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CERVICAL CANCER-1.pptx
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- 2. EPIDEMIOLOGY & GLOBAL: Cervical cancer isthe fourth most common cancer among women globally, with an estimated 604 000 new cases and 342 000 deaths in 2020. About 90% of the new cases and deaths worldwide in 2020 occurred in low- and middle-income countries PAKISTAN: Every year 5008 women are diagnosed with cervical cancer and 3197 die from the disease. Cervical cancer ranks as the 3rd most frequent cancer among women in Pakistan and the 2nd most frequent cancer among women between 15 and 44 years of age..
- 3. EITIOLOGY: PERSISTENT, HIGH RISK HUMANPAPILLOMA VIRUS (HPV)INFECTION IS THE CAUSE. TRANSMITTED VIA SEXUAL INTERCOURSE
- 4. RISK FACTORS: Early intercourse and earlychildbirth Multiple sexual partners High parity Low socioeconomic status STDs- HIV Smoking OCPs
- 5. PATHOPHYSIO LOGY: HPV persists intransformation zone TZ Triggers oncogenic process Integrates into basal epithelial cells Immortalization and rapid turnover CIN 1, CIN 2 & CIN 3 Malignant disease of cervix
- 7. TYPES Squamous cell carcinoma Morecommon Ectocervix Adenocarcinoma Less common Arises from endocervix
- 8. SIGN AND SYMPTOMS: Asymptomatic Post-coital bleeding(PCB)* Intermenstrual bleeding (IMB) Post- menopausal bleeding (PMB) Pelvic pain Incontinence Renal failure
- 9. EXAMINTION: PER VAGINAL EXAMINATION: Hardon palpation Bleeding on touch PER SPECULUM EXAMINATION: Exophytic Ulcerative COLPOSCOPY: Acetic acid- whitish area Iodine-stain brown
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- 11. Cervical cancer asvisualized on per speculum examination
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- 15. TREATMENT: CERVICAL INTRA-EPITHELIAL NEOPLASIA: •Largeloop excision of transformation zone (LLETZ) •Cone biopsy CARCINOMA CERVIX: Pre-clinical lesions Clinically invasive lesions
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- 17. CLINICALLY INVASIVE STAGE1B-4 STAGE 1B FAMILY COMPLETE: Radical hysterectomy with bilateral pelvic node dissection FAMILY NOT COMPLETE: Radical trachelectomy with pelvic node dissection STAGE 2-4 Radiotherapy plus chemotherapy
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- 21. SCREENING: *Regular Pap Smears/ Liquid based cytology (LBC) or VIA screening should start after 3 to 5 yrs of marriage at 3 to 5 yearly intervals. VIA training should be mandatory *By the age of 35 years at least one Pap Smear/LBC/ HPV Testing or VIA screening should be done *Stop doing Pap smears at 65 years age if previous smears have been normal, and no other risk factors are present. HTTP://SOGP.ORG/GUIDELINES
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