RISK FACTORS, SIGNS & SYMPTOMS, INVESTIGATIONS & DIAGNOSIS
RISK FACTORS
- Early first sexual intercourse
- Multiple partners
- History of STIs
- Lack of barrier protection
- Smoking
- Combined oral contraceptive use >5 years
- Family history
- High parity
Immunosuppression
Coinfection with other STIs
SIGNS & SYMPTOMS
- Abnormal vaginal discharge
- Unexplained vaginal bleeding
- Pelvic pain
- Pain during intercourse
- Post-menopausal bleeding
- Abnormal cervical appearance
INVESTIGATIONS & DIAGNOSIS
Primary screening:
- HPV testing
- If HPV positive: cytology
- If cytology is positive: colposcopy
- Third positive HPV test (for those where the cytology test was negative on two previous occasions after being repeated in 12 months each time): direct to colposcopy Colposcopy findings:
- Low grade: CIN1
- High grade: CIN2, CIN3
- Transformation zone examination
Cancer types: squamous cell and adenocarcinomas