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Cervical cancer


  • 110 deaths a year
  • screening allows treatment of CIN
  • caused by HPV infection
  • surgery and or chemoradiation
  • LBC and HPV pilot studies
  • stage 1b+ managed in cancer centres

Aetiology

  • HPV
  • smoking

Symptoms

  • post-coital bleeding
  • irregular bleeding
  • vaginal discharge
  • pelvic pain

Signs

  • exophytic mass
  • contact bleeding
  • colposcopic changes
  • DVT

Investigations

  • cervical smear / Cervical Screening
  • FBC / U&E / LFTs
  • CXR
  • MRI
  • EUA, cystoscopy, sigmoidoscopy

Staging

  • stage 1 confined to cervix
  • stage 2 spread to vagina or parametrium
  • stage 3 spread to pelvic wall
  • stage 4 distant metastasis

Treatment

  • Wertheims (radical ) hysterectomy
  • chemoradiation  - cisplatinum

Prognosis (5 year survival)

  • Stage 1 - 85-100%
  • Stage II - 55-75%
  • Stage III - 35%
  • Stage IV - <15%