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8 Cards in this Set
- Front
- Back
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HPV infection
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75% lifetime risk
Risk Factors: multiple partners, young age of debut, older first partner, no condoms, partner w/ multiple partners, CIGARETTES tends to occur at transformation zones (cervix, anus, tonsils) 16/18 - vaginal, vulvar, penile, anal cancer, oral cancer (16) 18 - some oral carcinogenicity 6,11 - condyloma acuminata |
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HPV progression
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small percentage will develop microscopic abnormalities
25-40% of these pts will develop cervical abnormalities (importance of persistence) most infections cleared within 18 mo Risk of progression dependent on degree of dysplasia (CIN staging) |
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HPV Screening
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Start annual screens at 21 y/o
Start screening every 2 years at 30 Start screening every 3 years after 3 consecutive negative pap smears Stop screening at 65-70 y/o |
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HPV teesting
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adjunct to cytology in screening women > 30 y/o
managing women w/ ASC-US results post-colposcopy follow up CIN2/3 tx follow up |
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pap smear sensitivity/specificity
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40-50%/90%
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squamous cell abnormalities
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Low Grade Squamous Intraepithelial Lesion - mild dysplasia (CIN 1)
High Grade Squamous Intraepithelial Lesion - moderate or severe dysplasia (CIN2/3) |
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Glandular Cell abnormalities
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Atypical glandular cells - endocervical, endometrial, not otherwise specified, favors neoplastic
Adenocarcinoma in situ Adenocarcinoma |
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Management
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ASC-US - HPV DNA test, repeat cytology in 6-12 mo, colposcopy
HSIL - colposcopy or immediate LEEP |
