National Cancer Institute®
Last Modified: April 1, 2002
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.
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. email@example.com
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.
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.
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. firstname.lastname@example.org
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.
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. email@example.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.
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.
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. firstname.lastname@example.org
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.
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
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.
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.
UI - 11925972
AU - Anonymous
TI - Evaluation of cervical cytology.
SO - Evid Rep Technol Assess (Summ) 1999 Jan;(5):1-6
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. email@example.com
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 - 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. firstname.lastname@example.org
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.
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. email@example.com
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.
UI - 11570410
AU - Gjorgov AN
TI - Tubal ligation and risk of ovarian cancer.
SO - Lancet 2001 Sep 8;358(9284):843-4; discussion 844
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.
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.
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
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. firstname.lastname@example.org
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.
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. email@example.com
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.
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. firstname.lastname@example.org
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.
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. email@example.com
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.
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.
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. firstname.lastname@example.org
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.
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.
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.
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. email@example.com
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.
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