Cervical cancer: Difference between revisions
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With the advent of screening, it is rare to see cervical cancer clinically. The main symptom is vaginal bleeding but is often asymptomatic in the early stages. | With the advent of screening, it is rare to see cervical cancer clinically. The main symptom is vaginal bleeding but is often asymptomatic in the early stages. | ||
===Investigations=== | ===Investigations=== | ||
====Smears==== | |||
'''Screening''' in the UK happens for sexually active women '''over 25''' and '''3 yearly''' in the form of a '''Pap''' (Papanicolaou - the bloke who invented it) '''smear'''. This involves, via a speculum exam, getting cervical cells with a brush. Essentially, there are different results that can come back. "Unsatisfactory" is fairly self-explanatory; "inflammatory/inconclusive" means there's probably an infection which needs to treated and then the smear repeated; "normal"; and then the different levels '''dysplasia''' (aka "dyskariosis" - this term is generally reserved for cervical cells). | |||
Dysplasia is an abnormality in the maturation of cells. CIN is essentially dysplasia in cervical cells and is a precancerous state. There are '''three stages of CIN''' - '''CIN I, II''' and '''III'''. | |||
*CIN I - ''mild dysplasia''. This is repeated after 6 months and if it is abnormal, it is sent for [[#Colposcopy|colposcopy]]. | |||
*CIN II - ''moderate dysplasia''. Send for [[#Colposcopy|colposcopy]]. | |||
*CIN III - ''severe dysplasia''. Send for urgent [[#Colposcopy|colposcopy]]. | |||
===Management=== | ===Management=== | ||
===Prognosis=== | ===Prognosis=== | ||
Revision as of 13:10, 16 October 2008
Definition
CIN (cervical intraepithelial neoplasia) is the premalignant condition which can lead to cervical carcinoma.
Epidemiology
Incidence of cervical cancer is about 8.8/100 000 and mortality is 2.8/100 000. However, worldwide it is the fifth most common cancer.
Pathophysiology
The cause is the sexually transmitted human papilloma virus (HPV). There are fifteen different types which increase the risk of cervical cancer, the increase in risk varying depending on which type is present.
Risk Factors
HPV is sexually transmitted and so cervical cancer almost solely occurs in the sexually active.
Clinical Features
With the advent of screening, it is rare to see cervical cancer clinically. The main symptom is vaginal bleeding but is often asymptomatic in the early stages.
Investigations
Smears
Screening in the UK happens for sexually active women over 25 and 3 yearly in the form of a Pap (Papanicolaou - the bloke who invented it) smear. This involves, via a speculum exam, getting cervical cells with a brush. Essentially, there are different results that can come back. "Unsatisfactory" is fairly self-explanatory; "inflammatory/inconclusive" means there's probably an infection which needs to treated and then the smear repeated; "normal"; and then the different levels dysplasia (aka "dyskariosis" - this term is generally reserved for cervical cells).
Dysplasia is an abnormality in the maturation of cells. CIN is essentially dysplasia in cervical cells and is a precancerous state. There are three stages of CIN - CIN I, II and III.
- CIN I - mild dysplasia. This is repeated after 6 months and if it is abnormal, it is sent for colposcopy.
- CIN II - moderate dysplasia. Send for colposcopy.
- CIN III - severe dysplasia. Send for urgent colposcopy.