HPV vaccine
For maximum efficacy, the HPV vaccine should ideally be administered:
before sexual contact
1.What is the recommended age to start regular cervical cancer screening as per WHO guidelines?
30 years
What should be done for a 35 year old woman with CIN 2 who are not eligible for ablative treatment?
Excisional treatment
.In the context of colposcopy, what does a 'Type 3' transformation zone indicate?
The transformation zone extends into the endocervical canal and is not fully visible.
VIA is appropriate to use in women upto which age and why?
in women whose transformation zone is visible (typically in those younger than 50 years).
This is because once menopause occurs, the transformation zone, where most pre-cancer lesions occur, frequently recedes into the endocervical canal and prevents it from being fully visible
The first radical hysterectomy was performed in 1898 by
Ernst Wertheim
Which HPV type is most commonly associated with cervical cancer
HPV 16
Which land mark trial established concurrent chemoradiation as standard of care for locally advanced cervical cancer?
GOG trials 1999
What is the primary focus of the WHO's HPV vaccination strategy?
preventing cervical cancer
In a 'screen-and-treat' approach, what follows a positive primary screening test for cervical cancer?
Immediate treatment
Which gene mutation is most closely associated with HPV-related carcinogenesis?
P53
what are the different types of cone biopsies
1. Cold knife cone
2. laser cone
3. LLETZ cone
which region bears the highest burden of cervical cancer world wide
Subsaharan Africa
who discovered pap smear in 1928
George paanicolaou
What is the most common route of HPV transmission
sexual contact
which landmark trial compared radical hysterectomy versus radiotherapy for early stage cervical cancer?
Landoni trial
Which HPV vaccine has the broadest coverage in terms of HPV types?
Gardasil 9
In PRIMARY HPV DNA SCREENING AND VIA TRIAGE (SCREEN, TRIAGE AND TREAT APPROACH) the HPV is positive and VIA is negative in a NON HIV positive patient
how should we manage such woman?
repeat HPV test in 2 years
What is the follow-up protocol for a patient with a negative result after immediate HPV triage following an ASCUS cytology finding?
Rescreen in 3 years with cytology
The recommended biopsy site during colposcopy is
area showing the most abnormal acetowhite change
which trial caused the most emotional trauma to surgeons world wide in 2018.
LACC
which organization launched the global initiative to eliminate cervical cancer?
WHO
Which cofactor increases the risk of cervical cancer in HPV positive women?
smoking
The Shape trial primarily evaluated
Simple versus radical hysterectomy
At what age does the dosage schedule change from 2 doses to 3 doses for Gardasil?
15 years and above
Besides screen and treat approach visual inspection with acetic acid is also used for
determining eligibility for ablative treatment
what are the eligibility criterias for ablative treatment for pre invasive lesions
1. The entire lesion is on the ectocervix.
2. The lesion does not cover more than three-quarters of the cervix.
3. All margins of the lesion are visible.
What is a key piece of information we as providers need to know about the colposcopy in order to determine treatment modalities?
whether colposcopy was adequate or inadequate
Roast the tumour board
stage 1b1, 1.5 cm lesion lets do radical hysterectomy.....robotically
which trial just left the tumour board meeting?
LACC, succor, shape
which drug became the backbone of concurrent chemoradiation?
Cisplatin
What is the estimated percentage of cervical cancers globally caused by HPV 16 and 18?
90%
The LACC trial compared which two surgical approaches?
MIS versus open radical hysterectomy
In which year did the FDA approve the first HPV vaccine
2006
What is the maximum room temperature stability duration for self-collected HPV DNA test specimens
30 days
If treated with ablation or LLETZ without histopathology results available, or if treated based on histopathology of CIN2/3 or AIS, when should the follow up testing be done
After 12 months
What is schiller's test
a preliminary test for cancer of the uterine cervix in which the cervix is painted with an aqueous solution of iodine and potassium iodide and which shows up healthy tissue by staining it brown and possibly cancerous tissue as white or yellow due to its failure to take up the stain because of a deficiency of glycogen in the cells
where was the first colposcopy performed
Berlin, germany
which scientist established the causal link between HPV and the cervical cancer and was awarded nobel prize
Harold Zur Hausen
What other cancer, besides cervical cancer is HPV strongly associated with?
Oropharyngeal cancer
based on LACC trial results major guidelines recommended
Open radical hysterectomy as preferred approach
which HPV vaccine is recommended for prevention of genital warts
Gardasil
HPV testing is not recommended in women less than 30 years of age because
because of high rate of transient infections
Preferred treatment for CIN 2 -3 in women of reproductive age
LEEP/cold knife conization
which colposcopic feature suggests high grade CIN
Punctation or mosaic with sharp borders
Which organ gets the "cone shaped makeover" during the procedure
cervix
what are the three pillars of WHO cervical cancer elimination strategy
vaccination, screening and treatment
Which population of women has a higher prevalence of HPV and co infections with multiple types?
women living with HIV
what was the impact of using a uterine manipulator in MIS according to Succor trial?
Associated with higher recurrence risk