Around 900 women/year die in the UK of cervical cancer.
Presentation includes:
- post-coital bleeding
- intermenstrual bleeding
- post menopausal bleeding
- finding on routine screening
In the UK all females aged 25 to 49 are invited for cervical smear tests to screen for cervical cancer every 3 years, then every 5 years from 50 to 65 years of age.
Around 5% of smears need to be repeated due to inadequate sample.
Risk of cervical cancer is increased in:
- smokers
- those with multiple sexual partners
- younger age of first intercourse
- women on immunosuppressant drugs
It is strongly associated with human papillomavirus, with HPV 16 implicated in 50% of cases and HPV 18 in 15% of cases.
Management:
- CIN (cervical intraepithelial neoplasia) 1 - can be managed by increased surveillance
- CIN 2 or 3 - ablation or excision
- invasive cancer - surgery, radiotherapy
Prevention:
Vaccination - girls aged 12/13 are given 3 doses of either
- cervarix – active against HPV 16 and 18 or
- gardasil – active against HPV 6,11, 16 and 18
References:
NHS Cervical screening programme. Cervical Screening: the facts. Available at http://www.cancerscreening.nhs.uk/cervical/publications/in-04.html
The British Society for Colposcopy and Cervical Pathology. European guidelines for the management of abnormal cytology. Available at http://bsccp.org.uk/index.asp?PageID=20
The British Society for Colposcopy and Cervical Pathology. European guidelines for the management of abnormal cytology. Available at http://bsccp.org.uk/index.asp?PageID=20
