Cervical Cancer
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Introduction
HPV is found in almost 100% of cases of cervical cancer. Genotypes 16 and 18 are the most substantial.
HPV infection must become persistent, requiring immunologic permission. However, HPV itself is not sufficient to cause the disease. Cellular dysregulation leading to dysplasia and then invasive cancer requires co-carcinogens. These include:
- smoking
The Case of...
a simple case introducing clincial presentation and calling for a differential diagnosis to get students thinking.
Causes and Risk Factors
Pathophysiology
Signs and Symptoms
- history
- physical exam
History
Physical Exam
Investigations
- lab investigations
- diagnostic imaging
Lab Investigations
Pap testing is one of the most effective means of picking up cancer or its precursors.
The WHO has produced screen-and-treat guidelines (WHO, 2013). It includes:
- HPV testing
- visualization with acetic acid
- cytology (Pap testing)
HPV testing is very sensitive, but not specific. It can pick up dysplasia that would likely have resolved.
Diagnostic Imaging
IVP intravenous pyelogram is useful by takes approx. 1 hour
CXR for lung mets
Eua +/- cystoscopy or sigmoidoscopy
Differential Diagnosis
Treatments
LEEP and LLETZ
Radiation is the number one treatment modality.
Consequences and Course
Cure of Stage 2B
Resources and References
WHO guidelines for screening and treatment of precancerous lesions for cervical cancer prevention. 2013.
Topic Development
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