Cervical Cancer (HPV)

by Lynae Brayboy, MD

My Notes
  • Required.
Save Cancel
    Learning Material 2
    • PDF
      Slides CervicalCancer PathologyInfectionsNeoplasmsandScreening.pdf
    • PDF
      Download Lecture Overview
    Report mistake

    00:01 Hi.

    00:02 Today I'd like to talk to you about HPV (human papilloma virus), cervical cancer and screening.

    00:09 Let's talk a little bit about human papilloma virus, HPV for short.

    00:14 The HPV genotype appears to be the most important determinant for the persistence and progression of disease.

    00:22 There are two different oncogenic types.

    00:24 One type is human papilloma virus 16 or HPV-16.

    00:29 It has the highest carcinogenic potential and this is very important to remember for your test.

    00:35 It accounts for about 55 to 60% of all cases of cervical cancer worldwide.

    00:41 The next most carcinogenic type of HPV is HPV-18.

    00:46 It's responsible for a lot less, 10 to 15% of all cases of cervical cancer.

    00:53 There are risk factors for cervical cancer besides just HPV infection.

    00:58 The known risk factors increase the likelihood of persistence of HPV infection which is normally cleared by a young, healthy woman.

    01:05 However, if you're a smoker, that incidence of clearing is reduced.

    01:12 Also, if you have a compromised immune system, that is with years of taking glucocorticoids, you can potentially have an increased persistence of HPV.

    01:23 Also, we know that HIV infection can also increase the persistence of human papilloma virus leading to cervical cancer.

    01:33 Let's talk a little bit about the molecular pathogenesis of HPV.

    01:37 HPV belongs to the papillomavirus family and is a group of double-stranded DNA viruses.

    01:45 HPV 6 and 11 which I have not mentioned yet causes genital warts while 16 and 18 are more likely to cause cervical cancer.

    01:54 The progression to invasive cervical cancer is characterized by the viral DNA integrating into the host DNA.

    02:01 HPV is very common.

    02:04 It's usually an infection that occurs in teenagers and women in their twenties.

    02:09 Although the prevalence is not quite known, it decreases as women age.

    02:14 The lifetime cumulative risk though of acquiring it is about 80%.

    02:20 Most young women, especially those under 21 have a very effective immune system that can clear the infection in about an average of eight months.

    02:30 There's some guidelines that we now need to review.

    02:33 They're from the United States Preventive Service Task Force, and they only apply to certain women.

    02:40 So this is important to remember.

    02:41 They apply to women who have a cervix and who are of age, greater than 21 years old, regardless of their sexual history.

    02:51 It does not apply to women who have already received a pre-cancer cervical lesion diagnosis or have frank cervical cancer.

    02:58 It does not apply to women who've been exposed to DES or diethylstilbestrol It does not apply to women who are immunocompromised such as women who are HIV-positive.

    03:09 Here are the guidelines.

    03:10 Again, women ages 21 to 65 should be screened with cytology every three years.

    03:16 Women who are 30 to 65 who want to lengthen the screening can have intervals of five years with a combination of cytology and HPV screening.

    03:26 And there are other recommendations that we no longer follow which are grade D recommendations.

    03:32 So if you are younger than 21 or older than 65 or you already have had a hysterectomy due to cancer, or you are younger than 30, we don't do HPV testing alone or in combination with cytology in women again who are younger than 30.

    03:50 What about prevention? So how can we prevent all of this morbidity and potentially mortality with HPV.

    03:56 Well, now there is a vaccine that protects women against nine strains of HPV.

    04:02 While it protects women, both boys and girls should receive the vaccine between the ages of 9 and 26 years old.

    04:10 Thank you for listening.

    About the Lecture

    The lecture Cervical Cancer (HPV) by Lynae Brayboy, MD is from the course Gynecologic Pathology: Infections, Neoplasms and Screening.

    Included Quiz Questions

    1. HPV 16
    2. HPV 18
    3. HPV 11
    4. HPV 33
    5. HPV 35
    1. Women who are above 21 regardless of sexual history.
    2. Women who do not have a cervix.
    3. Women who are received a diagnosis of a high-grade precancerous cervical lesion or cervical cancer.
    4. Women with in utero exposure to diethylstilbestrol.
    5. Women who are immunocompromised.
    1. HPV 11
    2. HPV 16
    3. HPV 18
    4. HPV 33
    5. HPV 35
    1. HPV vaccination is recommended in boys and girls between the age of 9 to 26 years
    2. HPV vaccination is recommended for girls between the age of 9 to 26 years
    3. HPV vaccination is recommended for boys between the age of 9 to 26 years
    4. HPV vaccination is recommended for ladies between the age of 27 to 45 years
    5. HPV vaccination is recommended for men between the age of 27 to 45 years

    Author of lecture Cervical Cancer (HPV)

     Lynae Brayboy, MD

    Lynae Brayboy, MD

    Customer reviews

    5,0 of 5 stars
    5 Stars
    4 Stars
    3 Stars
    2 Stars
    1  Star
    Basic need to know info, straight to the point!
    By Sergio R. on 08. January 2018 for Cervical Cancer (HPV)

    Straight to the point! Thi lecture gives you basic need to know info

    Good lecture
    By Enja O. on 03. December 2017 for Cervical Cancer (HPV)

    I liked this lecture, it was short and very to point