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Abramson Cancer CenterNCI CANCERLIT® Search: Screening and Prevention of Gynecologic Neoplasms - June 2002
National Cancer Institute®
Last Modified: June 1, 2002
- Does cervical cancer screening do more harm than good?
- Cervical cancer screening.
- State trends in health risk factors and receipt of clinical preventive services among US adults during the 1990s.
- Effect of prevention strategies on survival and quality-adjusted survival of women with BRCA1/2 mutations: an updated decision analysis.
- Use of preventive services in a population of very low-income women.
- Recruitment strategies for cervical cancer prevention study.
- Effects of difluoromethylornithine on growth inhibition and apoptosis in human cervical epithelial and cancerous cell lines.
- Ignore smears against cervical screening.
- Is it reality or an illusion that liquid-based cytology is better than conventional cervical smears? Authors' reply.
- Is it reality or an illusion that liquid-based cytology is better than conventional cervical smears?
- Is it reality or an illusion that liquid-based cytology is better than conventional cervical smears?
- Is it reality or an illusion that liquid-based cytology is better than conventional cervical smears?
- Liquid-based cytology: is this the way forward for cervical screening?
- Diagnosing human papillomaviruses: recent advances.
- [Hormone replacement therapy and ovarian tumors]
- Breast and cervical cancer screening in Hispanic women: a literature review using the health belief model.
- The association of health literacy with cervical cancer prevention knowledge and health behaviors in a multiethnic cohort of women.
- Human papillomavirus detection for cervical cancer prevention with polymerase chain reaction in self-collected samples.
- Advances highlighted at US cancer meeting.
- Equity versus efficiency: a dilemma for the NHS. If the NHS is serious about equity it must offer guidance when principles conflict.
- [Colpocytology in a preventive gynecological ambulatory service]
- [Genital human papillomavirus infection identification by molecular biology among asymptomatic women]
- An economic appraisal of a mobile cervical cytology screening service.
- Prophylactic surgery in patients with inherited risk of ovarian cancer.
- The acceptability of self-collected samples for HPV testing vs. the pap test as alternatives in cervical cancer screening.
- Cervical cancer, oral contraceptives and parity.
- BRCAPRO validation, sensitivity of genetic testing of BRCA1/BRCA2, and prevalence of other breast cancer susceptibility genes.
- Primary screening with liquid-based cytology in an unscreened population in rural China, with an emphasis on reprocessing unsatisfactory samples.
- Cancer studies explore targeted therapy, researchers seek new prevention strategies.
- Women who participate in spontaneous screening are not at higher risk for cervical cancer than women who attend programme screening.
Table of Contents
1
UI - 11957496
AU - Payne L; Lavis P
TI -
Does cervical cancer screening do more harm than good?
SO - Nurs Times 2001 Jul 19-25;97(29):20
AD - Darent Valley Hospital, Dartford.
2
UI - 12018800
AU - Teichman P
TI -
Cervical cancer screening.
SO - Am Fam Physician 2002 May 1;65(9):1747, 1751
3
UI - 12020301
AU - Nelson DE; Bland S; Powell-Griner E; Klein R; Wells HE; Hogelin G; Marks
TI -
JS
State trends in health risk factors and receipt of clinical preventive
services among US adults during the 1990s.
SO - JAMA 2002 May 22-29;287(20):2659-67
AD - National Cancer Institute, Division of Cancer Control and Population
Sciences, 6130 Executive Blvd, MSC 7365, EPN 4068, Bethesda, MD
20892-7365, USA. nelsond@mail.nih.gov
CONTEXT: Monitoring trends is essential for evaluating past activities
and guiding current preventive health program and policy efforts.
Although tracking progress toward national health goals is helpful, use
of national estimates is limited because most preventive health care
activities, policies, and other efforts occur at the state or community
level. There may be important state trends that are obscured by national
data. OBJECTIVE: To estimate state-specific trends for 5 health risk
factors and 6 clinical preventive services. DESIGN: Telephone surveys
were conducted from 1991 through 2000 as part of the Behavioral Risk
Factor Surveillance System. SETTING AND PARTICIPANTS: Randomly selected
adults aged 18 years or older from 49 US states. Annual state sample
sizes ranged from 1188 to 7543. MAIN OUTCOME MEASURES: Statistically
significant changes (P<.01) in state prevalences of cigarette smoking,
binge alcohol use, physical inactivity, obesity, safety belt use, and
mammography; screening for cervical cancer, colorectal cancer, and
cholesterol levels; and receipt of influenza and pneumococcal disease
vaccination. RESULTS: There were statistically significant increases in
safety belt use for 39 of 47 states and receipt of mammography in the
past 2 years for women aged 40 years or older for 43 of 47 states. For
persons aged 65 years or older, there were increases in receipt of
influenza vaccination for 44 of 49 states and ever receiving
pneumococcal vaccination for 48 of 49 states. State trends were mixed
for binge alcohol use (increasing in 19 of 47 states and declining in
3), physical inactivity (increasing in 3 of 48 states and declining in
11), and cholesterol screening (increasing in 13 of 47 states and
decreasing in 5). Obesity increased in all states and smoking increased
in 14 of 47 states (declining only in Minnesota). Cervical cancer
screening increased in 8 of 48 states and colorectal cancer screening
increased in 13 of 49 states. New York experienced improvements for 8 of
11 measures, while 7 of 11 measures improved in Delaware, Kentucky, and
Maryland; in contrast, Alaska experienced improvements for no measures
and at least 4 of 11 measures worsened in Iowa, North Dakota, and South
Dakota. CONCLUSIONS: Most states experienced increases in safety belt
use, mammography, and adult vaccinations. Trends for smoking and binge
alcohol use are disturbing, and obesity data support previous findings.
Trend data are useful for targeting state preventive health efforts.
4
UI - 12011131
AU - Grann VR; Jacobson JS; Thomason D; Hershman D; Heitjan DF; Neugut AI
TI -
Effect of prevention strategies on survival and quality-adjusted
survival of women with BRCA1/2 mutations: an updated decision analysis.
SO - J Clin Oncol 2002 May 15;20(10):2520-9
AD - Herbert Irving Comprehensive Cancer Center, Department of Medicine,
College of Physicians and Surgeons, Columbia University, 630 W 168th
Street, New York, NY 10032, USA.
PURPOSE: This study updates findings regarding the effects of
prophylactic surgery, chemoprevention, and surveillance on the survival
and quality-adjusted survival of women who test positive for BRCA1/2
mutations. MATERIALS AND METHODS: Markov modeling of outcomes was
performed in a simulated cohort of 30-year-old women who tested positive
for BRCA1/2 mutations. The model incorporated breast and ovarian cancer
incidence rates from the literature and mortality rates from the
Surveillance, Epidemiology, and End Results Program. Quality adjustment
of survival estimates were obtained from a survey of women aged 33 to 50
years. Sensitivity analyses were performed of varied assumptions
regarding timing and effects of preventive measures on cancer incidence
and adverse effects. RESULTS: A 30-year-old woman could prolong her
survival beyond that associated with surveillance alone by use of
preventive measures: 1.8 years with tamoxifen, 2.6 years with
prophylactic oophorectomy, 4.6 years with both tamoxifen and
prophylactic oophorectomy, 3.5 years with prophylactic mastectomy, and
4.9 years with both surgeries. She could prolong her quality-adjusted
survival by 2.8 years with tamoxifen, 4.4 years with prophylactic
oophorectomy, 6.3 years with tamoxifen and oophorectomy, and 2.6 years
with mastectomy, or with both surgeries. The benefits of all of these
strategies would decrease if they were initiated at later ages.
CONCLUSION: Women who test positive for BRCA1/2 mutations may derive
greater survival and quality adjusted survival benefits than previously
reported from chemoprevention, prophylactic surgery, or a combination.
Observational studies and clinical trials are needed to verify the
results of this analysis of the long-term benefits of preventive
strategies among BRCA1/2-positive women.
5
UI - 12017906
AU - Diamant AL; Brook RH; Fink A; Gelberg L
TI -
Use of preventive services in a population of very low-income women.
SO - J Health Care Poor Underserved 2002 May;13(2):151-63
AD - Division of General Medicine and Health Services Research, University of
California, Los Angeles, USA.
6
UI - 11972383
AU - Brewster WR; Anton-Culver H; Ziogas A; Largent J; Howe S; Hubbell FA;
TI -
Manetta A
Recruitment strategies for cervical cancer prevention study.
SO - Gynecol Oncol 2002 May;85(2):250-4
AD - Epidemiology Division, Department of Medicine, University of
California-Irvine, 224 Irvine Hall, Irvine, CA 92697-7550, USA.
wrbrewst@uci.edu
OBJECTIVE: The aim of this study was to describe recruitment strategies
for a single-visit cervical cancer prevention study. METHODS: From
were recruited to participate in a single-visit cervical cancer
prevention study. For the first 6 months, all women who had ever visited
one of two community-based study clinics were invited to participate
(clinic registry recruitment). For the remainder of the year,
recruitment was modified to be primarily inclusive of advertisements in
English- and Spanish-language community newspapers and fliers left in
local businesses and organizations (media campaign recruitment).
Eligible volunteers were randomized to one of two study arms, usual-care
program or single-visit program. All study subjects completed
demographic and medical questionnaires delivered by bilingual staff.
Women who declined to participate in this study were asked to provide
reasons for this preference. Statistical analyses included the use of
chi-square, logistic regression, and Student's t test. RESULTS: The
proportion of women who agreed to participate was higher in the media
recruitment group than in the clinic registry group [51% (535/1041)
compared to 26% (405/1542), P < 0.001]. The no-show rate among
participants solicited from the media strategy was significantly less
than that from the clinic registry. There were no significant
differences in the median age, number of months since the last
Papanicolaou smear, incidence of abnormal Papanicolaou smear, education,
or income of the subjects based on the recruitment strategy. CONCLUSION:
A media-based recruitment strategy was effective for this single-visit
cervical prevention study. This approach may be effective for
recruitment of other low-income groups to clinical trials.
7
UI - 11972386
AU - Zou C; Vlastos AT; Yang L; Wang J; Nishioka K; Follen M
TI -
Effects of difluoromethylornithine on growth inhibition and apoptosis in
human cervical epithelial and cancerous cell lines.
SO - Gynecol Oncol 2002 May;85(2):266-73
AD - Department of Obstetrics, Gynecology, and Reproductive Sciences,
University of Texas Medical School at Houston, 1515 Holcombe Boulevard,
Houston, TX 77030, USA.
OBJECTIVE: Difluoromethylornithine(DFMO), an irreversible inhibitor of
ornithine decarboxylase and an angiogenesis inhibitor, has been used in
phase I cervical intraepithelial neoplasia (CIN) trials, producing a 50%
regression of CIN 3 lesions. DFMO is currently in phase II trials. In
the experiments reported here, DFMO's growth inhibition and apoptosis
induction were explored in an in vitro model to elucidate mechanisms of
action. METHODS: Four immortalized cervical epithelial cell lines,
serving as in vitro models of precancerous CIN lesions, and nine
cervical carcinoma cell lines were studied. DFMO's growth inhibitory
effect was tested in monolayer culture and in semisolid medium, and
concentrations required for a 50% growth inhibition (IC(50)) with a
5-day treatment were determined. Apoptosis induction was analyzed using
the terminal deoxynucleotidyl transferase assay of DNA fragmentation.
RESULTS: DFMO inhibited growth of immortalized cervical epithelial cell
lines and cervical cancer cell lines in monolayer culture and in
semisolid medium. The immortalized cervical epithelial cell lines were
more sensitive than the cervical cancer cell lines to DFMO's growth
inhibitory effect. Concentrations required for 50% growth inhibition
after a 5-day treatment ranged from 100 microM to >5 mM for cervical
carcinoma cell lines and from 100 microM to 1 mM for immortalized
cervical epithelial cell lines. DFMO induced apoptosis in precancerous
and cancerous cell lines at a concentration of 5 mM, regardless of the
cells' human papillomavirus status. CONCLUSION: DFMO inhibits the growth
of cervical precancerous and cancerous cells in vitro in a
dose-dependent and time-dependent manner, partially through inducing
apoptosis. (c) 2002 Elsevier Science (USA).
8
UI - 11957524
AU - Houghton J
TI -
Ignore smears against cervical screening.
SO - Nurs Times 2001 Aug 2-8;97(31):18
9
UI - 11952753
AU - Herbert A; Johnson J
TI -
Is it reality or an illusion that liquid-based cytology is better than
conventional cervical smears? Authors' reply.
SO - Cytopathology 2002 Apr;13(2):133
10
UI - 11952754
AU - Imrie JE; Gardiner DS; Wilson A
TI -
Is it reality or an illusion that liquid-based cytology is better than
conventional cervical smears?
SO - Cytopathology 2002 Apr;13(2):133-4
11
UI - 11952755
AU - Clelland CA
TI -
Is it reality or an illusion that liquid-based cytology is better than
conventional cervical smears?
SO - Cytopathology 2002 Apr;13(2):134-5
12
UI - 11952756
AU - Moseley R
TI -
Is it reality or an illusion that liquid-based cytology is better than
conventional cervical smears?
SO - Cytopathology 2002 Apr;13(2):135-6
13
UI - 11952745
AU - Moseley RP; Paget S
TI -
Liquid-based cytology: is this the way forward for cervical screening?
SO - Cytopathology 2002 Apr;13(2):71-82
AD - The Pauline Cooper Department of Cytology, Addenbrooke's Hospital, Hills
Road, Cambridge CB2 2QQ, UK. rpm21@hermes.cam.ac.uk
Liquid-based cytology (LBC) is currently being marketed as an
alternative methodology to replace the conventional PAP smear in
cervical cytology. A substantial body of literature exists in support of
LBC, some of which is at least partially sponsored by product
manufacturers. The majority of published literature in support of LBC
employs Bethesda reporting terminology. In this study we have analysed
published raw data and presented this in NHSCSP terminology. Claims
relating to sensitivity, specificity and smear adequacy have then been
considered with reference to this data. Our analysis of existing data
does not support the nationwide implementation of LBC at present.
Further studies are recommended in order to evaluate the place of this
technology within the NHSCSP.
14
UI - 11979116
AU - Jenkins D
TI -
Diagnosing human papillomaviruses: recent advances.
SO - Curr Opin Infect Dis 2001 Feb;14(1):53-62
AD - Division of Pathology, Faculty of Medicine and Health Sciences,
University of Nottingham, Nottingham, UK. david.jenkins@nottingham.ac.uk
The biological importance of a group of human papillomaviruses, known as
high-risk human papillomaviruses, as the key causal agent for almost all
cervical cancer has now been established. Many aspects of the natural
history of high-risk human papillomaviruses as sexually transmitted
infections and as oncogenic agents have been researched. Although human
papillomavirus diagnosis is largely confined to DNA detection techniques
in cervical smears, there is accumulating evidence that the best
polymerase chain reaction and hybrid capture techniques are more
sensitive and probably of similar specificity compared with cervical
cytology as a triage test for women with borderline smear abnormalities
and for screening older women. This is strong presumptive evidence that
high-risk human papillomavirus testing could be useful in cervical
screening. Current research is aimed at establishing a place for
high-risk human papillomavirus testing in routine screening practice.
Randomised clinical trials, long-term natural history studies,
mathematical modelling, and economic and psychosocial studies are being
used to demonstrate whether this testing can improve both the
effectiveness and efficiency of cervical screening in a range of
situations.
15
UI - 11987569
AU - Sevcik L; Klat J; Koliba P
TI -
[Hormone replacement therapy and ovarian tumors]
SO - Ceska Gynekol 2002 Mar;67(2):55-8
AD - Porodnicko-gynekologicka klinika, FNsP Ostrava.
OBJECTIVE: Analysis of risk and protective factors and hormone
replacement therapy in the aethiology and pathogenesis of ovarian
cancer. The role of hormone replacement therapy in the complex treatment
in women with ovarian cancer is discussed. DESIGN: Reviewed article.
SETTING: Department of Obstetrics and Gynaecology, University Hospital
Ostrava. METHODS: Analysis of epidemiological studies. CONCLUSION: The
role of hormone replacement therapy as a risk factor of ovarian cancer
has not been confirmed. Hormone replacement therapy as a part of
supportive and symptomatic therapy has been acceptable in a great deal
of patients with ovarian cancer.
16
UI - 12015184
AU - Austin LT; Ahmad F; McNally MJ; Stewart DE
TI -
Breast and cervical cancer screening in Hispanic women: a literature
review using the health belief model.
SO - Womens Health Issues 2002 May-Jun;12(3):122-8
AD - University Health Network Women's Health Program, Toronto, Ontario,
Canada.
The aim of this study was to review published studies that examined
factors influencing breast and cervical cancer screening behavior in
Hispanic women, using the Health Belief Model (HBM). MEDLINE and
PsycINFO databases and manual search were used to identify articles.
Cancer screening barriers common among Hispanic women include fear of
cancer, fatalistic views on cancer, linguistic barriers, and culturally
based embarrassment. In addition, Hispanic women commonly feel less
susceptible to cancer, which is an important reason for their lack of
screening. Positive cues to undergo screening include physician
recommendation, community outreach programs with the use of Hispanic lay
health leaders, Spanish print material, and use of culturally specific
media. Critical review of the literature using the theoretical framework
of the Health Belief Model identified several culturally specific
factors influencing cancer screening uptake and compliance among
Hispanic women. Future interventions need to be culturally sensitive and
competent.
17
UI - 12015518
AU - Lindau ST; Tomori C; Lyons T; Langseth L; Bennett CL; Garcia P
TI -
The association of health literacy with cervical cancer prevention
knowledge and health behaviors in a multiethnic cohort of women.
SO - Am J Obstet Gynecol 2002 May;186(5):938-43
AD - Department of Obstetrics and Gynecology, Northwestern University Medical
School, the University of Chicago Robert Wood Johnson Clinical Scholars
Program, Ill 60637, USA.
OBJECTIVE: Our purpose was to describe the relationship between health
literacy, ethnicity, and cervical cancer screening practices and to
evaluate physician recognition of low literacy. STUDY DESIGN: We studied
a prospective cohort of English-speaking patients > or =18 years (n =
529) in ambulatory women's clinics. Univariate and multivariate analyses
were used to evaluate demographics, health practices and beliefs, and
knowledge regarding cervical cancer screening and prevention.
Physicians' assessments of patient reading skills were obtained.
RESULTS: Low health literacy (<9th grade) was found among 40% of
participants. Minority women were half as likely to know the purpose of
the Papanicolaou test (9% vs 21%; P <.03) and were significantly more
likely to have low literacy levels compared with white women (46% vs
15%; P <.05). Literacy was the only factor independently associated with
knowledge related to cervical cancer screening (adjusted odds ratio,
2.25; 95% CI, 1.05-4.80). Physicians detected only 20% of the lowest
readers. CONCLUSION: Poor health literacy was a better predictor of
cervical cancer screening knowledge than ethnicity or education, yet
physicians infrequently recognized low literacy. Improved physician
awareness and development of low literacy interventions may improve
cervical cancer screening, particularly for the most vulnerable women.
18
UI - 12015522
AU - Lorenzato FR; Singer A; Ho L; Santos LC; Batista Rde L; Lubambo TM;
TI -
Terry G
Human papillomavirus detection for cervical cancer prevention with
polymerase chain reaction in self-collected samples.
SO - Am J Obstet Gynecol 2002 May;186(5):962-8
AD - Department of Obstetrics and Gynecology, Instituto Materno Infantil de
Pernambuco, Brazil. lorenzato@br.inter.net
OBJECTIVE: We studied the usefulness of self-sampling in cervical cancer
prevention. STUDY DESIGN: A cross-sectional study was undertaken at
screening services in Recife (Brazil); 253 women aged 16 to 88 years
were included. Participants were randomly selected from a high-risk
population for cervical neoplasia. All participants collected a
self-sample with a cotton-tipped swab by rotating it against the vaginal
epithelium and, possibly, the cervix. Physician-collected samples from
the ectocervix and endocervix, respectively, with an Ayre's spatula and
a Cytobrush endocervical brush (Medscand) were followed by thorough
colposcopy. Human papillomaviruses were detected by consensus polymerase
chain reaction and typed by restriction fragment length polymorphism.
RESULTS: The difference among human papillomavirus results in samples
that were self-collected versus physician collected was significant (P
<.03). The agreements were poor among patients with cervical
intraepithelial neoplasia (CIN) grade 3 (kappa <0.29) and cervical
cancer (kappa < 0.10). Self-sampling missed 50% more cancers than did
physician sampling (P =.04). CONCLUSION: Self-sampling with a
cotton-tipped swab for human papillomavirus detection is not a safe
method for the collection of samples that are aimed at primary cervical
cancer screening.
19
UI - 12044383
AU - McCarthy M
TI -
Advances highlighted at US cancer meeting.
SO - Lancet 2002 May 25;359(9320):1835
20
UI - 11588063
AU - Sassi F; Le Grand J; Archard L
TI -
Equity versus efficiency: a dilemma for the NHS. If the NHS is serious
about equity it must offer guidance when principles conflict.
SO - BMJ 2001 Oct 6;323(7316):762-3
21
UI - 11813045
AU - Motta EV; Fonseca AM; Bagnoli VR; Ramos L; Pinotti JA
TI -
[Colpocytology in a preventive gynecological ambulatory service]
SO - Rev Assoc Med Bras 2001 Oct-Dec;47(4):302-10
AD - Divisao de Ginecologia, Hospital das Clinicas, Faculdade de Medicina,
Universidade de Sao Paulo.
BACKGROUND: evaluate the results of Pap smear in women attended at a
gynecology preventive ambulatory (University of Sao Paulo Medical School
Clinical Hospital). METHODS: 6821 women were submitted to a medical
interview, clinical and gynecologic exam. Cervical and vaginal cytology
(Pap smear) were analyzed according to the Papanicolaou method and
classification. All women were grouped according to their age into three
categories:under 40 years old, between 41 and 60 years and over 60
years. RESULTS: most of them, and mainly the younger ones, had been
submitted to a previous Pap smear in a period shorter than 1 year
(44.2%). The majority of women recognized the usefulness of the exam and
knew its interval; the group that best knew its importance and interval
was the one with ages between 41 and 60 years, while most women over 60
years did not know both its importance and interval. Cytological
material was considered insufficient for analysis in 15,1% and
inadequate in 1.1%, and for those with adequate material results were
classes I (21.7%), II (59.9%), III (2.0%), IV (0.1%) and V (0.1%).
Distribution of cervical intraepithelial neoplasia (CIN) were similar in
the three groups. The main microbiologic findings was Gardnerella sp.
(8,6%) and Human papillomavirus (HPV) incidence was significantly lower
among women over 60 years. CONCLUSION: Cytological diagnoses of
neoplastic modifications were performed in 2,2% and Gardnerella sp. was
the most prevalent microbiologic agent. Distribution of HPV showed a
decrease with age. Older women had lower knowledge on the importance of
regular Pap smear examination.
22
UI - 11887236
AU - Nonnenmacher B; Breitenbach V; Villa LL; Prolla JC; Bozzetti MC
TI -
[Genital human papillomavirus infection identification by molecular
biology among asymptomatic women]
SO - Rev Saude Publica 2002 Feb;36(1):95-100
AD - Universidade Luterana do Brasil, Canoas, RS, Brasil. bernadet@zaz.com.br
OBJECTIVE: To evaluate whether epidemiological factors may be associated
to genital human papillomavirus (HPV) infection. METHODS: A
cross-sectional study was carried out among 975 women seen at a public
health service for cervical cancer screening in Porto Alegre, Brazil.
Women were considered infected if tested positive to HPV either by
Polymerase Chain Reaction (PCR) or Hybrid Capture II (HC-II) methods.
Women with genital HPV infection were compared to women without
infection drawn from the same population. RESULTS: The study enrolled
975 women. The HPV prevalence (both methods combined) in this population
was 27%. However, when each diagnostic method is analyzed separately,
HPV prevalence was 15% and 16% for HC-II and PCR, respectively.
Unconditional multiple logistic regression was used to correlate disease
status to women characteristics. A positive association was found with
HPV infection for the following variables: years of schooling (11 years:
OR=2.05; 95%CI =1.31; 3.20), married (OR=1.69; 95%CI=0.78; 2.00), number
of lifetime sexual partners (2 partners: OR=1.67; 95%CI=1.01; 2.77; 4 or
+: OR=2.18; 95%CI=1.15; 4.13), age at first intercourse (15-16 years:
OR=4.05; 95%CI=0.89; 18.29). CONCLUSIONS: Various factors may contribute
to genital HPV infection, especially those related to sexual behavior
(young age at first intercourse, high number of lifetime sexual
partners, and marital status), and those related to social and economic
status (years of schooling).
23
UI - 9180819
AU - Bloch B
TI -
An economic appraisal of a mobile cervical cytology screening service.
SO - S Afr Med J 1997 Feb;87(2):231
24
UI - 11606116
AU - Morice P; Pautier P; Delaloge S
TI -
Prophylactic surgery in patients with inherited risk of ovarian cancer.
SO - Gynecol Oncol 2001 Nov;83(2):445-7
25
UI - 11988136
AU - Dzuba IG; Diaz EY; Allen B; Leonard YF; Lazcano Ponce EC; Shah KV;
TI -
Bishai D; Lorincz A; Ferris D; Turnbull B; Hernandez Avila M; Salmeron J
The acceptability of self-collected samples for HPV testing vs. the pap
test as alternatives in cervical cancer screening.
SO - J Womens Health Gend Based Med 2002 Apr;11(3):265-75
AD - The Johns Hopkins University School of Public Health, Baltimore,
Maryland, USA.
OBJECTIVE: To explore the acceptability of the self-collection of
samples for human papillomavirus (HPV) testing in comparison with that
of the Pap test. METHODS: The study population consisted of 1069 women
20 years and older who were eligible for coverage through the Mexican
Institute of Social Security (IMSS). These women were randomly selected
among participants in a larger study to evaluate the use of HPV testing
as an alternative in cervical cancer screening. All participants
provided a self-collected vaginal sample for HPV testing according to
explicit instructions and underwent a Pap test. Afterwards, each woman
was interviewed about her experience and opinion regarding the two
procedures. Acceptability was measured by a calculated score based on
discomfort, pain, embarrassment, privacy, perception of personal
treatment during the Pap test, and understanding of how to perform the
self-sampling method. RESULTS: Ninety-three percent of women experienced
sufficient privacy with the Pap test, whereas 98% of women reported that
privacy with the self-sampling procedure was acceptable. The Pap test
consistently provoked more discomfort, pain, and embarrassment than
self-sampling. Sixty-eight percent of the women who indicated a test
preference chose self-sampling. Preference for this method was
positively associated with monthly household income. Women reported a
preference for self-sampling because it is more comfortable (71.2%) and
causes less embarrassment (55.8%). CONCLUSIONS: Self-sampling is more
acceptable than the Pap test and could improve coverage rates of early
detection programs. The incorporation of self-collected samples to
detect HPV could encourage participation in screening programs among
those women who reject the Pap test because of the necessary pelvic
examination.
26
UI - 12040742
AU - Anonymous
TI -
Cervical cancer, oral contraceptives and parity.
SO - Wkly Epidemiol Rec 2002 May 17;77(20):167-8
27
UI - 12039933
AU - Berry DA; Iversen ES Jr; Gudbjartsson DF; Hiller EH; Garber JE; Peshkin
TI -
BN; Lerman C; Watson P; Lynch HT; Hilsenbeck SG; Rubinstein WS; Hughes
KS; Parmigiani G
BRCAPRO validation, sensitivity of genetic testing of BRCA1/BRCA2, and
prevalence of other breast cancer susceptibility genes.
SO - J Clin Oncol 2002 Jun 1;20(11):2701-12
AD - Department of Biostatistics, University of Texas M.D. Anderson Cancer
Center, Houston, TX 77030-4009, USA. dberry@mdanderson.org
PURPOSE: To compare genetic test results for deleterious mutations of
BRCA1 and BRCA2 with estimated probabilities of carrying such mutations;
to assess sensitivity of genetic testing; and to assess the relevance of
other susceptibility genes in familial breast and ovarian cancer.
PATIENTS AND METHODS: Data analyzed were from six high-risk genetic
counseling clinics and concern individuals from families for which at
least one member was tested for mutations at BRCA1 and BRCA2.
Predictions of genetic predisposition to breast and ovarian cancer for
301 individuals were made using BRCAPRO, a statistical model and
software using Mendelian genetics and Bayesian updating. Model
predictions were compared with the results of genetic testing. RESULTS:
Among the test individuals, 126 were Ashkenazi Jewish, three were male
subjects, 243 had breast cancer, 49 had ovarian cancer, 34 were
unaffected, and 139 tested positive for BRCA1 mutations and 29 for BRCA2
mutations. BRCAPRO performed well: for the 150 probands with the
smallest BRCAPRO carrier probabilities (average, 29.0%), the proportion
testing positive was 32.7%; for the 151 probands with the largest
carrier probabilities (average, 95.2%), 78.8% tested positive. Genetic
testing sensitivity was estimated to be at least 85%, with
false-negatives including mutations of susceptibility genes heretofore
unknown. CONCLUSION: BRCAPRO is an accurate counseling tool for
determining the probability of carrying mutations of BRCA1 and BRCA2.
Genetic testing for BRCA1 and BRCA2 is highly sensitive, missing an
estimated 15% of mutations. In the populations studied, breast cancer
susceptibility genes other than BRCA1 and BRCA2 either do not exist, are
rare, or are associated with low disease penetrance.
28
UI - 12040639
AU - Belinson JL; Pan QJ; Biscotti C; Wu LY; Pretorius RG; Li L; Elson P;
TI -
Rong SD; Zhang WH; Qiao YL
Primary screening with liquid-based cytology in an unscreened population
in rural China, with an emphasis on reprocessing unsatisfactory samples.
SO - Acta Cytol 2002 May-Jun;46(3):470-4
AD - Section of Gynecologic Oncology, Department of Obstetrics and
Gynecology, Cleveland Clinic Foundation, 9500 Euclid Avenue, A-81,
Cleveland, Ohio 44195, USA.
OBJECTIVE: To determine the sensitivity and specificity of liquid-based
cytology in a high-risk, unscreened population. STUDY DESIGN: A
cross-sectional comparative trial of multiple screening techniques. This
report focuses on the performance of liquid-based cytology using biopsy
as the standard. RESULTS: In total, 1,997 women were screened. All
subjects had a minimum of five cervical biopsies. Of the subjects, 4.3%
had CIN 2 on biopsy. The ThinPrep Pap with ASCUS as positive had a
sensitivity for CIN 2 of 94% and specificity of 78%; the sensitivity for
CIN 3 was 98% and for cancer, 100%. The unsatisfactory rate due to
bloody specimens was 7.9% (158/1,997). After reprocessing, the
unsatisfactory rate was 0.15% (3/1,997). CONCLUSION: Reprocessing
effectively recovers ThinPrep samples otherwise unsatisfactory due to
blood and mucus. The ThinPrep Pap test is a highly sensitive screening
test when used in a high-risk, unscreened population.
29
UI - 12069652
AU - Stephenson J
TI -
Cancer studies explore targeted therapy, researchers seek new prevention
strategies.
SO - JAMA 2002 Jun 19;287(23):3063-7
30
UI - 11937318
AU - Bos AB; van Ballegooijen M; van Oortmarssen GJ; Habbema JD
TI -
Women who participate in spontaneous screening are not at higher risk
for cervical cancer than women who attend programme screening.
SO - Eur J Cancer 2002 Apr;38(6):827-31
AD - Department of Public Health, Faculty of Medicine, Erasmus University
Rotterdam, PO Box 1738, 3000 DR, The Netherlands. bos@mgz.fgg.eur.nl
Up to 1995, programme screening for cervical cancer in The Netherlands
was targeted at women between 35 and 54 years of age at 3-yearly
intervals. Spontaneous screening in addition to programme screening was
common practice. Our aim was to compare the underlying risk for cervical
neoplasia for women involved in both types of screening. From the
national pathological database, we retrieved all primary smears
(n=693318) taken in 1994 in The Netherlands. Among the smears registered
for screening purposes (39%), 79% was taken within the mass screening
programme and 21% was taken for spontaneous screening. The underlying
risk was studied from the detection rates of histologically confirmed
severe dysplasia or worse, using a multivariate loglinear model,
including age and screening history. The detection rate of at least
severe dysplasia, adjusted for age and screening history, was equal for
women who had a spontaneous smear and for those who had a programme
smear (odds ratio (OR): 0.97; 95% Confidence Interval (CI): 0.84-1.14).
In our data, women participating in spontaneous screening were not at a
higher risk for cervical cancer than women who used programme screening.
Therefore, all asymptomatic women in the Netherlands should follow the
general guidelines for age-range and screening-interval.
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