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What is this? 
Acetowhite
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What is CIN?
What is it associated with?
- It is Cervical Intraepithelial Neoplasia
- HIGHLY associated with HPV 16,18 (for high grade) and HPV 6,11 (for low grade)
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In the cervix, what is SCC associated with?
What is Adenocarcinoma associated with?
How is CIN graded?what is it associated with?
- -HPV 16 and MICROINVASION
- -HPV 18
-graded on how far it moves up in the epithelium. CIN III all the way through. Associated with either HPV6,11 or 16,18 depending on the grade.
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What are some risk factors for CIN? (OIMESS)
- Multiple sexual partners
- Early age at first intercourse
- STDs
- Smoking
- Immunosuppression
- Oral contraceptive use
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What is the natural history of:
LSIL?
HSIL? How many of these develope de novo?
60% regress, 30% persist, 10% progress to HSIL
- 30% regress, 60% persist, 10% progress to carcinoma
- 20% de nuvo
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- See its progression
- from low grade (lft--> to high grade)
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For Cervical SCC
What is the Mean age?
What % of all cervical cancers are SCC?
Mean age is 45
80% of cervical cancers are SCC
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What percent of cervical cancers are Adenocarcinomas?
What is its precursor lesion?
Is it more or less aggressive then SCC?
makes up 15% of all cervical cancers
Adenocarcinoma in situ (AIS) is its precursor
it is MORE AGGRESSIVE
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AdenoCarcinoma
See the thickened gland on the Right
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How do you treat CIN I, II, III?
- CIN I
- -Follow-up, Ablative therapy
- CIN II/III
- -LEEP (loopelectrosurgical excision procedure) AND “Cold Knife” Conization
- Cervical Cancer
- Radiation/chemotherapy AND Surgical
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what are the ages for the HPV vaccine?
do we test for low risk HPV? Why?
- Recommendations (ACIP)
- -Young as 9 years old
- -Females 11-12 years old
- -Catch up 13-26 years old
We do not because they do not cause cancer
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