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    Lecture 1 Management of Cervical Cancer

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    Razlina A Rahman
    Cervical cancer is the 4th most common cancer in women worldwide and the 2nd most common cancer in Malaysian women. The rate of cervical cancer increases after age 30 and peaks between 65-69 years old. Most cases occur in low-resource countries. Early detection through regular Pap smear screening is important but many women are still diagnosed at late stages when symptoms appear. Common symptoms include postmenopausal bleeding, vaginal discharge, post-coital bleeding, and abdominal pain. Timely referral to a gynecologist after an abnormal Pap smear or symptoms is crucial for prompt diagnosis and management.

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    Lecture 1 Management of Cervical Cancer

    Uploaded by

    Razlina A Rahman
    26 views17 pages
    Cervical cancer is the 4th most common cancer in women worldwide and the 2nd most common cancer in Malaysian women. The rate of cervical cancer increases after age 30 and peaks between 65-69 years old. Most cases occur in low-resource countries. Early detection through regular Pap smear screening is important but many women are still diagnosed at late stages when symptoms appear. Common symptoms include postmenopausal bleeding, vaginal discharge, post-coital bleeding, and abdominal pain. Timely referral to a gynecologist after an abnormal Pap smear or symptoms is crucial for prompt diagnosis and management.

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    outline of management of cervical cancer

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    01. Lecture 1 Management of Cervical Cancer

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    Cervical cancer is the 4th most common cancer in women worldwide and the 2nd most common cancer in Malaysian women. The rate of cervical cancer increases after age 30 and peaks between 65-69 years old. Most cases occur in low-resource countries. Early detection through regular Pap smear screening is important but many women are still diagnosed at late stages when symptoms appear. Common symptoms include postmenopausal bleeding, vaginal discharge, post-coital bleeding, and abdominal pain. Timely referral to a gynecologist after an abnormal Pap smear or symptoms is crucial for prompt diagnosis and management.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    26 views17 pages

    Lecture 1 Management of Cervical Cancer

    Uploaded by

    Razlina A Rahman
    Cervical cancer is the 4th most common cancer in women worldwide and the 2nd most common cancer in Malaysian women. The rate of cervical cancer increases after age 30 and peaks between 65-69 years old. Most cases occur in low-resource countries. Early detection through regular Pap smear screening is important but many women are still diagnosed at late stages when symptoms appear. Common symptoms include postmenopausal bleeding, vaginal discharge, post-coital bleeding, and abdominal pain. Timely referral to a gynecologist after an abnormal Pap smear or symptoms is crucial for prompt diagnosis and management.

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    Download as pptx, pdf, or txt
    of 17

    MANAGEMENT OF

    CERVICAL CANCER:
    INTRODUCTION, EPIDEMIOLOGY
    AND CLINICAL FEATURES

    Dr. Habshoh Hat


    Dr. Fuziah Paimin
    Family Medicine Specialist
    Training of Core Trainer Clinical Practice Guideline
    Management of Cervical Cancer (Second Edition)
    INTRODUCTION
    Important health issue among women in
    Malaysia.
    Available screening programs for early
    detection of pre-invasive diseases.
    However, many women were still diagnosed
    at invasive stage of cervical cancer
    Tremendous implications to the patients,
    caregivers & healthcare system
    Cervical Cancer (CC):
    Increasing trend :
    2008 2012
    New cancer case: 12.7 million 14.1 million
    Cancer death : 7.6 million 8.2 million
    Ref: Torre LA, Bray F, Siegel RL, et al. Global Cancer Statistics, 2012. 2015;00(00):1–22
    Worldwide:

    5 th after lung, breast, colorectal


    & prostate ca.

    70% of 4th after breast,


    CC occur colorectal and lung
    in low cancer.
    resourced
    countries

    Ref: Torre LA, Bray F, Siegel RL, et al. Global Cancer Statistics, 2012. 2015;00(00):1-22
    Worldwide:
    5th after lung, breast, colorectal &
    prostate ca

    70% of CC
    occur 4th after breast,
    in low colorectal and lung
    resourced cancer.
    countries
    2nd
    after
    Breast
    Ca.

    ASR is
    Rate of CC highest among
    1. Indian
    increases after 30 (10.3/100,000)
    2.Chinese
    year old and peaked at (9.5/100,000)
    3. Malay
    65-69 year old (5.3/100,000))
    ASR: age-standardised rate
    Ref: NCR 2007
    WHO IS HIGH RISK?
    • Primary cause of cervical cancer is HPV
    (human Papilloma Virus) which is transmitted sexually.

    • Risk factors associated with cervical cancer are:


    1. > 3 sexual partners
    2. Early sexualy intercourse (< 17 yearold)
    3. First delivery before 17 year old
    4. > 10 years of oral contraceptive
    5. High parity (≥ 7 full term pregnancies)
    6. Smoking
    7. Low socioeconomic status
    CLINICAL FEATURES

    Among those with PCB:


    Conventional Pap smear: Colposcopy:
    Sensitivity : 50% Sensitivity : 78.6%
    Specificity : 86.5% Specificity :-
    Positive predictive value: Positive predictive value:
    92.8% 23.4%

    PCB: post coital bleeding


    Ref: Tehranian A et al. Evaluation of women presenting with postcoital bleeding by cytology and colposcopy. Int J
    Gynaecology Obstet; 2009;105(1):18-20
    Common presenting symptoms in CC are:
    postmenopausal bleeding (84.0%)
    vaginal discharge (72.0%)
    PCB (64.0%) and
    abdominal pain (56.0%)1

    Prevalence of PCB in cervical cancer ranges


    between 0.7% to 39%2
    Ref:
    1. Ikechebelu JI et al. Clinicopathological analysis of cervical cancer seen in a tertiary health facility in Nnewi,
    south-east Nigeria. J Obstet Gynaecol. 2010;30(3):299–301
    2. Shapley M et al. A systematic review of postcoital bleeding and risk of cervical cancer. Br J Gen Pract.
    2006;56(527):453–60
    STAGE OF DISEASE AT PRESENTATION

    35
    34.7
    30

    25 25.6

    20 21
    18.7
    15

    10

    0
    STAGE 1 STAGE 2 STAGE 3 STAGE 4

    Ref: Malaysian National Cancer Statistic 2007


    Referral

    • Appropriate referral can improve the quality


    of care to the patient

    • Referral to gynaecologist/gynae-oncologist
    clinic after abnormal cytology or symptoms
    is important to establish prompt diagnosis
    Time frame for Referral of abnormal
    cytology to gynaecology clinic
    Referral

    Ref:
    Sahu B etal. Prevalence of pathology in women attending colposcopy for post coital bleeding
    with negative cytology. Arch Gynecol Obstet. 2007;276(5):471–3.
    Algorithm 1:
    Assessment
    of Cervical
    Cancer
    Take Home Messages
    1. Most cervical cancer patients are asymptomatic &
    presented at late stage of disease, hence pap smear
    screening is of utmost importance in early detection.
    2. The common symptoms are postmenopausal bleeding,
    vaginal discharge, post coital bleeding and abdominal
    pain.
    3. Appropriate and timely referral is important to establish
    prompt diagnosis and management
    Thank You

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