for colposcopy
- If cells normal but HPV+ve, then repeat smear in 12/12
What ages are included in the cervical screening programme and how often should they have a smear?
25-49: every 3 years
50-64: every 5 years
If cytology returns an ‘inadequate’ result, how should the screening proceed?
Repeat in 3 months
What is the appropriate course of action:
Initially: HPV+ve, cytology normal
12/12 later: HPV-ve
Return to normal screening i.e. retest in 3yrs
What is the appropriate course of action:
Initially: HPV+ve, cytology normal
12/12 later: HPV+ve, cytology normal
Repeat in 12/12
What is the appropriate course of action:
Initially: HPV+ve, cytology normal
12/12 later: HPV+ve, cytology normal
12/12 later: HPV+ve, vytology normal
After 24 months with remaining HPV positive, refer to colposcopy
What is the appropriate course of action:
Initially: HPV+ve, cytology normal
12/12 later: HPV+ve, cytology normal
12/12 later: HPV-ve
Return to routine screening (e.g. next smear in 3 years)
How is CIN1 managed?
Nil required. Will likely spontaneously resolve.
Repeat screening in 12/12
How is CIN2 managed?
LLETZ
How is CIN3 managed?
LLETZ
How is CGIN managed?
LLETZ
How is cervical cancer staged?
FIGO staging
How might cervical cancer present?
Most are picked up on screening. Symptoms may include: PCB IMB Persistent and offensive discharge PMB
How is FIGO 1a1 cervical cancer managed?
Loop excision
How is FIGO stage 1a2-1b2 managed?
Hysterectomy + BSO + pelvic node clearance
What is the treatment for a woman with cervical cancer who wishes to preserve her fertility?
Cone biopsy OR radical trachelectomy
What type of endometrial hyperplasia is a precursor to endometrial cancer?
Complex atypical endometrial hyperplasia
How is endometrial hyperplasia treated?
Hysterectomy as it is likely that a cancer is already present.
How is endometrial hyperplasia managed if a hysterectomy is refused?
Progesterone given to thin the endometrium and endometrial biopsies to follow up.
Who gets endometrial cancer (generally)?
Post-menopausal women aged 50y/o+
What risk factor is most likely to blame for rising incidences of endometrial cancer?
Obesity
