UI - 11544696
AU - Nieminen P
[How to read a PAP report?]
SO - Duodecim 1998;114(11):1138-43
AD - HYKS:n naistenklinikka PL 140, 00029 HYKS. firstname.lastname@example.org
UI - 11941821
AU - Vuopala S
[Is Bethesda system better than Pap classification?]
SO - Duodecim 1999;115(18):2030-4
UI - 11072200
AU - Linos A; Riza E; Ballegooijen M
Introduction. Cervical cancer screening.
SO - Eur J Cancer 2000 Nov;36(17):2175-6
AD - Department of Hygiene and Epidemiology, University of Athens Medical
School, 75 Mikras Asias St, GR 115 27 Goudi, Athens, Greece.
UI - 11818195
AU - Miller AB
The (in)efficiency of cervical screening in Europe.
SO - Eur J Cancer 2002 Feb;38(3):321-6
UI - 11930025
AU - Jastreboff AM; Cymet T
Role of the human papilloma virus in the development of cervical
intraepithelial neoplasia and malignancy.
SO - Postgrad Med J 2002 Apr;78(918):225-8
AD - University of Maryland School of Medicine Family Medicine, USA.
Human papilloma virus (HPV) is a public health problem as a sexually
transmitted disease and as a critical factor in the pathogenesis of
various cancers. The clinical manifestations, epidemiology, and virology
that are critical to understanding the process of cervical dysplasia and
neoplasia are reviewed. A discussion of the cervical transformation zone
and the classification of cervical dysplasia and neoplasia leads into
the importance of the Papanicolaou smear in prevention of potentially
devastating sequelae of this virus. The role of the immune system in the
progression of the disease and how it relates to vaccines, as well as
treatment and prevention of HPV, are reviewed.
UI - 11873549
AU - Fries MH; Holt C; Carpenter I; Carter CL; Daniels J; Flanagan J; Murphy
K; Hailey BJ; Martin L; Hume R; Hudson G; Cadman M; Weatherly R; Nunes
Guidelines for evaluation of patients at risk for inherited breast and
ovarian cancer: recommendations of the Department of Defense Familial
Breast/Ovarian Cancer Research Project.
SO - Mil Med 2002 Feb;167(2):93-8
AD - Air Force Medical Genetics Center, Keesler Air Force Base, MS 39534,
Patients at high risk for inherited breast and/or ovarian cancer are
frequently encountered in all medical specialties. Department of
Defense, Health Affairs funding as part of the Breast Cancer Education
and Awareness Program was used to develop a comprehensive program for
the identification, counseling, genetic testing, and long-term follow-up
of such high-risk patients. This article reports the recommendations for
high-risk patient management based on 4 years of evaluation and care,
including discussions of the approach to counseling, indications for
genetic testing, post-testing counseling, patient surveillance with
examination, imagining, and laboratory testing, and suggested options
for surgical and chemoprophylaxis as well as lifestyle modifications.
UI - 11883302
AU - Dudkiewicz J; Waksmanski B; Cieslak-Stec M
[Detection of human papillomavirus genome in cervical squamous
SO - Ginekol Pol 2001 Dec;72(12A):1489-96
AD - Katedry i Kliniki Ginekologii Zabrze SAM Katowice.
OBJECTIVES: The aim of this work was the assessment of the correlation
between different types of HPV and abnormal stages of uterine cervix.
MATERIALS AND METHODS: The smears were simultaneously collected for both
cytooncologic examination and PCR identification of HPV viruses.
Cytologic smears were classified according to the Bethesda system.
RESULTS: A strong relationship between the presence of HPV types 16, 18
and 33 and the intensification of cytologic changes was confirmed. The
more advanced abnormal changes in the uterine cervix, the more often
presence of these HPV types. The presence of HPV types 6 and 11 were
more often in low grade lesions. CONCLUSIONS: The conclusions from this
examinations are: there is a proportional correlation between the grades
of Squamous Intraepithelial Lesions, uterine cervix carcinoma and the
presence of oncogenic types of human papillomavirus.
UI - 11925112
AU - Skates SJ
Screening for ovarian cancer-risk, education, worry: path to appropriate
SO - Gynecol Oncol 2002 Apr;85(1):1-2
UI - 11973975
AU - Makinen J
SO - Duodecim 1999;115(22):2506-7
UI - 11880131
AU - Juneja M; Jose R; Kekre AN; Viswanathan F; Seshadri L
Tamoxifen-induced endometrial changes in postmenopausal women with
SO - Int J Gynaecol Obstet 2002 Mar;76(3):279-84
AD - Department of Obstetrics & Gynecology & Radiotherapy, Christian Medical
College & Hospital, Vellore, India.
OBJECTIVES: To assess the effects of tamoxifen (TAM) on the endometrium
in postmenopausal women. METHODS: A case control study of postmenopausal
women with breast carcinoma, who were undergoing treatment in the
Department of Radiotherapy and Surgery at the Christian Medical College
Hospital, Vellore, India was done. Thirty-five women who were on
tamoxifen (20 mg/day) for a period of at least 6 months formed the study
group. Thirty-three women who were not receiving tamoxifen, formed the
control group. Subjects in both groups had a pelvic examination and
transvaginal sonogram followed by endometrial biopsy. RESULTS: There was
a statistically significant difference in the mean endometrial thickness
between the study group and control group (7.8+/-6.4 mm vs. 4.0+/-2.0
mm, respectively) More women in the tamoxifen group had an endometrial
thickness of >5 mm but the number of women with polyps or hyperplasia of
the endometrium did not differ significantly between the two groups.
There were no women with endometrial carcinoma in either group.
CONCLUSION: All patients on tamoxifen need to be evaluated by clinical
examination annually. A transvaginal sonogram and endometrial
biopsy/hysteroscopy may be performed on patients with abnormal vaginal
bleeding, bloody discharge, staining or spotting.
UI - 11906986
AU - Mauad EC; Gomes UA; Nogueira JL; Melani AG; Lemos DL; Hidalgo GS
Prevention of cervical cancer in a poor population in Brazil.
SO - Fam Pract 2002 Apr;19(2):189-92
AD - Department of Clinical Oncology, Fundacao Pio XII, Barretos and
Faculdade de Medicina de Ribeirao Preto (USP), Ribeirao Preto, Sao
OBJECTIVE: The purpose of this study was to determine the possibility of
providing a cervical screening facility to a poor population. METHODS: A
Paulo and three other neighbouring cities. Performed by a nurse, the
programme included door-to-door interviews and cervical screening. The
Papanicolaou smears were taken either at the community centre or at home
using a portable gynaecological table transportable by bicycle,
developed by the Institution. RESULTS: From 1384 interviewed women, 1044
(75.4%) agreed to undergo the examination and 499 (47.8%) had never had
the test or had not had it repeated within the last 3 years. Among 1044
examined women, seven cases of carcinoma 'in situ', one invasive
squamous cell carcinoma (stage IB) and two polyps were found.
CONCLUSIONS: This study shows that programmes of cancer prevention in
poor populations can be as successful as those carried out in more
developed countries by taking advantage of innovations in the delivery
UI - 11975858
AU - Saraiya M; Lee NC; Blackman D; Smith MJ; Morrow B; McKenna MT
Observations from the CDC. An assessment of Pap smears and
hysterectomies among women in the United States.
SO - J Womens Health Gend Based Med 2002 Mar;11(2):103-9
AD - Division of Cancer Prevention and Control, National Center for Chronic
Disease Prevention and Health Promotion, Centers for Disease Control and
Prevention, and The Klemm Analysis Group, Atlanta, Georgia 30341, USA.
UI - 11973875
AU - Vuopala S
[A comment to Docent Pekka Nieminen]
SO - Duodecim 1999;115(21):2410
UI - 11988058
AU - Mandelblatt JS; Lawrence WF; Womack SM; Jacobson D; Yi B; Hwang YT; Gold
K; Barter J; Shah K
Benefits and costs of using HPV testing to screen for cervical cancer.
SO - JAMA 2002 May 8;287(18):2372-81
AD - Lombardi Cancer Center, 2233 Wisconsin Ave NW, Suite 317, Washington, DC
CONTEXT: Despite quality assurance standards, Papanicolaou (Pap) test
characteristics remain less than optimal. OBJECTIVE: To compare the
societal costs and benefits of human papillomavirus (HPV) testing, Pap
testing, and their combination to screen for cervical cancer. DESIGN,
SETTING, AND POPULATION: A simulation model of neoplasia natural history
was used to estimate the societal costs and quality-adjusted life
expectancy associated with 18 different general population screening
strategies: Pap plus HPV testing, Pap testing alone, and HPV testing
alone every 2 or 3 years among hypothetical longitudinal cohorts of US
women beginning at age 20 years and continuing to 65 years, 75 years, or
death. MAIN OUTCOME MEASURE: Discounted costs per quality-adjusted
life-year (QALY) saved of each screening strategy. RESULTS: Maximal
savings in lives were achieved by screening every 2 years until death
with combined HPV and Pap testing at an incremental cost of $76 183 per
QALY compared with Pap testing alone every 2 years. Stopping biennial
screening with HPV and Pap testing at age 75 years captures 97.8% of the
benefits of lifetime screening at a cost of $70 347 per QALY. Combined
biennial HPV and Pap testing to age 65 years captures 86.6% of the
benefits achievable by continuing to screen until age 75 years. Human
papillomavirus screening alone was equally effective as Pap testing
alone at any given screening interval or age of screening cessation but
was more costly and therefore was dominated. In sensitivity analyses,
HPV testing would be more effective and less costly than Pap testing at
a cost threshold of $5 for an HPV test. CONCLUSIONS: Screening with HPV
plus Pap tests every 2 years appears to save additional years of life at
reasonable costs compared with Pap testing alone. Applying age limits to
screening is a viable option to maintain benefits while reducing costs.
UI - 11988059
AU - Kim JJ; Wright TC; Goldie SJ
Cost-effectiveness of alternative triage strategies for atypical
squamous cells of undetermined significance.
SO - JAMA 2002 May 8;287(18):2382-90
AD - Department of Health Policy and Management, Harvard Center for Risk
Analysis, 718 Huntington Ave, Second Floor, Boston, MA 02115, USA.
CONTEXT: Every year approximately 2 million US women are diagnosed as
having a cervical cytological result of atypical squamous cells of
undetermined significance (ASC-US). OBJECTIVE: To determine the most
efficient and cost-effective management strategy for women in the United
States diagnosed as having ASC-US. DESIGN AND SETTING:
Cost-effectiveness analysis of data from clinical trials, prospective
studies, and other published literature. A computer-based model was used
to compare 4 management strategies for a cytological result of ASC-US:
immediate colposcopy; human papillomavirus (HPV) triage, which includes
colposcopy if high-risk HPV types are detected; repeat cytology, which
includes follow-up cytology at 6 and 12 months and referral for
colposcopy if a repeat abnormal result occurs; and reclassifying ASC-US
as normal in which a cytological result of ASC-US is ignored. Reflex HPV
DNA testing uses either residual liquid-based cytological specimens or
samples co-collected at the time of the initial screening for
conventional cytology. Another method, referred to as the 2-visit HPV
DNA triage, requires a woman with an ASC-US result to return within 1
month to provide another speciman sample. MAIN OUTCOME MEASURES: Years
of life saved (YLS), quality-adjusted life-years (QALYs), and
incremental cost-effectiveness ratios. RESULTS: The least costly
strategy for biennial screening was to reclassify ASC-US as normal,
resulting in a reduction in total cancer incidence of 75% for
conventional cytology and 84% for liquid-based cytology compared with no
screening. The next least costly strategy was HPV DNA testing resulting
in a reduction in total cancer incidence of 86% for conventional
cytology and 90% for liquid-based cytology, followed by immediate
colposcopy with a reduction of 87% and 91%, respectively. Compared with
reflex HPV DNA testing, a strategy of repeat cervical cytology or
delayed HPV testing costs more but is less effective. When all
strategies were compared simultaneously, varying frequency and type of
cytological test, biennial (vs every 3 years) liquid-based cytology with
reflex HPV testing had a cost of $174 200 per YLS. In a similar
comparison, liquid-based cytology with reflex HPV testing conducted
every 3 years (vs every 5 years) had a cost of $59 600 per YLS and was
more effective and less costly than a strategy of conventional cytology
incorporating repeat cytology or immediate colposcopy conducted
biennially. CONCLUSION: Reflex HPV DNA testing provides the same or
greater life expectancy benefits and is more cost-effective than other
management strategies for women diagnosed as having ASC-US.
UI - 11988064
AU - Mark DH
Visualizing cost-effectiveness analysis.
SO - JAMA 2002 May 8;287(18):2428-9
UI - 11814067
AU - Smith RA; Cokkinides V; von Eschenbach AC; Levin B; Cohen C; Runowicz
CD; Sener S; Saslow D; Eyre HJ; American Cancer Society
American Cancer Society guidelines for the early detection of cancer.
SO - CA Cancer J Clin 2002 Jan-Feb;52(1):8-22
AD - Cancer Control Department, American Cancer Society, Atlanta, GA, USA.
Each year the American Cancer Society publishes a summary of existing
recommendations for early cancer detection, including updates, and/or
emerging issues that are relevant to screening for cancer. In last
year's article, the guidelines regarding screening for the early
detection of prostate, colorectal, and endometrial cancers were updated,
as was the narrative pertaining to testing for early lung cancer
detection. Although none of the ACS's guidelines were updated in 2001,
work is proceeding on an update of screening recommendations for breast
and cervical cancer and an update of these guidelines will be announced
review recommendations for the "cancer-related check-up," in which
clinical encounters provide case-finding and health counseling
opportunities. Finally, we provide an update of the most recent data
pertaining to participation rates in cancer screening by age, gender,
and ethnicity from the Centers for Disease Control and Prevention's
Behavioral Risk Factor Surveillance System (BRFSS) and National Health
Interview Survey (NHIS).
UI - 11957447
AU - Fomsgaard A
[Human papillomavirus testing. Important to differ between screening and
SO - Ugeskr Laeger 2002 Mar 25;164(13):1831; discussion 1831
UI - 11570410
AU - Gjorgov AN
Tubal ligation and risk of ovarian cancer.
SO - Lancet 2001 Sep 8;358(9284):843-4; discussion 844
UI - 11930570
AU - Seiser BV
Ovarian cancer strategies for nurse practitioners.
SO - J Am Acad Nurse Pract 2001 Aug;13(8):359-63
AD - Wausau Family Practice Center, Wausau, WI, USA.
PURPOSE: To review and outline practical strategies for the effective
detection and prevention of ovarian cancer. DATA SOURCES: Selected
scientific literature, government consensus findings, and the author's
experience. CONCLUSIONS: Ovarian cancer is the fourth most common cause
of cancer death in American women, ranking behind lung, breast, and
colorectal cancer. Seventy-five percent of ovarian cancers are currently
diagnosed at an advanced stage. IMPLICATIONS FOR PRACTICE: No
cost-effective screening methods are currently available. The battle to
beat ovarian cancer is based on four strategies: identification of risk
factors, appropriate screening methods, early detection, and prevention.
UI - 11995272
AU - Todd RW; Wilson S; Etherington I; Luesley D
Effect of nurse colposcopists on a hospital-based service.
SO - Hosp Med 2002 Apr;63(4):218-23
AD - Department of Obstetrics and Gynaecology, City Hospital NHS Trust,
Birmingham B18 7QH.
The number of colposcopies performed annually in the UK is increasing.
Nurse colposcopists have been introduced by many units to cope with this
workload. The small amount of evidence to support the introduction of
nurse colposcopists suggests that nurses are viable alternative
providers of colposcopy. This study compares the performance of nurse
colposcopists with that of doctors.
UI - 11996168
AU - Rotmensch J
Controversies associated with cervical cytologic screening: a
SO - Am J Clin Pathol 2000 Nov;114 Suppl():S44-7
AD - Section of Gynecologic Oncology, Department of Obstetrics and
Gynecology, University of Chicago, IL 60637, USA.
UI - 11996169
AU - DeMay RM
Should we abandon pap smear testing?
SO - Am J Clin Pathol 2000 Nov;114 Suppl():S48-51
AD - Department of Pathology, Cytopathology Section, University of Chicago,
IL 60637, USA.
UI - 11996170
AU - McCoy DR
Defending the pap smear: a proactive approach to the litigation threat
in gynecologic cytology.
SO - Am J Clin Pathol 2000 Nov;114 Suppl():S52-8
AD - Saperston & Day, Buffalo, NY 14203, USA.
UI - 12023992
AU - Kauff ND; Satagopan JM; Robson ME; Scheuer L; Hensley M; Hudis CA; Ellis
NA; Boyd J; Borgen PI; Barakat RR; Norton L; Castiel M; Nafa K; Offit K
Risk-reducing salpingo-oophorectomy in women with a BRCA1 or BRCA2
SO - N Engl J Med 2002 May 23;346(21):1609-15
AD - Clinical Genetics Service, Memorial Sloan-Kettering Cancer Center, New
York 10021, USA.
BACKGROUND: Risk-reducing salpingo-oophorectomy is often considered by
carriers of BRCA mutations who have completed childbearing. However,
there are limited data supporting the efficacy of this approach. We
prospectively compared the effect of risk-reducing salpingo-oophorectomy
with that of surveillance for ovarian cancer on the incidence of
subsequent breast cancer and BRCA-related gynecologic cancers in women
with BRCA mutations. METHODS: All women with BRCA1 or BRCA2 mutations
identified during a six-year period were offered enrollment in a
prospective follow-up study. A total of 170 women 35 years of age or
older who had not undergone bilateral oophorectomy chose to undergo
either surveillance for ovarian cancer or risk-reducing
salpingo-oophorectomy. Follow-up involved an annual questionnaire,
telephone contact, and reviews of medical records. The time to cancer in
the two groups was compared by Kaplan-Meier analysis and a Cox
proportional-hazards model. RESULTS: During a mean follow-up of 24.2
months, breast cancer was diagnosed in 3 of the 98 women who chose
risk-reducing salpingo-oophorectomy and peritoneal cancer was diagnosed
in 1 woman in this group. Among the 72 women who chose surveillance,
breast cancer was diagnosed in 8, ovarian cancer in 4, and peritoneal
cancer in 1. The time to breast cancer or BRCA-related gynecologic
cancer was longer in the salpingo-oophorectomy group, with a hazard
ratio for subsequent breast cancer or BRCA-related gynecologic cancer of
0.25 (95 percent confidence interval, 0.08 to 0.74). CONCLUSIONS:
Salpingo-oophorectomy in carriers of BRCA mutations can decrease the
risk of breast cancer and BRCA-related gynecologic cancer.
UI - 12023993
AU - Rebbeck TR; Lynch HT; Neuhausen SL; Narod SA; Van't Veer L; Garber JE;
Evans G; Isaacs C; Daly MB; Matloff E; Olopade OI; Weber BL; The
Prevention and Observation of Surgical End Points Study Group
Prophylactic oophorectomy in carriers of BRCA1 or BRCA2 mutations.
SO - N Engl J Med 2002 May 23;346(21):1616-22
AD - Center for Clinical Epidemiology and Biostatistics, University of
Pennsylvania School of Medicine, Philadelphia 19104-6021, USA.
BACKGROUND: Data concerning the efficacy of bilateral prophylactic
oophorectomy for reducing the risk of gynecologic cancer in women with
BRCA1 or BRCA2 mutations are limited. We investigated whether this
procedure reduces the risk of cancers of the coelomic epithelium and
breast in women who carry such mutations. METHODS: A total of 551 women
with disease-associated germ-line BRCA1 or BRCA2 mutations were
identified from registries and studied for the occurrence of ovarian and
breast cancer. We determined the incidence of ovarian cancer in 259
women who had undergone bilateral prophylactic oophorectomy and in 292
matched controls who had not undergone the procedure. In a subgroup of
241 women with no history of breast cancer or prophylactic mastectomy,
the incidence of breast cancer was determined in 99 women who had
undergone bilateral prophylactic oophorectomy and in 142 matched
controls. The length of postoperative follow-up for both groups was at
least eight years. RESULTS: Six women who underwent prophylactic
oophorectomy (2.3 percent) received a diagnosis of stage I ovarian
cancer at the time of the procedure; two women (0.8 percent) received a
diagnosis of papillary serous peritoneal carcinoma 3.8 and 8.6 years
after bilateral prophylactic oophorectomy. Among the controls, 58 women
(19.9 percent) received a diagnosis of ovarian cancer, after a mean
follow-up of 8.8 years. With the exclusion of the six women whose cancer
was diagnosed at surgery, prophylactic oophorectomy significantly
reduced the risk of coelomic epithelial cancer (hazard ratio, 0.04; 95
percent confidence interval, 0.01 to 0.16). Of 99 women who underwent
bilateral prophylactic oophorectomy and who were studied to determine
the risk of breast cancer, breast cancer developed in 21 (21.2 percent),
as compared with 60 (42.3 percent) in the control group (hazard ratio,
0.47; 95 percent confidence interval, 0.29 to 0.77). CONCLUSIONS:
Bilateral prophylactic oophorectomy reduces the risk of coelomic
epithelial cancer and breast cancer in women with BRCA1 or BRCA2
UI - 12024000
AU - Haber D
Prophylactic oophorectomy to reduce the risk of ovarian and breast
cancer in carriers of BRCA mutations.
SO - N Engl J Med 2002 May 23;346(21):1660-2
UI - 11978265
AU - Sulik SM; Becker LA; Grant WD
Liquid-based cervical cytology tests.
SO - J Fam Pract 2002 Apr;51(4):378
UI - 11876611
AU - Gavarasana S; Kalasapudi RS; Rao TD; Thirumala S
Prevention of carcinoma of cervix with human papillomavirus vaccine.
SO - Indian J Cancer 2000 Jun-Sep;37(2-3):57-66
AD - Department of Surgery, Brockton Hospital, MA 02402, USA.
BACKGROUND: Carcinoma of cervix is the most common cancer found among
the women of India. Though cervical cytology screening was effective in
preventing carcinoma of cervix in developed nations, it is considered
unsuitable in developing countries. Recent research has established an
etiological link between human papillomavirus infection and carcinoma of
cervix. In this review, an attempt is made to answer the question,
'whether carcinoma of cervix can be prevented with human papillomavirus
vaccine?' METHODS: Literature search using Pubmed and Medline was
carried out and relevant articles were reviewed. RESULTS: There is ample
experimental evidence to show that DNA of human papillomavirus
integrates with cervical cell genome. Viral genes E6 and E7 of HPV type
16 and 18 inactivate p53 function and Rb gene, thus immortalize the
cervical epithelial cells. Recombinant vaccines blocked the function of
E6 and E7 genes preventing development of papillomas in animals.
Vaccination with HPV-VLPs encoding for genes of E6 and E7 neutralizes
HPV integrated genome of malignant cells of uterine cervix. CONCLUSIONS:
Based on experimental evidence, it is possible to prevent carcinoma of
cervix with human papillomavirus vaccine, IMPLICATIONS: Further research
is necessary to identify a effective and safe HPV vaccine, routes of
administration and characteristics of potential beneficiaries.
UI - 11965215
AU - Blumenthal PD; Ringers P; McIntosh N; Gaffikin L
Innovative approaches to cervical cancer prevention.
SO - Medscape Womens Health 2001 Dec;6(6):1
The above citations and abstracts reflect those newly added to CANCERLIT for the month and topic listed in the title. The citations have been retrieved from CANCERLIT using a predefined search strategy of indexed subject terms. Although the search strategy has been refined as best as possible, citations may appear that are not directly related to the topic, and occasionally relevant references may be omitted.