cin

1. By
Dr.Hafsa
AN OVERVIEWOF
CERVICAL INTRAEPITHELIAL
NEOPLASIAS & cancer

2. • Hippocrates was the first to use the word “cancer” to
describe tumors .
• Cancer is derived from the Greek word “karkinos” which
means crab.
DECLARE THE PAST,
DIAGNOSE THE PRESENT ,
FORETELL THE FUTURE,
- HIPPOCRATES
WHAT IS CANCER?

3. Cervical cancer is a slow
developing cancer that starts
in the interior lining of the
cervix.
Almost all cases begin with
changes caused by the human
papillomavirus (HPV), a
sexually transmitted infection.
Over time the changes caused
by HPV build up and a pre-
cancerous condition called
cervical intraepithelial
neoplasia (CIN) develops.
CIN can progress to cervical
cancer.

4. • 400 BCE : First description of cervical cancer by Hippocrates.
• 1834 : Cervical cancer is identified as a sexually transmitted
disease
• 1925 : German gynaecologist Hans Hinselmann first describes
the foundation of the colposcope.
• 1928 : Greek cytopathologist Georgios Papanikolaou develops a
cervical cytology smear test (today called Pap smear) to detect
cancer cells.
• 1985 : Harald Zur Hausen and Lutz Gissmann demonstrate the
presence of HPV DNA in cervical cancer cells. disease.
• 2006 : United States FDA approves Gardasil, a vaccine that
prevents infection with the two high- risk strains of HPV.
TIMELINE OF CERVICAL
CANCER

7. • World wide: 3rd most common female cancer
• Developing countries: 85 % of all cases
• Over 500,000 women worldwide die of cervical cancer
annually.
• Approximately every 47 minutes a woman is diagnosed
with cervical cancer.
Magnitude of the Problem

9. PATHOPHYSIOLOGY

19. • Direct invasion cervical stroma, vagina, and
parametrium.
• Lymphatic spread pelvic and then par aortic lymph nodes
• Hematogenous spread such as lungs, liver, and bone
Patterns of spread

21. One of the most preventable and curable
malignancies
• More than 75% cases belong to developing countries.
• Incidence falling by about 7% per annum in developed
countries due to operational screening programs

22. Social ecological model in
cervical cancer prevention

23. • Primary prevention – education, vaccination
• Secondary prevention – screening, early diagnosis and
treatment
• Tertiary prevention – stage wise treatment, palliation,
rehabilitation
Prevention strategies

26. 1:PhysicalExamination
2:PV examination
3:PAP smear
4:Colposcopy
5: Cervical Biopsy

29. What is cervical cancer
screening?
Cervical cancer screening is used
to find changes in the cells of the
cervix that could lead to cancer.

30. Why is cervical cancer screening important?
It usually takes 3–7 years for high-grade changes in cervical cells to
become cancer.
Cervical cancer screening may detect these changes before they
become cancer.

31. How is cervical cancer screening done?
Cervical cancer screening includes the Pap test and, for
some women, an HPV test. Both tests use cells taken
from the cervix.The screening process is simple and fast.
For a Pap test, the sample is examined to see if abnormal
cells are present.
For an HPV test, the sample is tested for the presence of
13–14 of the most common high-risk HPV types.

32. How often cervical cancer
screening done and which
tests should be done?
Women aged 21–29 years
should have a Pap test alone
every 3 years. HPV testing is not
recommended.
Women aged 30–65 years
should have a Pap test and an
HPV test (co-testing) every 5
years (preferred). It also is
acceptable to have a Pap test
alone every 3 years.

33. When to stop having cervical cancer screening?
stop having cervical cancer screening after age 65 years if
• No history of moderate or severe abnormal cervical cells or
cervical cancer
• three negative Pap test results in a row or two negative co-test
results in a row within the past 10 years, with the most recent
test performed within the past 5 years.