NUR241 Assessment 2: Cervical Cancer Case Study, Screening Guidelines

This case study delves into cervical cancer, beginning with an explanation of its pathophysiology, which involves the infection of Human Papilloma Virus (HPV) and the uncontrolled multiplication of damaged cervical cells. It identifies risk factors in Sarah's case, including multiple sexual partners, lack of birth control, early menarche and sexual activity, and infrequent pelvic examinations. The study further outlines the latest Australian guidelines for cervical screening, emphasizing the shift to five-yearly HPV tests followed by liquid-based cytology if needed. The rationale behind the new guidelines is the increased accuracy of combined HPV and cytology tests in detecting oncogenic HPV, leading to better health outcomes. Desklib offers this and other solved assignments to aid students in their studies.

CASE STUDY ON CERVICAL CANCER 1
Answer to Question no. 1
Pathophysiology of cervical cancer
Cervical cancer is caused by a malignant tumor that is formed at the lowermost region of the
uterus, called the cervix, that remains connected to the vagina(Cohen et al, 2019). Cervical
cancer is initiated by the infection of Human Papilloma Virus(HPV), which is released into
the vagina during sexual intercourse, which then moves into the basal cervical region and
infects the basal cells, thus inhibiting the ability of the cervical cells to destroy the tumor. The
damaged cells begins to multiply uncontrollably and spread to the surrounding tissues, thus
increasing the chance of cervical cancer(Johnson et al, 2019).
Risk factors for Sarah
The risk factors which may have led to the development of cervical cancer for Sarah in this
particular Case study include:
Having multiple sexual partners increase the risk of getting infected by sexually transmitted
disease(Lee & Cancer Genome Atlas Research Network., 2017).
No intake of birth control pills for an extended period (2 years)
The onset of menstruation or menarche at the age of 20
Engaging in sexual activity from an early age
Conceiving at the age of only 20, which is much before puberty
No pelvic examination is done for the last five years

CASE STUDY ON CERVICAL CANCER 2
Answer for Question no. 2
Guidelines for cervical screening
On 1st December 2017, the Australian Government announced a legislature regarding the new
National Cervical Screening Program(Curry et al, 2018) bringing out a change and revising
the previous guidelines of the program for providing better health access and improved
healthcare service to the women who have cervical cancer. According to the new guideline,
women are eligible for a five-yearly HPV screening test; previously, they were allowed two
early HPV tests. HPV tests will be followed by a liquid-based cytology test (LBC) if the
patient shows positive results. Moreover, the cervical screening process will be commenced
for women belonging to the age group 18-25 years, and they can also terminate the test in
between 70-74 years if the test comes negative. The women who undergo HPV tests are also
provided with Medicare benefits(Small Jr et al, 2017).
In 2014, there were nearly 220 deaths in Australia, which resulted due to cervical cancer
among women belonging to all age groups, among them 150 occurred in the target screening
group of 20-69 years of age. Previously, there were no Pap test or HPV tests offered to the
women who had cervical cancer; most of them were left under-screened. So, the new
guidelines were implemented, which will better address the issue and ensure better health
outcomes (Kessler, 2017).
The scientific rationale for the new guideline
The new guideline of the National Cervical Screening Program recommends that, if an
woman is tested positive for cervical cancer, she should undergo HPV tests, which will be
followed by a liquid-based cytology test(Koliopoulos et al, 2017). The combined effect of
these tests has been found to detect the presence of oncogenic Human Papilloma Virus,
which signifies that these tests are more accurate than a single cytology (Pap test) test alone.

CASE STUDY ON CERVICAL CANCER 3
REFERENCE:
Cohen, P. A., Jhingran, A., Oaknin, A., & Denny, L. (2019). Cervical cancer. The
Lancet, 393(10167), 169-182.
Curry, S. J., Krist, A. H., Owens, D. K., Barry, M. J., Caughey, A. B., Davidson, K. W., ... &
Landefeld, C. S. (2018). Screening for cervical cancer: US Preventive Services Task
Force recommendation statement. Jama, 320(7), 674-686.
Johnson, C. A., James, D., Marzan, A., & Armaos, M. (2019, March). Cervical cancer: an
overview of pathophysiology and management. In Seminars in oncology nursing. WB
Saunders.
Kessler, T. A. (2017, May). Cervical cancer: prevention and early detection. In Seminars in
oncology nursing (Vol. 33, No. 2, pp. 172-183). WB Saunders.
Koliopoulos, G., Nyaga, V. N., Santesso, N., Bryant, A., Martin‐Hirsch, P. P., Mustafa, R.
A., ... & Arbyn, M. (2017). Cytology versus HPV testing for cervical cancer screening
in the general population. Cochrane Database of Systematic Reviews, (8).
Lee, S., & Cancer Genome Atlas Research Network. (2017). Integrated genomic and
molecular characterization of cervical cancer.
Small Jr, W., Bacon, M. A., Bajaj, A., Chuang, L. T., Fisher, B. J., Harkenrider, M. M., ... &
Gaffney, D. K. (2017). Cervical cancer: a global health crisis. Cancer, 123(13), 2404-
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