Cervical Cancer Screening and Management

A 38-year-old woman from Tamil Nadu, HPV-16 positive, presents with abnormal cervical cytology (CIN 2). She has completed 2 doses of quadrivalent HPV vaccine 6 months ago. Colposcopy-directed biopsy confirms CIN 2 with negative margins. She declines excisional treatment and requests conservative management. According to current FIGO and Indian guidelines, which of the following is the most appropriate management?

A 42-year-old woman from rural Maharashtra presents with postcoital bleeding and vaginal discharge for 3 months. Pap smear shows atypical squamous cells of undetermined significance (ASCUS). HPV testing is positive for HPV-16. Colposcopy with directed biopsy reveals cervical intraepithelial neoplasia grade 2 (CIN-2). She is counselled regarding treatment options. Which of the following is the MOST appropriate management for CIN-2?

A 42-year-old woman from Delhi presents with postmenopausal bleeding for 3 months. On examination, a 4 cm friable, bleeding cervical mass is noted. Pap smear shows HSIL (High-Grade Squamous Intraepithelial Lesion). HPV testing is positive for HPV-16. What is the most appropriate next step in management?

A 52-year-old woman from urban Delhi presents with postmenopausal bleeding and vaginal discharge for 3 weeks. On speculum examination, a friable, bleeding cervical mass is noted. Pap smear shows malignant cells. Colposcopy-guided cervical biopsy confirms squamous cell carcinoma of the cervix. Staging workup including pelvic MRI reveals a 4 cm cervical lesion with parametrial invasion but no distant metastases (FIGO Stage IIB). The patient has no contraindications to chemotherapy or radiation. What is the most appropriate treatment?

A 35-year-old woman from rural Maharashtra attends the primary health centre for cervical cancer screening. Pap smear is performed and reported as ASC-US (Atypical Squamous Cells of Undetermined Significance). HPV testing is not available at the centre. What is the most appropriate next step in management?