Question 1
Globally, cervical cancer is the fourth most common cancer in women (Rachana & Giri, 2019), caused by a certain type of high-risk human papillomavirus (HPV), which is sexually transmitted (WHO, 2019). All HPV infections are not malignant (Boardman & Matthews, 2019). Cervical epithelial tumours that are either squamous or adenosquamous lead to cervical cancers (Marth et al., 2017). 90% HPV infections subside on their own and only 5% progress into CIN grade II or III lesions by 3 years of HPV-infection (Boardman & Matthews, 2019).
Cervical intraepithelial neoplasia (CIN) or cervical dysplasia is a precondition featuring abnormal squamous cell growth on the cervical surface that progresses in severity from grade I to III before finally turning to invasive cancer (Craft et al., 2018). Only 20% CIN III lesions become malignant by 5 years (Boardman & Matthews, 2019).
Sarah’s risk factors are:
- Diagnosis of high-risk HPV serotypes, acute squamous intraepithelial lesions and grade III cervical dysplasia are precursors to invasive carcinoma (Craft et al., 2018).
- Lifestyle factors like multiple sexual partners (Toribio, Vargas & Menéndez, 2019).
- History of birth control/menstrual regulation foster iatrogenic and HPV infections (Fathalla & Fathalla, 2011; Craft et al., 2018).
- Lack of pelvic examination increases scope of sexually-transmitted pathogens, creating infertility/infections (Fathalla & Fathalla, 2011).
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