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Suspected cervical cancer — DRCOG MCQ

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HardGynaecological OncologySuspected cervical cancerDRCOG

A 59-year-old reports a single episode of vaginal bleeding four years after her last menstrual period. Examination shows no visible vulval or cervical cause. What is the best next step?

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Correct answer: A — Arrange urgent assessment through the endometrial-cancer pathway

The best answer is “Arrange urgent assessment through the endometrial-cancer pathway”. Postmenopausal bleeding in a woman aged 55 or over meets NICE criteria for a suspected endometrial-cancer referral. A normal speculum examination does not exclude endometrial disease; specialist assessment usually includes transvaginal ultrasound and endometrial investigation according to findings. Cervical ectropion can cause contact bleeding, but it does not account safely for an irregular friable lesion in this age group.

Reference: NICE NG12: Suspected cancer recognition and referral: https://www.nice.org.uk/guidance/ng12/chapter/recommendations-organised-by-site-of-cancer