CERVICAL CANCER

 Age

Incidence: - PGH and Rizal Province: 40-60 y.o. 40- same observation nationwide and worldwide

RISK FACTORS
sexual partners  Early sexual activity  Multiparity  History of sexually transmitted infection  History of such infection in the sexual partner  Smoking history 40 pack- years pack Multiple

RELATIVE RISK
         

HIV Moderate dysplasia on Pap Smear within past 5 years Intercourse w/in 1 year of menarche No prior screening HPV Six or more lifetime sexual partners Low socioeconomic class Race smoking OCP use Barrier contraception

CLINICAL PRESENTATION
 Early

symptoms 1. vaginal bleeding most impt Sx a. induced by sexual intercourse or internal exam b. intermenstrual 2. vaginal discharge

CLINICAL PRESENTATION
 Late

symptoms 1. bone pain 2. urinary and bowel disturbances 3. leg edema

DIAGNOSIS
 Cervical

punch biopsy for those with gross evident tumor  Colposcopy and colpo-guided biopsies ff. colpoinvestigation of an abnormal Pap Smear  Pelvic examination including rectovaginal examination

PREVENTION
 Primary

prevention 1. monogamous sexual relationship between husband and wife 2. delay in onset of sexual intercourse 3. use of barrier contraceptives like condoms and diaphragms 4. prompt and adequate treatment of STI 5. vaccination

PREVENTION
 Secondary

prevention recommended screening Pap Smear approximately 3 years after onset of sexual activity

STAGES OF CERVICAL CA
 

 

Stage I carcinoma is confined to the cervix Stage 2 carcinoma extends beyond the cervix, involves the vagina but not as far as the lower 3rd Stage 3 no extension onto the pelvic sidewalls but involvement of the lower 3rd of the vagina Stage 4 carcinoma has extended beyond the true pelvis or has clinically involved the mucosa of the bladder and/or rectum