Table of Contents
1
UI - 11302886
AU - Manos MM
TI -
HPV testing for clarifying borderline cervical smear results.
SO - BMJ 2001 Apr 14;322(7291):878-9
2
UI - 11302900
AU - Rebello G; Hallam N; Smart G; Farquharson D; McCafferty J
TI -
Human papillomavirus testing and the management of women with mildly
abnormal cervical smears: an observational study.
SO - BMJ 2001 Apr 14;322(7291):893-4
AD - Colposcopy Clinic, Royal Infirmary of Edinburgh, Lothian University
Hospitals NHS Trust, Edinburgh EH3 9YW, UK.
3
UI - 11801872
AU - Narod SA; Boyd J
TI -
Current understanding of the epidemiology and clinical implications of
BRCA1 and BRCA2 mutations for ovarian cancer.
SO - Curr Opin Obstet Gynecol 2002 Feb;14(1):19-26
AD - The Centre for Research on Women's Health, Women's College Hospital,
University of Toronto, Toronto, Canada. steven.narod@swchsc.on.ca
Genetic testing for susceptibility to ovarian cancer is rapidly becoming
integrated into the clinical practice of oncology. Genetic testing for
BRCA1 and BRCA2 is now recommended to most women with invasive ovarian
cancer. Approximately 10% of these women will have a positive test,
including 4% of women without a family history of cancer. Currently, the
treatment of hereditary ovarian cancer is the same as for non-hereditary
ovarian cancer. It appears that women with ovarian cancer and a BRCA
mutation experience better survival than women without a mutation,
possibly due to enhanced susceptibility to chemotherapy. Strategies for
prevention of ovarian cancer among carriers include oral contraceptives,
tubal ligation and prophylactic oophorectomy.
4
UI - 11902497
AU - Sharma DC
TI -
Delhi launches cancer awareness campaign.
SO - Lancet Oncol 2002 Mar;3(3):133
5
UI - 11902526
AU - Arbyn M; Temmerman M
TI -
Belgian Parliament calls for organised cervical cancer screening and HPV
research throughout Europe.
SO - Lancet Oncol 2002 Feb;3(2):74
AD - European Network of Cervical Cancer Screening, Scientific Institute of
Public Health, Brussels, Belgium.
6
UI - 11917572
AU - Simsir A; Brooks S; Cochran L; Bourquin P; Ioffe OB
TI -
Cervicovaginal smear abnormalities in sexually active adolescents.
Implications for management.
SO - Acta Cytol 2002 Mar-Apr;46(2):271-6
AD - Departments of Pathology and Gynecologic Oncology, University of
Maryland Medical System, Baltimore, Maryland, USA. simsia01@med.nyu.edu
OBJECTIVE: To assess the prevalence and spectrum of Pap smear (PS)
abnormalities in sexually active adolescents in comparison to adult
women in order to determine whether management of adolescents should
differ from that of adults. STUDY DESIGN: Five hundred twenty-four
adolescents who had an initial PS at our institution from January to
cervical biopsy. Initial PS results were compared with those of adult
women. The chi 2 test was used to calculate the statistical significance
of differences between the two groups. The qualified atypical squamous
cells of undetermined significance (ASCUS) cytologic diagnosis in
adolescents was correlated with follow-up data. RESULTS: The overall
prevalence of squamous intraepithelial lesions (SILs) in adolescents was
29% as compared to 23% in adults. Almost all initial squamous lesions
were ASCUS and low grade squamous intraepithelial lesion (LSIL); only
one case of high grade squamous intraepithelial lesion (HSIL) was
detected. On follow-up 18% and 2.4% of adolescents developed LSIL and
HSIL, with a LSIL/HSIL ratio of 8/1 as compared to 5/1 in adults. The
average time from initial PS to detection of HSIL was 20 months. All
patients with HSIL except one had had one or more previous abnormal PSs.
The positive predictive values (PPVs) for subsequent dysplasia for ASCUS
favor reactive (ASCUS.R), ASCUS not otherwise specified (ASCUS.NOS) and
ASCUS favor dysplasia (ASCUS.D) in adolescents were .13, .17 and .31,
respectively. ASCUS.NOS (P = .01) and ASCUS.D (P = .007) were strong
indicators of dysplasia as compared to ASCUS.R. CONCLUSION: PS
abnormalities are more common in sexually active adolescents, with a
significantly higher prevalence of LSIL over HSIL as compared to adult
women. Given the natural history of HPV infection, we recommend
follow-up with cytology rather than colposcopy/biopsy for adolescents
with ASCUS and LSIL PSs. Qualification of ASCUS is useful in determining
which adolescents are at the highest risk of cervical dysplasia.
7
UI - 11695227
AU - Huncharek M; Klassen H; Kupelnick B
TI -
Dietary beta-carotene intake and the risk of epithelial ovarian cancer:
a meta-analysis of 3,782 subjects from five observational studies.
SO - In Vivo 2001 Jul-Aug;15(4):339-43
AD - Department of Clinical Oncology, Marshfield Clinic Cancer Center,
Marshfield, WI, USA. metaresearch@hotmail.com
OBJECTIVE: The etiology of epithelial ovarian cancer is unknown. Prior
work suggests that high dietary beta-carotene intake is associated with
a decreased risk of this tumor although this association remains
speculative. A meta-analysis was performed to evaluate this suspected
relationship. METHODS: Using previously described methods, a protocol
was developed for a meta-analysis examining the association between high
dietary beta-carotene intake versus low intake and the risk of
epithelial ovarian cancer. Literature search techniques, study inclusion
criteria and statistical procedures were prospectively defined. Data
from observational studies were pooled using a general variance based
meta-analytic method employing confidence intervals previously described
by Greenland. The outcome of interest was a summary relative risk (RRs)
reflecting the risk of ovarian cancer associated with high beta-carotene
intake versus low dietary intake. Sensitivity analyses were performed
when necessary to evaluate any observed statistical heterogeneity.
RESULTS: Five observational studies enrolling 3,782 subjects were
initially pooled in a meta-analysis subsequent to an analysis showing a
lack of statistical heterogeneity. The meta-analysis showed a summary
relative risk of 0.84 with a 95% confidence interval of 0.75-0.94, a
statistically significant result. These data suggest that high (versus
low) dietary intake of beta-carotene is associated with a sixteen
percent decrease in ovarian cancer risk. Sensitivity analyses showed no
impact of study design or differences in quantitative measure of
beta-carotene intake across studies on the summary relative risk.
CONCLUSIONS: High dietary intake of beta-carotene appears to represent a
protective factor for the development of ovarian cancer although its
magnitude is modest. Further work is needed to clarify factors that may
modify the effects of beta-carotene in vivo.
8
UI - 11845768
AU - Petersen WO; Trapp MA; Vierkant RA; Sellers TA; Kottke TE; de Groen PC;
TI -
Nicometo AM; Kaur JS
Outcomes of training nurses to conduct breast and cervical cancer
screening of Native American women.
SO - Holist Nurs Pract 2002 Jan;16(2):58-79
AD - Department of Health Sciences Research, Mayo Clinic Comprehensive Cancer
Center, Rochester, Minnesota, USA.
Native WEB (Women Enjoying the Benefit) is a unique training program for
nurses employed by the Indian Health Service (IHS), tribal clinics, and
other clinics with large, underserved populations. It teaches nurses
breast and cervix cancer screening techniques and trains them to
administer and maintain high-quality screening programs that include
patient outreach, education, and training. We review American Indian
(AI)/Alaska Native (AN) women's need for screening services, identify
some of the obstacles to screening, and present our evaluation of the
Native WEB's impact on clinics, nurses, and patients. Findings show that
Native WEB training is associated with increased screening activity at
all three levels.
9
UI - 11919069
AU - Hewitt M; Devesa S; Breen N
TI -
Papanicolaou test use among reproductive-age women at high risk for
cervical cancer: analyses of the 1995 National Survey of Family Growth.
SO - Am J Public Health 2002 Apr;92(4):666-9
AD - Institute of Medicine, National Cancer Policy Board, 2101 Constitution
Avenue, Washington, DC 20418, USA. mhewitt@nas.edu
OBJECTIVES: This study assessed the relationship between risk factors
for cervical cancer and Papanicolaou (Pap) test use within the past year
among reproductive-age women. METHODS: The 1995 National Survey of
Family Growth, a demographic and reproductive health survey of 10 847
women aged 15 to 44, was analyzed with multiple logistic regression.
RESULTS: Of the women, 62% reported having had a Pap test within the
past year. Use was significantly higher among women with risk factors
and among African American women. Use was significantly lower among
uninsured, poor, and foreign-born women and among women with lower
educational attainment and of "other" race/ethnicity. CONCLUSIONS:
Strategies to improve Pap test use include (1) educational campaigns
that inform women of cervical cancer risk factors and encourage
screening and (2) increased support for programs that expand access to
Pap tests.
10
UI - 10925628
AU - Apold J; Heimdal K; Moller P
TI -
[Screening for ovarian cancer]
SO - Tidsskr Nor Laegeforen 2000 Jun 20;120(16):1913-4
11
UI - 11801560
AU - Rodriguez-Burford C; Barnes MN; Oelschlager DK; Myers RB; Talley LI;
TI -
Partridge EE; Grizzle WE
Effects of nonsteroidal anti-inflammatory agents (NSAIDs) on ovarian
carcinoma cell lines: preclinical evaluation of NSAIDs as
chemopreventive agents.
SO - Clin Cancer Res 2002 Jan;8(1):202-9
AD - Department of Obstetrics and Gynecology, Comprehensive Cancer Center,
Biostatistics Unit, The University of Alabama at Birmingham, Birmingham,
Alabama 35213, USA.
PURPOSE: Nonsteroidal anti-inflammatory agents may inhibit
carcinogenesis in specific tissues including the colon, breast, and
pancreas, and, hence, may prove to be effective chemopreventive agents.
The purpose of this study was to investigate the cellular effects of
acetylsalicylic acid (ASA), acetaminophen, and a COX-2 inhibitor
(NS-398) on the growth of cell lines of human ovarian cancer in vitro.
EXPERIMENTAL DESIGN: SK-OV-3, Caov-3, and NIH:OVCAR-3 ovarian carcinoma
cell lines were treated with ASA (10(-6) M-10(-2) M), acetaminophen
(10(-6) M-10(-2) M), and a COX-2 inhibitor (10(-6) M-10(-4) M) for 96 h.
The number of viable cells was determined using a tetrazolium conversion
assay. Immunohistochemical assessment was performed for alterations in
expression of Ki-67, erbB-2, COX enzyme, and apoptosis in primary
ovarian cancer cells using terminal deoxynucleotidyl transferase
(Tdt)-mediated nick end labeling assay. RESULTS: A decrease in cell
number compared with controls was observed for all of the cell lines
treated with ASA, acetaminophen, and COX-2 inhibitor by cell count and
tetrazolium conversion assay. A significant decrease in Ki-67 compared
with controls in the OVCAR-3 (P = 0.005) and SK-OV-3 (P = 0.007) cell
lines after treatment with the COX-2 inhibitor was observed. We observed
a decrease in mitotic activity compared with controls in each cell line
after treatment with the COX-2 inhibitor. Apoptosis was observed in
primary ovarian cancer cell culture treated with COX-2 inhibitor.
CONCLUSION: Our results suggest additional study for the use of
nonsteroidal anti-inflammatory agents, specifically COX-2 inhibitors, as
a strategy of chemoprevention for ovarian cancer.
12
UI - 11480666
AU - Wu AH
TI -
Soy and risk of hormone-related and other cancers.
SO - Adv Exp Med Biol 2001;492():19-28
AD - University of Southern California, Department of Preventive Medicine,
Los Angeles 90089, USA.
13
UI - 11925972
AU - Anonymous
TI -
Evaluation of cervical cytology.
SO - Evid Rep Technol Assess (Summ) 1999 Jan;(5):1-6
14
UI - 11902582
AU - Schatzkin A; Gail M
TI -
The promise and peril of surrogate end points in cancer research.
SO - Nature Rev Cancer 2002 Jan;2(1):19-27
AD - Nutritional Epidemiology Branch, Division of Cancer Epidemiology and
Genetics, National Cancer Institute, Bethesda, Maryland 20892-7232, USA.
schatzka@mail.nih.gov
Both experimental and observational studies of cancer need to have an
end point. Traditionally, in aetiological and prevention studies, that
end point has been the incidence of cancer itself, whereas in
therapeutic trials, the end point is usually time to cancer recurrence
or death. But cancer takes a long time to develop in an individual and
is rare in the population. Therefore, aetiological studies and
prevention trials must be large and lengthy to be meaningful. Similarly,
many therapeutic trials require a long follow-up of large numbers of
patients. Surrogate end points--markers of preclinical cancer or of
imminent recurrence--are therefore an attractive alternative. But how
can we be sure that a study with a surrogate outcome gives us the right
answer about the true end point?
15
UI - 11948269
AU - Castellsague X; Bosch FX; Munoz N; Meijer CJ; Shah KV; de Sanjose S;
TI -
Eluf-Neto J; Ngelangel CA; Chichareon S; Smith JS; Herrero R; Moreno V;
Franceschi S; The International Agency for Research on Cancer
Multicenter Cervical Cancer Study Group
Male circumcision, penile human papillomavirus infection, and cervical
cancer in female partners.
SO - N Engl J Med 2002 Apr 11;346(15):1105-12
AD - Servei d'Epidemiologia i Registre del Cancer, Institut Catala
d'Oncologia, Hospitalet de Llobregat, Barcelona, Spain.
xcastellsague@ico.scs.es
BACKGROUND: It is uncertain whether male circumcision reduces the risks
of penile human papillomavirus (HPV) infection in the man and of
cervical cancer in his female partner. METHODS: We pooled data on 1913
couples enrolled in one of seven case-control studies of cervical
carcinoma in situ and cervical cancer in five countries. Circumcision
status was self-reported, and the accuracy of the data was confirmed by
physical examination at three study sites. The presence or absence of
penile HPV DNA was assessed by a polymerase-chain-reaction assay in 1520
men and yielded a valid result in the case of 1139 men (74.9 percent).
RESULTS: Penile HPV was detected in 166 of the 847 uncircumcised men
(19.6 percent) and in 16 of the 292 circumcised men (5.5 percent). After
adjustment for age at first intercourse, lifetime number of sexual
partners, and other potential confounders, circumcised men were less
likely than uncircumcised men to have HPV infection (odds ratio, 0.37;
95 percent confidence interval, 0.16 to 0.85). Monogamous women whose
male partners had six or more sexual partners and were circumcised had a
lower risk of cervical cancer than women whose partners were
uncircumcised (adjusted odds ratio, 0.42; 95 percent confidence
interval, 0.23 to 0.79). Results were similar in the subgroup of men in
whom circumcision was confirmed by medical examination. CONCLUSIONS:
Male circumcision is associated with a reduced risk of penile HPV
infection and, in the case of men with a history of multiple sexual
partners, a reduced risk of cervical cancer in their current female
partners.
16
UI - 11948277
AU - Adami HO; Trichopoulos D
TI -
Cervical cancer and the elusive male factor.
SO - N Engl J Med 2002 Apr 11;346(15):1160-1
17
UI - 11377596
AU - Narod SA; Sun P; Ghadirian P; Lynch H; Isaacs C; Garber J; Weber B;
TI -
Karlan B; Fishman D; Rosen B; Tung N; Neuhausen SL
Tubal ligation and risk of ovarian cancer in carriers of BRCA1 or BRCA2
mutations: a case-control study.
SO - Lancet 2001 May 12;357(9267):1467-70
AD - Centre for Research on Women's Health, University of Toronto, 790 Bay
Street, Room 750, M5G 1N8, Ontario, Canada. steven.narod@swchsc.on.ca
BACKGROUND: In several case-control and prospective studies, tubal
ligation has been associated with a decreased risk of invasive
epithelial ovarian cancer. We aimed to assess the potential of tubal
ligation in reducing the risk of ovarian cancer in women who carry
predisposing mutations in the BRCA1 or BRCA2 genes. METHODS: We did a
matched case-control study among women from Canada, the USA, and the UK
who had undergone genetic testing and who carried a pathogenic mutation
in BRCA1 or BRCA2. Cases were 232 women with a history of invasive
ovarian cancer, and controls were 232 women without ovarian cancer, and
who had both ovaries intact. Cases and controls were matched for year of
birth, country of residence, and mutation (BRCA1 or BRCA2). The odds
ratio for developing ovarian cancer was estimated for tubal ligation,
adjusting for oral contraceptive use, parity, history of breast cancer,
and ethnic group. FINDINGS: In an unadjusted analysis among BRCA1
carriers, significantly fewer cases than controls had ever had tubal
ligation (30 of 173 [18%] vs 60 of 173 [35%], odds ratio 0.37 [95% CI
0.21-0.63]; p=0.0003). After adjustment for oral contraceptive use,
parity, history of breast cancer and ethnic group, the odds ratio was
0.39 (p=0.002). Combination of tubal ligation and past use of an oral
contraceptive was associated with an odds ratio of 0.28 (0.15-0.52). No
protective effect of tubal ligation was seen among carriers of the BRCA2
mutation. INTERPRETATION: Tubal ligation is a feasible option to reduce
the risk of ovarian cancer in women with BRCA1 mutations who have
completed childbearing.
18
UI - 11570410
AU - Gjorgov AN
TI -
Tubal ligation and risk of ovarian cancer.
SO - Lancet 2001 Sep 8;358(9284):843-4; discussion 844
19
UI - 11939723
AU - Davey DD
TI -
Advocating for patient preference in cervical cytology screening.
SO - Am J Clin Pathol 2002 Apr;117(4):517-9
20
UI - 11939725
AU - Raab SS; Grzybicki DM; Hart AR; Kiely S; Andrew-JaJa C; Scioscia E Jr
TI -
Willingness to pay for new Papanicolaou test technologies.
SO - Am J Clin Pathol 2002 Apr;117(4):524-33
AD - Department of Pathology and Laboratory Medicine, Allegheny General
Hospital, Pittsburgh, PA 15212, USA.
The amount of money a woman is willing to pay for liquid-based cytology
technology has not been measured. In the present study, 175 women
answered a questionnaire asking how much they would pay to decrease
their risk of dying of cervical cancer if a new (liquid-based)
Papanicolaou (Pap) test was used in place of the conventional smear.
When women assumed that the new Pap test reduced the risk of dying of
cervical cancer from 1 in 37,000 to 1 in 50,000, the mean amount they
were willing to pay was $237. If women had more than 2 children, they
were willing to pay more for the new Pap test than women with 2 or fewer
children. These data indicate that liquid-based and conventional Pap
tests are undervalued and that cost-effectiveness studies generally have
not taken into account the preference of women for new Pap test
technologies.
21
UI - 9062331
AU - Burke W; Petersen G; Lynch P; Botkin J; Daly M; Garber J; Kahn MJ;
TI -
McTiernan A; Offit K; Thomson E; Varricchio C
Recommendations for follow-up care of individuals with an inherited
predisposition to cancer. I. Hereditary nonpolyposis colon cancer.
Cancer Genetics Studies Consortium.
SO - JAMA 1997 Mar 19;277(11):915-9
AD - Department of Medicine, University of Washington, Seattle 98105-6920,
USA.
OBJECTIVE: To provide recommendations for cancer surveillance and risk
reduction for individuals carrying mutations associated with hereditary
nonpolyposis colon cancer (HNPCC). PARTICIPANTS: A task force with
expertise in medical genetics, oncology, primary care, gastroenterology,
and epidemiology convened by the Cancer Genetics Studies Consortium
(CGSC), organized by the National Human Genome Research Institute
(previously the National Center for Human Genome Research). EVIDENCE:
Studies evaluating cancer risk, surveillance, and risk reduction in
individuals genetically susceptible to colon cancer were identified
using MEDLINE and bibliographies of articles thus identified. Indexing
terms used were "genetics" in combination with "colon cancer," and
"screening" in combination with "cancer family" and "HNPCC." For studies
evaluating specific interventions, quality of evidence was assessed
using criteria of the US Preventive Services Task Force. CONSENSUS
PROCESS: The task force developed recommendations through discussions
over a 14-month period. CONCLUSIONS: Efficacy of cancer surveillance or
other measures to reduce risk in individuals who carry
cancer-predisposing mutations is unknown. Based on observational
studies, colonoscopy every 1 to 3 years starting at age 25 years is
recommended for individuals known to have HNPCC-associated mutations.
Endometrial cancer screening is also recommended, based on expert
opinion concerning presumptive benefit. No recommendation is made for or
against prophylactic surgery (ie, colectomy, hysterectomy); these
surgeries are an option for mutation carriers, but evidence of benefit
is lacking. It is recommended that individuals considering genetic
testing be counseled regarding the unknown efficacy of measures to
reduce risk and that care for individuals with cancer-predisposing
mutations be provided whenever possible within the context of research
protocols designed to evaluate clinical outcomes.
22
UI - 11957447
AU - Fomsgaard A
TI -
[Human papillomavirus testing. Important to differ between screening and
diagnostics]
SO - Ugeskr Laeger 2002 Mar 25;164(13):1831; discussion 1831
23
UI - 11766142
AU - Schwartz PE
TI -
Nongenetic screening of ovarian malignancies.
SO - Obstet Gynecol Clin North Am 2001 Dec;28(4):637-51, vii
AD - Department of Obstetrics and Gynecology, Yale University School of
Medicine, New Haven, Connecticut 06510-3289, USA.
peter.schwartz@yale.edu
Ovarian cancer is the leading pelvic reproductive organ cancer health
hazard for American women. Seventy percent of women are not diagnosed
until the disease is in an advanced stage because of a lack of early
warning signals and effective early detection techniques. Understanding
the risk factors for sporadic ovarian cancer and the recently recognized
inherited susceptibility for ovarian cancer associated with BRCA1 and
BRCA2 gene mutations may allow physicians to identify women who might
benefit from prophylactic oophorectomy. Current early detection
techniques, including serum CA-125 levels and endovaginal ultrasound
studies, are of limited value. Strategies to reduce the risk of ovarian
cancer in women with increased risk include the use of oral
contraceptives and tubal ligations in addition to prophylactic
oophorectomy.
24
UI - 11766143
AU - Unger ER; Duarte-Franco E
TI -
Human papillomaviruses: into the new millennium.
SO - Obstet Gynecol Clin North Am 2001 Dec;28(4):653-66, vii-viii
AD - Division of Viral and Rickettsial Diseases, National Center for
Infectious Diseases, Centers for Disease Control and Prevention,
Atlanta, Georgia 30333, USA. eunger@cdc.gov
Human papillomaviruses (HPV) are newsworthy in this new millennium.
Numerous articles have appeared in the lay press ranging in style and
quality from informative essays to sensationalized exposes. Women,
sensitized by confusing information, are asking obstetricians hard
questions about HPV transmission and prevention, partner notification,
the need for HPV testing, and methods of treatment. These questions are
difficult because none of the answers are clear cut. This article
provides the practicing gynecologist and obstetrician a concise and
accurate summary of clinically important issues surrounding HPV. Current
knowledge about HPV virology, epidemiology, testing, and the prospects
for vaccination and other prevention measures is summarized.
25
UI - 11927505
AU - Wang SS; Hildesheim A; Gao X; Schiffman M; Herrero R; Bratti MC; Sherman
TI -
ME; Barnes WA; Greenberg MD; McGowan L; Mortel R; Schwartz PE; Zaino RJ;
Glass AG; Burk RD; Karacki P; Carrington M
Human leukocyte antigen class I alleles and cervical neoplasia: no
heterozygote advantage.
SO - Cancer Epidemiol Biomarkers Prev 2002 Apr;11(4):419-20
AD - Interdisciplinary Studies Section, Division of Cancer Epidemiology and
Genetics, National Cancer Institute, Bethesda, Maryland 20892, USA.
wangso@mail.nih.gov
26
UI - 11959878
AU - Ngelangel CA; Wang EH
TI -
Cancer and the Philippine Cancer Control Program.
SO - Jpn J Clin Oncol 2002 Mar;32 Suppl():S52-61
AD - Department of Medicine, University of the Phil-Phil General Hospital,
Manila, Philippines.
Cancer is the third leading cause of morbidity and mortality in the
Philippines. Leading cancer sites/types are lung, breast, cervix, liver,
colon and rectum, prostate, stomach, oral cavity, ovary and leukemia.
There is at present a low cancer prevention consciousness and most
cancer patients seek consultation only at advanced stages. Cancer
survival rates are relatively low. The Philippine Cancer Control
Program, begun in 1988, is an integrated approach utilizing primary,
secondary and tertiary prevention in different regions of the country at
both hospital and community levels. Six lead cancers (lung, breast,
liver, cervix, oral cavity, colon and rectum) are discussed. Features
peculiar to the Philippines are described; and their causation and
prevention are discussed. A recent assessment revealed shortcomings in
the Cancer Control Program and urgent recommendations were made to
reverse the anticipated 'cancer epidemic'. There is also today in place
a Community-based Cancer Care Network which seeks to develop a network
of self-sufficient communities sharing responsibility for cancer care
and control in the country.
27
UI - 11921648
AU - Emons G; Westphalen S
TI -
[Hormone replacement therapy in peri- and postmenopause. Routine use is
not indicated]
SO - MMW Fortschr Med 2002 Feb 28;144(9):30-3
AD - Klinik fur Gynakologie und Geburtshilfe, Georg-August-Universitat
Gottingen. emons@med.uni-goettingen.de
Hormone replacement therapy (HRT) with estrogens (in non-hysterectomized
women with estrogens and progestins) during the peri- and postmenopausal
period has been widely applied for many years. On the basis of new data,
HRT is currently being critically reviewed. HRT administered for up to 5
years to treat climacteric hot flashes, mood changes and sleep
disturbances continues to be advocated and is largely safe. When HRT is
used for longer periods, as required for the prevention of osteoporosis,
a possible increase in the relative risk for breast cancer must be
considered. Correctly applied in combination with an adequate dose of
progestins, HRT can avoid an increase in the endometrial cancer risk.
HRT is no longer recommended for secondary prevention of cardiovascular
disease, and its use in primary prevention has not been convincingly
demonstrated. The hoped-for efficacy of HRT in the prevention of
Alzheimer's disease has not been confirmed by the data. Selective
estrogen receptor modulators (e.g. Raloxifene) and biphosphonates are
efficacious drugs for the prevention and treatment of osteoporosis. For
women at risk of developing cardiovascular disease, changes in
lifestyle, lipid-lowering drugs (statins), blood pressure control, use
of acetylsalicylic acid, among others, have well-documented efficacy in
primary and secondary prevention.
28
UI - 11759278
AU - Kasum CM; Nicodemus K; Harnack LJ; Jacobs DR Jr; Folsom AR; Iowa Women's
TI -
Health Study
Whole grain intake and incident endometrial cancer: the Iowa Women's
Health Study.
SO - Nutr Cancer 2001;39(2):180-6
AD - Division of Epidemiology, School of Public Health, University of
Minnesota, Minneapolis, MN 55455, USA.
We examined whether there is an association between whole grain intake
and incident endometrial cancer and whether the association varied by
use of hormone replacement therapy. The study included 23,014 Iowa
women, aged 55-69 years in 1986. A mailed food frequency questionnaire
was used to estimate grain intake, hormone replacement therapy use, and
other cancer risk factors. Cancer incidence from 1986 to 1998 was also
collected. In analyses stratified by hormone replacement therapy use, an
inverse association between whole grain intake and endometrial cancer
was observed among never-users of hormone replacement therapy (p for
trend = 0.05). Never-users in the highest quintile of whole grain intake
were 0.63 times as likely to develop endometrial cancer as those in the
lowest quintile of whole grain intake (95% confidence interval =
0.39-1.01). Among hormone replacement therapy users, no association
between whole grain intake and endometrial cancer was evident. There was
no statistically significant association between whole grain intake and
incident endometrial cancer when users of hormone replacement therapy
and nonusers were analyzed together. There also was no association
between refined grain intake and endometrial cancer. Whole grain intake
may protect against endometrial cancer among never-users of hormone
replacement therapy.
29
UI - 11956270
AU - van Roosmalen MS; Verhoef LC; Stalmeier PF; Hoogerbrugge N; van Daal WA
TI -
Decision analysis of prophylactic surgery or screening for BRCA1
mutation carriers: a more prominent role for oophorectomy.
SO - J Clin Oncol 2002 Apr 15;20(8):2092-100
AD - Joint Center for Radiation Oncology Arnhem-Nijmegen (RADIAN), University
Medical Center Nijmegen, The Netherlands. m.vanroosmalen@rther.azn.nl
PURPOSE: BRCA1 mutation carriers have a high risk of developing breast
and ovarian cancer. Carriers may opt for prophylactic surgery and
screening. Recent data suggesting that prophylactic oophorectomy reduces
breast cancer risk have been incorporated in a decision analysis.
METHODS: A Markov model was developed to compare LE and QALE following
four strategies: (1) prophylactic mastectomy and prophylactic
oophorectomy (PMPO), (2) screening for breast cancer and prophylactic
oophorectomy (BSPO), (3) prophylactic mastectomy and screening for
ovarian cancer (PMOS), and (4) screening for breast and ovarian cancer
(BSOS). The analysis was performed for a high (85% breast cancer, 63%
ovarian cancer) and medium (56% breast cancer, 16% ovarian cancer) risk
level. Utilities for the health states after prophylactic surgery were
obtained from mutation carriers. Other model parameter values were
obtained from the literature. Sensitivity analyses were performed.
RESULTS: When compared with BSOS, the average gain in LE for 30-year-old
carriers in the high (medium) risk group was 11.7 (6.6) years for PMPO,
9.5 (5.3) years for BSPO, and 4.9 (4.4) years for PMOS. For 30-year-old
carriers, BSPO had a QALE advantage when PO was performed before age 40.
In the medium-risk group, there was a stronger advantage for BSPO when
QALE was considered. CONCLUSION: PMPO is the most effective strategy to
prolong life. However, if patient preferences were taken into account,
BSPO tends to be a better strategy in most women at medium risk or in
young women at high risk when PO was performed before age 40.
30
UI - 11187989
AU - Kostova P; Zlatkov V
TI -
[Effectiveness of cervical screening - expectation and reality]
SO - Akush Ginekol (Sofiia) 2000;39(3):23-4
The aim of the present study was to establish the effectiveness of the
conducted in Bulgaria cervical screening program for the period
1975-1996. The dynamics of the ratio invasive cancer/in situ cancer, as
well as the share of the diagnosed from cytologically signalized women
were analyzed. The tendency of deterioration of each of the indices was
evident. The crude incidence varies between 12.7 and 22.7 x 10(5) women,
while the frequency of CIS is from 3.2 and 6.2 x 10(5) women. This
defines unfavorable ratio of the cases with invasive cancer toward CIS,
which varies from 2:1 for 1982 to more than 5:1 for 1996 year. The study
demonstrates the prevalence of a low rate of confirmed by biopsy,
cytologically signalized women--from 15.6% and 30% (total for
country--33.3%), except DOD Blagoevgrad--50.6%, Plovdiv--46.4% and
Sofia-city--63.8%. The results of our study demonstrate the low
effectiveness of to date conducted cervical screening program. The lake
of a screening register is another weakness of the program, which lead
to a deteriorated registration and reading of the detected precancer
lesions, as well as, their diagnostic follow and therapy.
31
UI - 11879283
AU - Yu ES; Kim KK; Chen EH; Brintnall RA
TI -
Breast and cervical cancer screening among Chinese American women.
SO - Cancer Pract 2001 Mar-Apr;9(2):81-91
AD - Division of Epidemiology and Biostatistics, School of Public Health, San
Diego State University, San Diego, California 92182, USA. Echen@UIC.edu
PURPOSE: The purpose of this study was to describe breast and cervical
cancer screening knowledge and practices of a representative sample of
Chinese American women and to examine the factors associated with
screening practices. DESCRIPTION OF STUDY: A random sample of 332
Chinese American women, 40 to 69 years of age, from the Chinatown area
of Chicago, Illinois, were interviewed face to face, using both Chinese
Mandarin (or Putunghua) and Cantonese versions of the National Health
Interview Survey (NHIS) Cancer Control Supplement Questionnaire.
Knowledge and use of mammogram, clinical breast examination (CBE),
breast self-examination (BSE), and Pap smear test were assessed.
RESULTS: The results showed a low level of knowledge of cancer screening
tests and low use rates. Multiple logistics regression analysis showed
that women with spoken English fluency were more likely to have
knowledge and use of CBE, BSE, Pap test, and mammograms. Women with
better than an elementary education were more likely to have knowledge
and use of CBE, BSE, and Pap test. The source of medical care was
statistically significant for having had a mammogram. Knowledge of
cancer warning signs and symptoms was significant for knowledge of
mammogram and BSE and for the use of BSE. CLINICAL IMPLICATIONS:
Multiple strategies are needed. These might include the following: 1)
integration of research with population-based care by physicians and
scientists; 2) coordinated public health education on cancer screening
and postscreening support in Chinese languages; and 3) replication of
the NHIS survey methodology and adaptive application of these
instruments across several states and regions, combined with the
assessment of screening performance in Chinese American populations.
32
UI - 11941821
AU - Vuopala S
TI -
[Is Bethesda system better than Pap classification?]
SO - Duodecim 1999;115(18):2030-4
33
UI - 11966387
AU - Wright TC Jr; Cox JT; Massad LS; Twiggs LB; Wilkinson EJ;
TI -
ASCCP-Sponsored Consensus Conference
2001 Consensus Guidelines for the management of women with cervical
cytological abnormalities.
SO - JAMA 2002 Apr 24;287(16):2120-9
AD - Department of Pathology, College of Physicians and Surgeons of Columbia
University, Room 16-404, P&S Bldg, 630 W 168th St, New York, NY 10032,
USA. tcw1@columbia.edu
OBJECTIVE: To provide evidence-based consensus guidelines for the
management of women with cervical cytological abnormalities and cervical
cancer precursors. PARTICIPANTS: A panel of 121 experts in the diagnosis
and management of cervical cancer precursors, including representatives
from 29 professional organizations, federal agencies, and national and
international health organizations, were invited to participate in a
consensus conference sponsored by the American Society for Colposcopy
and Cervical Pathology (ASCCP). EVIDENCE AND CONSENSUS PROCESS:
Guidelines for the management of women with cervical cytological
abnormalities were developed through a multistep process. Starting 6
months before the conference, working groups developed draft management
guidelines based on formal literature reviews of English-language
articles published in 1988-2001, as well as input from the professional
community at large, obtained using interactive Internet-based bulletin
boards. On September 6-8, 2001, the ASCCP Consensus Conference was held
in Bethesda, Md. Guidelines with supporting evidence were presented and
underwent discussion, revision, and voting. CONCLUSIONS: Management of
women with atypical squamous cells (ASC) depends on whether the
Papanicolaou test is subcategorized as of undetermined significance
(ASC-US) or as cannot exclude high-grade squamous intraepithelial lesion
(HSIL) (ASC-H). Women with ASC-US should be managed using a program of 2
repeat cytology tests, immediate colposcopy, or DNA testing for
high-risk types of human papillomavirus (HPV). Testing for HPV DNA is
the preferred approach when liquid-based cytology is used for screening.
In most instances, women with ASC-H, low-grade squamous intraepithelial
lesion, HSIL, and atypical glandular cells should be referred for
immediate colposcopic evaluation.
34
UI - 11966390
AU - Stoler MH
TI -
New Bethesda terminology and evidence-based management guidelines for
cervical cytology findings.
SO - JAMA 2002 Apr 24;287(16):2140-1
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