NR602 - Cervical Cancer Grand Rounds.pptx - Cervical Cancer...

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Cervical Cancer NR602: Primary Care of the Childbearing and Childrearing Family Chamberlain University June 2019
Introduction & Pathophysiology Cervical intraepithelial neoplasia (CIN) Pathophysiology Squamocolumnar junction (SCJ) Two major types of cervical cancer Squamous cell carcinoma Adenocarcinoma Human papillomavirus (HPV) Integrates into host DNA Malignant transformation Most HPV infections are transient (McCance, Huether, Brashers, & Rote, 2014; DeCherney, Nathan, Laufer, & Roman, 2014; Hollier, 2018; Rerucha, Caro, & Wheeler, 2018)
Epidemiology Etiology Human papillomavirus (HPV) infection >200 types of HPV strains Low-risk (wart-causing) & high-risk (oncogenic/cancer-causing) HPV detected in 99.7% of cervical cancers High-risk strains of HPV 15 known strains HPV-16 and HPV-18 = 70% of cervical cancers HPV-16 = 50% of all squamous cell carcinomas HPV-18 = 20% of cervical adenocarcinomas (Rerucha et al., 2018) Retrieved from
Epidemiology Incidence of Cervical Cancer 3 Rd most common gynecologic cancer in the U.S. Approx. 13,000 new cases diagnosed annually > 4,000 deaths annually Highest incidence among women 40-49 years of age (14 cases per 100,000 women per year) Hispanic and black women affected most often Most commonly diagnosed after age 30 50-64% of cancers occur in women who were rarely or never screened. (Hollier, 2018; Wipperman, Neil, & Williams, 2018)
Risk Factors Risk factors for cervical cancer Early age at first intercourse (<18 years) Infection with HPV (current or previous) HIV, AIDS, or another immunocompromised state Cigarette smoking Having multiple sexual partners Diethylstilbestrol (DES) exposure Long-term use of oral contraceptives (>5 years) Parity of 3 or more births Family history Herpes simplex virus-2 and chlamydia (DeCherney et al., 2014; Hollier, 2018; Wipperman et al., 2018) Retrieved from
Clinical Physical Assessment Findings Physical assessment findings of cervical cancer Cervix may appear normal in early stages Cervical erosion, ulceration or a bleeding mass Decreased mobility or hardening of the cervix Irregular, cauliflower-like growth on cervix

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