BY DR.RICHA SHARMA

Moderator: Prof. A.N. Srivastava

CARCINOMA CERVIX Malignant tumor of uterine cervix. Second most common cancer worldwide and the commonest

cancer among Indian women

Early stage Late stageMicro -invasive cancercervix normal,shallow

ulcer or reddened area

stage IA to IIA cervical carcinoma

Symptoms:Asymptomatic diagnosis with

abnormal Pap

Appear as polyps, grow into cervix

hardened, barrel-shaped cervix.

stage IV cervical carcinoma

bleeding or discharge P/V

dyspareunia lower abdomen pain

HPV(Human Papilloma Virus)HPV is known as the"common cold" of the sexually

transmitted infection world. It is very common and affects roughly 80 % of all sexually

active people, whether they have symptoms or not. The most important risk factor in the development of

cervical cancer is infection with a high-risk strain of HPV.In 1976 Harald zur Hausen published the hypothesis that

HPV plays an important role in the cause of cervical cancer.

In 1983 and 1984 zur Hausen and his collaborators identified HPV16 and HPV18 in cervical cancer.

More than 150 types of HPV are acknowledged to exist (some sources indicate more than 200 subtypes).

Types 16and 18 are generally acknowledged to cause about 70% of cervical cancer cases. Together with type 31, they are the prime risk factors for cervical cancer

HPV InfectionHPV is spread through genital skin contact

during sex. The virus passes through tiny breaks in the skin. HPV is not spread through blood or other body fluid.

Condoms offer limited protection as they do not cover all of the genital skin.

Warts on any other parts of the body rarely spread to the genital area.

Blood- debatableAfter it enters the body, HPV behaves in one of

two ways:• it can stay dormant (inside the body’s cells)• it can become active.

Human papillomavirus (HPV) is a ds DNA virus from the papillomavirus family that is capable of infecting humans.

HPVs establish productive infections only in keratinocytes of the skin or mucous membranes.

HPV infection is limited to the basal cells of stratified epithelium, the only tissue in which they replicate.

The infectious process is slow, taking 12–24 hours for initiation of transcription.

HPV infections have not been shown to be cytolytic; rather, viral particles are released as a result of degeneration of desquamating cells.

The HPV TestIn March 2003, the U.S. FDA approved a test

manufactured by Qiagen/Digene, which is a "hybrid-capture" test as an adjunct to Pap testing.

The test may be performed during a routine Pap smear.

It can detect the DNA of 18 "high-risk" HPV types that most commonly affect the cervix, but it cannot determine the specific HPV types.

TYPES OF HPV TESTI. Signal amplification assaysII. DNA Target amplification assaysIII. Isothermal nucleic acid amplification methods

(typically for mRNA)IV. Read-out assays for target amplification

methodsV. Real time readout assays with type-specific

probes

Signal amplification assays

DNA Target amplification assays

Isothermal nucleic acid amplification methods

The HPV TestThe HPV test checks directly for the presence of the

high-risk HPV DNA. HPV testing is FDA-approved for use with a Pap test in routine cervical cancer screening for women age 30 and older and for women of all ages as a follow-up to inconclusive Pap test results, known as ASC-US (atypical squamous cells of undetermined significance).

Research shows that the two tests together are more accurate than the Pap test alone at identifying women with cervical cancer or its early signs.

Like the Pap test, the HPV test uses a small, soft brush to collect cervical cells. Women who receive the HPV test along with their Pap test will not notice any difference in their exam.

PEARLS Cervical cancer is largely preventable – regular screening, changing

or avoiding certain risk factors, and vaccinations are essential. Cervical cancer is caused by a common virus – the human

papillomavirus. 

Cervical cancer screenings include the traditional Pap tests, liquid-based Pap test and HPV testing. 

Cervical cancer and HPV do not usually have symptoms. 

From 50 percent to 80 percent of all people will have HPV at some point in their lifetime.  

The FDA has approved HPV vaccines for females aged 9 to 26 years.