UI - 10094000
AU - Eisinger F; Geller G; Burke W; Holtzman NA
Cultural basis for differences between US and French clinical
recommendations for women at increased risk of breast and ovarian
SO - Lancet 1999 Mar 13;353(9156):919-20
AD - Department of Cancer Control and INSERM CRI 9703, Paoli-Calmettes
Institute, Marseille, France.
UI - 11933263
AU - Young NA
Back to the negative Pap test: behind the scenes at Bethesda 2001.
SO - Diagn Cytopathol 2002 Apr;26(4):207-8
UI - 12037019
AU - Burton JL; Wells M
The effect of phytoestrogens on the female genital tract.
SO - J Clin Pathol 2002 Jun;55(6):401-7
AD - Section of Oncology and Pathology, Division of Genomic Medicine,
University of Sheffield Medical School, Beech Hill Road, S10 2RX, UK.
Environmental oestrogens have been implicated in the pathogenesis of
hormonally treated cancers (such as breast and prostate cancer), male
infertility, and abnormalities of the male and female reproductive
tracts. They may be derived from plants (phytoestrogens),
pharmaceuticals, or other synthetic compounds not originally intended to
have oestrogenic activity (including soy based infant formulas). This
review will discuss the evidence from both animal studies and humans for
an effect of these ubiquitous compounds on the development of the human
female genital tract, in addition to prolonging the menstrual cycle,
alleviating symptoms of the menopause, and protecting against the
development of endometrial carcinoma.
UI - 12058160
AU - Champion VL; Rawl SM; Menon U
Population-based cancer screening.
SO - Oncol Nurs Forum 2002 Jun;29(5):853-61
AD - Indiana University of Indianapolis, Indianapolis, IN, USA.
PURPOSE/OBJECTIVES: To provide an overview of current issues surrounding
the prevention of and screening for lung, breast, cervical, colorectal,
ovarian, prostate, and skin cancer. DATA SOURCES: Original research,
review articles, and published guidelines. DATA SYNTHESIS: Although
morbidity and mortality rates have decreased for these cancers,
prevention and early detection still require increased funding and
research. CONCLUSIONS: More behavioral scientists must be trained in
prevention and early detection of cancer, and increased research funding
is necessary to encourage advances in primary and secondary prevention.
IMPLICATIONS FOR NURSING: Oncology nurses should incorporate appropriate
prevention and early-detection strategies into practice.
UI - 12001440
AU - Tiitinen A
[Should estrogen replacement therapy be questioned?]
SO - Duodecim 2000;116(16):1669-71
UI - 11824890
AU - Symonds RP
Is screening for cervical cancer effective?
SO - Clin Oncol (R Coll Radiol) 2001;13(6):473-5
AD - University of Leicester, Leicester Royal Infirmary, UK.
UI - 11965197
AU - Friedenson B
A current perspective on genetic testing for breast and ovarian cancer:
the oral contraceptive decision.
SO - MedGenMed 2001 Nov 2;3(6):2
AD - Department of Biochemistry and Molecular Biology at the University of
Illinois at Chicago, Chicago, Illinois, USA. molmeddoc@Yahoo.com.
A clinician faces a problem in how best to counsel the woman with a
family history of breast or ovarian cancer about her options for
pregnancy prevention. The physician must guide her as she makes new and
complex decisions. Recent data strongly support an amplified effect of
the estrogens in oral contraceptives for the woman with a genetic risk
for breast cancer. Nonetheless, a woman's immediate need to prevent
pregnancy may be much more important to her than worrying about the
long-term risk of breast cancer. Another factor is that oral
contraceptives prevent ovarian cancer, so the physician may wish to
prescribe them to protect her from ovarian cancer. In some genetic
backgrounds, however, oral contraceptives not only do not prevent
ovarian cancer, but they may raise the risk of breast cancer so
significantly that they should not be taken. With other genetic
backgrounds, oral contraceptives will protect the woman from ovarian
cancer without much effect on her breast cancer risk. When does each of
these cancer risks or benefits become significant? The clinician can
provide an important benefit to a woman who must prevent pregnancy yet
worries about her cancer risk. The physician can help her evaluate the
evidence, with its gaps and uncertainties, in the context of her own
preferences. To assist in this evaluation, this decision aid provides
base-line estimates of the cancer risk that accompanies each of a
woman's options. In some cases, genetic testing is likely to provide
valuable information as she makes choices about contraception and the
risks vs. benefits of different alternatives available to her.
UI - 11822759
AU - Bidoli E; Lavecchia C; Talamini R; Negri E; Parpinel M; Conti E;
Montella M; Carbone MA; Franceschi S
Micronutrients and ovarian cancer: a case-control study in Italy.
SO - Ann Oncol 2001 Nov;12(11):1589-93
AD - Servizio di Epidemiologia, Centro di Riferimento Oncologico, Aviano
BACKGROUND: The role of selected micronutrients, vitamins and minerals
in the aetiology of epithelial ovarian cancer was investigated using
data from a case-control study conducted between 1992 and 1999 in five
Italian areas. PATIENTS AND METHODS: Cases were 1,031 patients with
histologically confirmed incident epithelial ovarian cancer. Controls
were 2,411 subjects admitted for acute, non-neoplastic diseases to major
hospitals in the same catchment areas. Dietary habits were elicited
using a validated food frequency questionnaire including 78 food groups
and recipes. Odds ratios (OR) and 95% confidence intervals (95% CI) were
computed by quintiles of intake of nutrients. RESULTS: Inverse
associations emerged for vitamin E (OR = 0.6; 95% CI: 0.5-0.8),
beta-carotene (OR = 0.8; 95% CI: 0.6-1.0), lutein/zeaxanthin (OR = 0.6;
95% CI: 0.5-0.8 for the highest vs. the lowest quintile of intake), and
calcium intake (OR = 0.7; 95% CI: 0.6-1.0). When the combined effect of
calcium and vitamin E was considered, the OR reached 0.4 (95% CI:
0.3-0.7) for subjects in the highest compared to those in the lowest
intake tertile of both micronutrients. Results were consistent across
strata of menopausal status, parity and family history of ovarian or
breast cancer. CONCLUSIONS: The intake of selected micronutrients, which
were positively correlated to a diet rich in vegetables and fruits, was
inversely associated with ovarian cancer.
UI - 11995063
AU - Anonymous
[Nursing and midwifery for Health 21--control of non-transmissible
SO - Osterr Krankenpflegez 2000 Oct;53(10):26-7
UI - 12095952
AU - Kaaks R; Lukanova A
Effects of weight control and physical activity in cancer prevention:
role of endogenous hormone metabolism.
SO - Ann N Y Acad Sci 2002 Jun;963():268-81
AD - International Agency for Research on Cancer, 69372 Lyon Cedex 08,
Excess body weight and/or lack of physical activity are increasingly
recognized as major risk factors for cancer of the colon, breast,
endometrium, and prostate. This paper reviews the effects of excess body
weight and physical inactivity on endogenous hormone metabolism
(insulin, the IGF-I/IGFBP system, and sex steroids) and of endocrine
alterations with risk of cancer of the endometrium, breast, prostate,
UI - 12026751
AU - Puleo E; Zapka J; White MJ; Mouchawar J; Somkin C; Taplin S
Caffeine, cajoling, and other strategies to maximize clinician survey
SO - Eval Health Prof 2002 Jun;25(2):169-84
AD - University of Massachusetts, USA.
An ongoing objective in health services research is to increase response
rates to clinician surveys to ensure generalizability of findings. Three
HMOs in the Cancer Research Network participated in a primary care
clinician survey to better understand organizational characteristics
affecting adoption and implementation of breast and cervical cancer
screening guidelines. A four-stage data collection strategy was
implemented to maximize response. This included careful attention to
survey design and layout, extensive piloting, choice of token incentive,
use of "local champions," and denominator management. An overall
response rate of 91% was attained, ranging from 83 to 100% among the
plans (N = 621). Although the response rate after the second stage of
data collection met commonly used standards, the authors argue for the
four-stage method due to the possibility of differences when comparing
early and late responders. This is important when multiple plans with
differing structure and internal characteristics are surveyed.
UI - 12051864
AU - Rubin SC
Prophylactic oophorectomy comes of age.
SO - Gynecol Oncol 2002 Jun;85(3):395-6
UI - 12051865
AU - Colgan TJ; Boerner SL; Murphy J; Cole DE; Narod S; Rosen B
Peritoneal lavage cytology: an assessment of its value during
SO - Gynecol Oncol 2002 Jun;85(3):397-403
AD - Department of Laboratory Medicine and Pathology, Mount Sinai Hospital,
Toronto, Canada. email@example.com
OBJECTIVE: Prophylactic oophorectomy (PO) is an accepted treatment
strategy for women who are at high risk for the development of ovarian
carcinoma, particularly women who are BRCA mutation-positive. This study
sought to assess the utility of peritoneal lavage cytology at the time
of PO in detecting occult malignancy in this group of patients. METHODS:
Thirty-five high-risk women, who were not suspected of having any
malignancy or ovarian mass, underwent peritoneal lavage at the time of
PO. Thirty-one of the thirty-five women had undergone BRCA mutation
analysis (BRCA1+, 18; BRCA2+, 10; BRCA-, 3). Intensive histopathologic
examination was used in all 35 cases to identify occult carcinoma.
Lavage specimens were reviewed for the presence of malignant cells and
endosalpingiosis. The cytologic review was conducted without knowledge
of either the histopathologic or BRCA results. RESULTS: In 32 of the 35
lavage specimens no malignancy was detected. In the remaining three
cases malignant cells were detected; in two of these cases
histopathologic examination confirmed an ovarian/tubal occult carcinoma.
Two of these women were BRCA1 mutation positive. Endosalpingiosis was
detected in the peritoneal lavage specimens of 7 of the 32 cases showing
no evidence of malignancy. All of these 7 women were BRCA mutation
positive or unknown. CONCLUSION: Peritoneal lavage cytology can detect
occult carcinoma at the time of PO and should be performed at PO. The
significance of occult carcinoma detected by either histopathologic or
cytopathologic examination is uncertain. Whether the prevalence of
endosalpingiosis detectable by lavage cytology is increased in BRCA
mutation-positive patients requires further study.
UI - 12072539
AU - Twombly R
New Pap test terminology, management guidelines published.
SO - J Natl Cancer Inst 2002 Jun 19;94(12):878-80
UI - 12072540
AU - Anonymous
Frequency of cervical cancer screening by age group, 2000.
SO - J Natl Cancer Inst 2002 Jun 19;94(12):879
UI - 12072541
AU - Arnold K
Guidelines for abnormal Pap tests: do physicians follow them?
SO - J Natl Cancer Inst 2002 Jun 19;94(12):880-1
UI - 12117706
AU - Goodman MT; Wu AH; Tung KH; McDuffie K; Kolonel LN; Nomura AM; Terada K;
Wilkens LR; Murphy S; Hankin JH
Association of dairy products, lactose, and calcium with the risk of
SO - Am J Epidemiol 2002 Jul 15;156(2):148-57
AD - Cancer Etiology Program, Cancer Research Center of Hawaii, University of
Hawaii, Honolulu, HI 96813, USA. firstname.lastname@example.org
Epidemiologic findings have been inconsistent regarding the association
of dietary fat, dairy products, and lactose with risk of ovarian cancer.
The authors conducted a case-control study in Hawaii and Los Angeles,
California, to examine several dietary hypotheses regarding the etiology
of ovarian cancer in a population with a broad range of dietary intakes.
A total of 558 patients with ovarian cancer diagnosed in 1993-1999 and
607 controls were interviewed regarding their diet. Consumption of all
dairy products, all types of milk, and low-fat milk, but not consumption
of whole milk, was significantly inversely related to the odds of
ovarian cancer. Similar inverse gradients in the odds ratios were
obtained for intakes of lactose and calcium, although these nutrients
were highly correlated (r = 0.77). The odds ratio for ovarian cancer was
0.46 (95% confidence interval: 0.27, 0.76) among women in the highest
quartile of dietary calcium intake versus the lowest (p for trend =
0.0006). The significant dietary association was limited to dairy
sources of calcium (p for trend = 0.003), although a nonsignificant
inverse gradient in risk was also found in relation to calcium
supplement intake. These results suggest that intake of low-fat milk,
calcium, or lactose may reduce the risk of ovarian cancer.
UI - 12112981
AU - Volm T
Familial ovarian cancer.
SO - Curr Womens Health Rep 2002 Feb;2(1):34-8
AD - Universitats-Frauenklinik Ulm, Prittwitzstrasse 43, 89075 Ulm, Germany.
Women with mutations in the BRCA1 or BRCA2 genes are at increased risk
for the development not only of breast, but of ovarian cancer. The
estimated lifetime risk of contracting ovarian cancer for women bearing
the mutation is 16% for Ashkenazi Jews and up to 60% for high-risk
populations. If a woman is at high familial risk of getting ovarian
cancer, an intense screening with transvaginal ultrasound or
determination of CA 125 can be done, although these methods have not
proved beneficial so far. It is thought by some that the use of the
contraceptive pill can prevent up to 50% of family-associated ovarian
cancers, but the few existing studies have yielded contradictory
results. That prophylactic oophorectomy can prolong the lives of healthy
women with a family history or who bear a germline BRCA mutation is
quite sure, but it is not helpful in preventing peritoneal carcinoma.
The clinicopathologic behavior of mutation-associated ovarian cancer
differs from the growth pattern of sporadic ovarian cancer. The hope is
to develop suitable therapies for both types.
UI - 11902582
AU - Schatzkin A; Gail M
The promise and peril of surrogate end points in cancer research.
SO - Nat 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.
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?
UI - 12115508
AU - Nieminen P; Hakama M; Tarkkanen J; Anttila A
Effect of type of screening laboratory on population-based occurrence of
cervical lesions in Finland.
SO - Int J Cancer 2002 Jun 10;99(5):732-6
AD - Department of Obstetrics and Gynecology, Helsinki University Central
Hospital, Helsinki, Finland. email@example.com
The incidence of cervical cancer decreased in Finland over a 30-year
period because of an effective screening program, but in the beginning
of the 1990s it began to increase. Reasons for such an increase are
variable: changes in sexual habits, shortcomings in attendance for
screening and possibly variation in laboratory quality. We evaluated the
impact of 3 laboratories in the greater Helsinki area on screening
performance and on the incidence of invasive cervical cancer and
preinvasive cervical lesions in the target population. We studied time
trends, geographic differences in attendance and detection rates from
screening and the incidence of invasive cancer in the greater Helsinki
area (population about 1 million) during the 1990s, when screening was
reorganized from the Cancer Society of Finland laboratory to the
municipal one (Helsinki) and to a private laboratory (Espoo), while in
Vantaa screening remained with the same Cancer Society laboratory. The
attendance rate for screening increased during the study period in all 3
cities. The numbers of cytologically suspected and histologically
confirmed precancerous lesions found, including severe lesions,
decreased significantly with the change of laboratory in Espoo; but in
Helsinki and Vantaa, they increased. The overall incidence of invasive
cervical cancer increased in all cities in the age groups screened but
mostly in Espoo. The rather rapid changes and variation in trends in the
number of screening findings cannot be explained by changes in etiologic
factors or attendance. They may be related more to the quality of the
laboratory performance and perhaps to the criteria used in cytology and
colposcopy. A well-organized auditing system is proposed to maintain
high quality in screening. Copyright 2002 Wiley-Liss, Inc.
UI - 12060075
AU - Wilson PO
Cervical cancer audit: and what is quality?
SO - Cytopathology 2002 Jun;13(3):141-4
UI - 12080158
AU - Lorant V; Boland B; Humblet P; Deliege D
Equity in prevention and health care.
SO - J Epidemiol Community Health 2002 Jul;56(7):510-6
AD - Health Sociology and Economics, School of Public Health, Faculty of
Medicine, Universite Catholique de Louvain, Brussels, Belgium.
STUDY OBJECTIVE: There is an increasing body of evidence about
socioeconomic inequality in preventive use, mostly for cancer screening.
But as far as needs of prevention are unequally distributed, even equal
use may not be fair. Moreover, prevention might be unequally used in the
same way as health care in general. The objective of the paper is to
assess inequity in prevention and to compare socioeconomic inequity in
preventive medicine with that in health care. DESIGN: A cross sectional
Health Interview Survey was carried out in 1997 by face to face
interview and self administered questionnaire. Two types of health care
utilisation were considered (contacts with GPs and with specialists) and
four preventive care mostly delivered in a GP setting (flu vaccination,
cholesterol screening) or in a specialty setting (mammography and pap
smear). SETTING: Belgium. PARTICIPANTS: A representative sample of 7378
residents aged 25 years and over (participation rate: 61%). Outcome
measure: Socioeconomic inequity was measured by the HI(wvp) index, which
is the difference between use inequality and needs inequality. Needs was
computed as the expected use by the risk factors or target groups. MAIN
RESULTS: There was significant inequity for all medical contacts and
preventive medicine. Medical contacts showed inequity favouring the rich
for specialist visits and inequity favouring the poor for contacts with
GPs. Regarding preventive medicine, inequity was high and favoured the
rich for mammography and cervical screening; inequity was lower for flu
immunisation and cholesterol screening but still favoured the higher
socioeconomic groups. In the general practice setting, inequity in
prevention was higher than inequity in health care; in the specialty
setting, inequity in prevention was not statistically different from
inequity in health care, although it was higher than in the general
practice setting. CONCLUSIONS: If inequity in preventive medicine is to
be lowered, the role of the GP must be fostered and access to specialty
medicine increased, especially for cancer screening.
UI - 12079295
AU - De Palo G; Mariani L; Camerini T; Marubini E; Formelli F; Pasini B;
Decensi A; Veronesi U
Effect of fenretinide on ovarian carcinoma occurrence.
SO - Gynecol Oncol 2002 Jul;86(1):24-7
AD - Unit of Preventive Medicine and Cancer Family Clinic, Istituto Nazionale
Tumori, Milan, Italy.
OBJECTIVE: The aim of this study was to update the effect of
fenretinide, a synthetic vitamin A analogue proposed for
chemoprevention, on the occurrence of ovarian carcinoma. METHODS: Data
were obtained from a randomized clinical trial for the prevention of
second breast cancer. For the present investigation, events of interest
were new primary carcinomas of the ovary arising in the fenretinide or
the no-treatment (control) arm. The probability of carrying a BRCA
germ-line mutation was assessed in women with ovarian carcinoma
according to G. Parmigiani et al. (1998, Am J Hum Genet 62, 145-58).
RESULTS: Fenretinide reduced ovarian carcinoma occurrence during the
5-year intervention period (0 versus 6 cases in the fenretinide and
control arm, P = 0.0327). This effect was no longer evident after the
5-year intervention period (6 versus 4 cases, P = 0.7563). Therefore
with median observation time of 121 months, a total of 6 carcinomas of
the ovary occurred in the fenretinide group and 10 in the control group.
The probability of carrying a BRCA mutation was lower for women with
ovarian carcinoma in the treatment arm. CONCLUSION: Fenretinide
treatment was associated with a lower incidence of ovarian carcinoma
during the intervention period but such a protective effect seems to
disappear after treatment. Furthermore, a possible protective effect of
fenretinide in BRCA-mutated women was suggested. Further studies on
fenretinide for the prevention of ovarian carcinoma particularly in
women with genetic susceptibility appear necessary. (c) 2002 Elsevier
UI - 12115366
AU - Coughlin SS; Thompson TD; Hall HI; Logan P; Uhler RJ
Breast and cervical carcinoma screening practices among women in rural
and nonrural areas of the United States, 1998-1999.
SO - Cancer 2002 Jun 1;94(11):2801-12
AD - Division of Cancer Prevention and Control, National Center for Chronic
Disease Prevention and Health Promotion, Centers for Disease Control and
Prevention, Atlanta, Georgia 30341,USA. firstname.lastname@example.org
BACKGROUND: Prior studies have suggested that women living in rural
areas may be less likely than women living in urban areas to have had a
recent mammogram and Papanicolau (Pap) test and that rural women may
face substantial barriers to receiving preventive health care services.
METHODS: The authors examined both breast and cervical carcinoma
screening practices of women living in rural and nonrural areas of the
United States from 1998 through 1999 using data from the Behavioral Risk
Factor Surveillance System. The authors limited their analyses of
screening mammography and clinical breast examination to women aged 40
years or older (n = 108,326). In addition, they limited their analyses
of Pap testing to women aged 18 years or older who did not have a
history of hysterectomy (n = 131,813). They divided the geographic areas
of residence into rural areas and small towns, suburban areas and
smaller metropolitan areas, and larger metropolitan areas. RESULTS:
Approximately 66.7% (95% confidence interval [CI] = 65.8% to 67.6%) of
women aged 40 years or older who resided in rural areas had received a
mammogram in the past 2 years, compared with 75.4% of women living in
larger metropolitan areas (95% CI = 74.9% to 75.9%). About 73.0% (95% CI
= 72.2% to 73.9%) of women aged 40 years or older who resided in rural
areas had received a clinical breast examination in the past 2 years,
compared with 78.2% of women living in larger metropolitan areas (95% CI
= 77.8% to 78.7%). About 81.3% (95% CI = 80.6% to 82.0%) of 131,813
rural women aged 18 years or older who had not undergone a hysterectomy
had received a Pap test in the past 3 years, compared with 84.5% of
women living in larger metropolitan areas (95% CI = 84.1% to 84.9%). The
differences in screening across rural and nonrural areas persisted in
multivariate analysis (P < 0.001). CONCLUSIONS: These results underscore
the need for continued efforts to provide breast and cervical carcinoma
screening to women living in rural areas of the United States. Copyright
2002 American Cancer Society.
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