Cervical, Endometrial, and Ovarian CA

What are the main HPV types associated with cervical cancer?

HPV 16 and 18

What is the precursor lesion for cervical cancer?

CIN (Cervical Intraepithelial Neoplasia)

What does CIN 1 represent?

Mild dysplasia

What do CIN 2 and 3 represent?

Moderate to severe dysplasia with higher cancer risk

At what age should Pap smear screening begin?

Age 21

At what age can Pap smear screening end in most patients?

Age 65

What is the primary management for CIN 1 in patients under 25?

Observation

What are the two main approaches for managing CIN 2/3?

Excision (LEEP/Cone) or Ablation

What obstetric risk is associated with excisional cervical procedures?

Increased risk of preterm labor

What is the most common symptom of endometrial cancer?

Abnormal Uterine Bleeding (AUB)

What postmenopausal symptom warrants immediate investigation for cancer?

Postmenopausal bleeding

What are the two main types of endometrial cancer?

Type I (estrogen-driven/endometrioid) and Type II (non-estrogen driven/serous/clear cell)

Which type of endometrial cancer has a better prognosis?

Type I (estrogen-driven/endometrioid)

What pathology finding requires a D&C to rule out cancer?

Hyperplasia with Atypia

What is the standard treatment for endometrial cancer?

Surgery (TAH + BSO)

When might progesterone therapy be used for endometrial hyperplasia or cancer?

In select cases like fertility-sparing treatment in young patients

What are the "Three NOs" of ovarian cancer?

NO precursor lesion, NO effective screening, NO early symptoms

What are the common late presenting symptoms of ovarian cancer?

Bloating, pelvic pain, early satiety

Why is pre-surgical biopsy avoided in suspected ovarian cancer?

Risk of spreading tumor cells

How is ovarian cancer definitively diagnosed?

Surgical staging

What is the key symptom of Vulvar Intraepithelial Neoplasia (VIN)?

Pruritus (itching)

What risk factors are shared between VIN and CIN?

HPV, smoking, immunosuppression

What is the purpose of a colposcopy?

Visualizes cervix/vulva with magnification to guide biopsy

What does a D&C procedure accomplish?

Diagnostic & therapeutic removal of endometrium

What is the key difference between LEEP/Cone Biopsy and Cryotherapy?

LEEP/Cone are excisional with pregnancy risks

Which procedure should never be performed for suspected ovarian masses?

Ovarian Biopsy

What makes endometrial cancer Type I different from Type II?

Type I is estrogen-driven with better prognosis

Why is ovarian cancer often diagnosed at late stages?

Lack of early symptoms, no effective screening, no precursor lesion

What is the primary concern with endometrial hyperplasia with atypia?

It may progress to or already contain endometrial cancer

What are two excisional treatments for cervical dysplasia?

LEEP and Cone Biopsy

What percentage of cervical cancers are caused by HPV?

Almost 100% (almost always due to HPV)

How is VIN typically identified?

Often found on visual inspection, requiring biopsy for confirmation

What is the standard initial test for abnormal uterine bleeding?

Endometrial Biopsy

What is the definition of postmenopausal bleeding?

Any vaginal bleeding that occurs after 12 months of amenorrhea in a woman who has gone through menopause

Why is postmenopausal bleeding considered "cancer until proven otherwise"?

High correlation with endometrial cancer, requiring thorough investigation

Which GYN cancer is known as "the silent killer" and why?

Ovarian cancer, due to lack of early symptoms, effective screening, and precursor lesions