Cervical Cancer (CaCx) screening power point

Cervical Cancer (CaCx) screening power point for students doing MBCHB

1. Cervical Cancer (CaCx) screening By Unit E

2. Primary prevention; creating an awareness about the risk factors among women, promoting practice of safe sex use of condoms to prevent SIDs lifestyle modification, screening for and early treatment of premalignant lesions HPV vaccines

3. Secondary prevention; Prevention of progression of intraepithelial to invasive cancer. This consists of: Screening 5 methods: 1. conventional cytology (PAP smear), 2. liquid based cytology (LBC), 3. human papillomavirus (HPV) testing, 4. visual inspection on acetic acid (VIA) 5. colposcopy

4. tertiary prevention: take cervical biopsy Do a VIA

5. PAP Smear: The Pap test (AKA Pap smear) is a way to examine cells collected from the cervix (the lower, narrow end of the uterus). The main purpose of the Pap test is to detect cancer or abnormal cells that may lead to cancer. Pap smear is done in women who are not menstruating Outside of cervix there is squamous cells & inside cervix is glandular cells.

6. Results are reported as: Squamous cells Squamous cells abnormalities are further subdivided into: 1. NILM - Negative for Intraepithelial Lesion or Malignancy 2. ASC —atypical squamous cells which is divided into 2 groups: a) ASC–US —atypical squamous cells of undetermined significance b) ASC–H —atypical squamous cells cannot exclude a high-grade squamous intraepithelial lesion. 3. CIN or AIS —endocervical adenocarcinoma in situ. 4. LSIL —low-grade squamous intraepithelial lesion. 5. HSIL —high-grade squamous intraepithelial lesion. This is divided into 2: - CIN 2 - CIN 3 6. Microinvasive cancer . 7. Squamous cell carcinoma .

7. Glandular cells are further subdivided into 3: 1. Atypical glandular cells (AGC). 2. Adenocarcinoma in situ. 3. Adenocarcinoma. All these 3 are evaluated or treated by doing an endocervical curettage (ECC) followed by colposcopy-directed biopsy.

8. The Wilson and Jungner classic screening criteria The condition sought should be an important health problem. There should be an accepted treatment for patients with recognized disease. Facilities for diagnosis and treatment should be available. There should be a recognizable latent or early symptomatic stage. There should be a suitable test or examination. The test should be acceptable to the population. The natural history of the condition, including development from latent to declared disease, should be adequately understood.

9. The Wilson and Jungner classic screening criteria continued There should be an agreed policy on whom to treat as patients. The cost of case-finding (including diagnosis and treatment of patients diagnosed) should be economically balanced in relation to possible expenditure on medical care as a whole. Case-finding should be a continuing process and not a “once and for all” project.