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Abramson Cancer CenterNCI CANCERLIT® Search: Screening and Prevention of Gynecologic Neoplasms - August 2002
National Cancer Institute®
Last Modified: August 1, 2002
- A simple 'paper smear' method for dry collection, transport and storage of cervical cytological specimens for rapid screening of HPV infection
- AWHONN partners with national cervical cancer campaign.
- Determinants of cervical cancer rates in developing countries.
- The Department of Defense Congressionally Directed Medical Research Program: innovations in the federal funding of biomedical research.
- [Etiotropic treatment of patients with early uterine carcinoma as a basis for prevention of relapses and complications]
- Criteria for organized cervical screening programs. Special emphasis on The Netherlands program.
- The role of the nurse in cancer genetics.
- Sexually transmitted diseases treatment guidelines 2002. Centers for Disease Control and Prevention.
- Confronting cervical cancer. Screening is the key to stopping this killer.
- Psychological impact of prophylactic oophorectomy in women at increased risk of developing ovarian cancer: a prospective study.
- [HPV testing--the effect must be evaluated prior to clinical use!]
- Postmenopausal hormone replacement therapy: scientific review.
Table of Contents
1
UI - 12132779
AU - Kailash U; Hedau S; Gopalkrishna V; Katiyar S; Das BC
TI -
A simple 'paper smear' method for dry collection, transport and storage
of cervical cytological specimens for rapid screening of HPV infection
by PCR.
SO - J Med Microbiol 2002 Jul;51(7):606-10
AD - Division of Molecular Oncology, Institute of Cytology and Preventive
Oncology (ICMR), New Delhi, India.
Human papillomaviruses (HPVs) are major pathogens associated with the
development of cancer of the uterine cervix, the most common malignant
tumour of women worldwide. Reliable diagnosis of HPV infection,
particularly the 'high-risk' types (16/18), may facilitate early
identification of 'high-risk' populations for developing cervical cancer
and may augment the sensitivity and specificity of primary cervical
cancer screening programmes by complementing the conventional Pap test.
A simple paper smear method has been developed for dry collection,
transport and storage of cervical smears/scrapes at room temperature for
subsequent detection of HPV DNA by PCR assay. Imprint biopsies, blood
and fine-needle aspirates were also collected by this method. The
cervical scrapes or other body fluids were smeared (within 0.5-1 cm
diameter) and dried on to sterile small slides made of Whatman 3MM
filter paper, and stored individually at room temperature or at 4
degrees C. A small piece (2-3 mm) of the paper smear was punched or cut
out with a sterile surgical blade, boiled in an eppendorf tube
containing 50 microl of distilled water for 5 min and used directly for
PCR amplification. The quality and quantity of DNA derived from paper
smears and the results of PCR amplifications for HPV type 16, BRCA1 and
p53 genes were identical to those obtained from the same samples
following collection in PBS, storage (-70 degrees C) and
phenol-chloroform-based DNA extraction. DNA was stable in the paper
smears for up to a year, whether stored at room temperature or at 4
degrees C. This method is simple, rapid and cost-effective, and can be
effectively employed for large-scale population screening, especially
for regions where the specimens are to be transported from distant
places to the laboratory.
2
UI - 11975131
AU - Anonymous
TI -
AWHONN partners with national cervical cancer campaign.
SO - AWHONN Lifelines 2002 Apr-May;6(2):163-4
3
UI - 12115570
AU - Drain PK; Holmes KK; Hughes JP; Koutsky LA
TI -
Determinants of cervical cancer rates in developing countries.
SO - Int J Cancer 2002 Jul 10;100(2):199-205
AD - International Health Program, Department of Epidemiology, School of
Public Health and Community Medicine, University of Washington, Seattle,
WA, USA.
Although cervical cancer (CC) is a leading cause of cancer-related
deaths in developing countries, incidence rates vary considerably,
ranging from 3 to 61 per 10(5) females. Identifying determinants of high
vs. low rates may suggest population-level prevention strategies. CC
rates for 175 countries were obtained from the IARC. Country-specific
behavioral, health, economic and demographic measures were obtained from
United Nations agencies and other international organizations.
Regression analyses performed for 127 low or medium developed countries
identified both geography and religion as independently associated with
high CC rates. Among behavioral measures, high fertility rates, early
age at birth of first child and high teenage birth rates were
significantly associated with high CC rates. Countries with high CC
rates had fewer doctors per capita, less immunization coverage, more HIV
infections and shorter life expectancies. CC rates also tended to be
higher in countries with more spending on health and younger, less
educated populations. Patterns of CC rates suggest that programmatic
approaches, such as promoting delayed childbearing and sexual monogamy,
may be appropriate interventions. For countries with high CC rates and
some flexibility in their health-care budgets, a once-in-a-lifetime
screen of women 30-50 years of age, using Pap smears, direct visual
inspection and/or HPV DNA testing, may be cost-effective. Finally,
relatively low immunization rates and a shortage of health-care workers
in countries with high CC rates suggest potential challenges for
introducing prophylactic HPV vaccines. Copyright 2002 Wiley-Liss, Inc.
4
UI - 11948100
AU - Young-McCaughan S; Rich IM; Lindsay GC; Bertram KA
TI -
The Department of Defense Congressionally Directed Medical Research
Program: innovations in the federal funding of biomedical research.
SO - Clin Cancer Res 2002 Apr;8(4):957-62
AD - United States Army Medical Research and Materiel Command,
Congressionally Directed Medical Research Programs, Fort Detrick,
Maryland 21702-5024, USA.
In response to the lobbying efforts of the women's advocacy movement, in
1993 Congress authorized funds for a substantial increase in support of
new and promising research aimed at the eradication of breast cancer.
This appropriation resulted in a major expansion of the United States
Army Medical Research and Materiel Command, Department of Defense Breast
Cancer Research Program. The Office of Congressionally Directed Medical
Research Programs was established within the United States Army Medical
Research and Materiel Command to facilitate the management of the
expanded extramural research program. Since that time, the programs have
grown to include not just breast cancer but also prostate cancer,
ovarian cancer, and neurofibromatosis. The unique appropriations to the
Office of Congressionally Directed Medical Research Programs has
resulted in a number of programmatic innovations. These include
development of unique mechanisms of grant support, inclusion of consumer
advocates on peer and programmatic review panels, and the introduction
of criteria-based evaluation and scoring in peer review. This article
describes these novel scientific management strategies and outlines
their success in meeting program visions and goals.
5
UI - 11519444
AU - Iaremchuk AIa; Vakulenko GA; Khadi D
TI -
[Etiotropic treatment of patients with early uterine carcinoma as a
basis for prevention of relapses and complications]
SO - Lik Sprava 2001 Mar-Apr;(2):90-3
In this paper, consideration is given to the role that etiological and
pathogenetic factors have in the development of malignant tumours.
Prevention of possible recurrencies and complications in patients with
incipient forms of hysterocarcinoma warrant etiotropic treatment which
has been shown to be effective and essential for the object to succeed
in.
6
UI - 12146020
AU - Hanselaar AG
TI -
Criteria for organized cervical screening programs. Special emphasis on
The Netherlands program.
SO - Acta Cytol 2002 Jul-Aug;46(4):619-29
AD - Department of Pathology, University Medical Center Nijmegen, P.O. Box
9101, 6500 HB Nijmegen, The Netherlands.
Based on the criteria of Wilson and Jungner and experiences in the
population-based organized cervical screening program in the
Netherlands, conditions for efficient and effective population screening
for cervical cancer are described. The purpose of this paper is to
determine if these criteria are met for cervical cancer screening and to
give recommendations for improvement. Cervical cancer is still an
important health problem; the present incidence reflects both background
risk and screening activity during previous decades. A positive effect
of screening is reached because of the long development time of the
disease and the ability of the Pap smear test to detect precancer and
early, symptomatic disease. Considerable reduction in the incidence and
mortality of cervical cancers can be reached if all women attend and all
detected lesions are adequately followed up. Common terminology and
classification criteria for histology and cytology should be used.
Whether newly developed techniques that may improve or replace cytology
can be used in screening programs should be a multidisciplinary decision
after clinical trials have given evidence-based information on the
performance, cost-effectiveness and need of these techniques. When
cervical cancer screening is undertaken, it should be offered in
organized programs at the medical level closest to the patients, the
general practitioner. High compliance is the most important factor in
reducing cervical cancer incidence. Quality control and assurance must
be performed at all levels. In the case of limited resources, the
program should use a five-year interval and concentrate on the age range
25-60 years, with special attention to women who have never been
screened or were screened > 10 years previously. Evaluation of medical
and organizational aspects is mandatory. Cooperation between all
involved parties is a prerequisite of creating a successful screening
program.
7
UI - 12040228
AU - Middelton L; Dimond E; Calzone K; Davis J; Jenkins J
TI -
The role of the nurse in cancer genetics.
SO - Cancer Nurs 2002 Jun;25(3):196-206
AD - Urology Oncology Branch, National Cancer Institute, National Institutes
of Health, Bethesda, Md. 20892-1873, USA.
Knowledge gained from the Human Genome Project and related genetic
research is already impacting clinical oncology nursing practice.
Because cancer is now understood to be a genetic disease, changes in the
traditional approaches to prevention, diagnosis, and therapeutic
management of cancer are becoming increasingly genetically based.
Therefore, to ensure competency in oncology nursing practice at all
levels, nurses must incorporate an understanding of the underlying
biology of carcinogenesis and the molecular rationale underlying
strategies to prevent, diagnose, and treat cancer.
8
UI - 12184549
AU - Anonymous
TI -
Sexually transmitted diseases treatment guidelines 2002. Centers for
Disease Control and Prevention.
SO - MMWR Morb Mortal Wkly Rep 2002 May 10;51(RR-6):1-78
These guidelines for the treatment of patients who have sexually
transmitted diseases (STDs) were developed by the Centers for Disease
Control and Prevention (CDC) after consultation with a group of
professionals knowledgeable in the field of STDs who met in Atlanta on
September 26-28, 2000. The information in this report updates the 1998
Guidelines for Treatment of Sexually Transmitted Diseases (MMWR 1998;47
[No. RR-1]). Included in these updated guidelines are new alternative
regimens for scabies, bacterial vaginosis, early syphilis, and granuloma
inguinale; an expanded section on the diagnosis of genital herpes
(including type-specific serologic tests); new recommendations for
treatment of recurrent genital herpes among persons infected with human
immunodeficiency virus (HIV); a revised approach to the management of
victims of sexual assault; expanded regimens for the treatment of
urethral meatal warts; and inclusion of hepatitis C as a sexually
transmitted infection. In addition, these guidelines emphasize education
and counseling for persons infected with human papillomavirus, clarify
the diagnostic evaluation of congenital syphilis, and present
information regarding the emergence of quinolone-resistant Neisseria
gonorrhoeae and implications for treatment. Recommendations also are
provided for vaccine-preventable STDs, including hepatitis A and
hepatitis B.
9
UI - 12078567
AU - Adams KL
TI -
Confronting cervical cancer. Screening is the key to stopping this
killer.
SO - AWHONN Lifelines 2002 Jun-Jul;6(3):216-22
AD - Lakewood Hospital, Lakewood, OH, USA.
10
UI - 12144830
AU - Tiller K; Meiser B; Butow P; Clifton M; Thewes B; Friedlander M; Tucker
TI -
K
Psychological impact of prophylactic oophorectomy in women at increased
risk of developing ovarian cancer: a prospective study.
SO - Gynecol Oncol 2002 Aug;86(2):212-9
AD - Department of Medical Oncology, Prince of Wales Hospital, Sydney,
Australia. k.tiller@unsw.edu.au
OBJECTIVES: The objectives of this study were twofold: to prospectively
assess whether expressed intention to undergo prophylactic oophorectomy
translated into uptake and to evaluate the psychological impact of the
procedure in a sample of unaffected women with a strong family history
of breast/ovarian cancer. METHODS: Ninety-five women, initially assessed
at the time of their first attendance at a familial cancer clinic, were
followed-up 3 years later. A total of 22 women (23.2%) in this study had
undergone a prophylactic oophorectomy. Ten women (10.5%) who had
undergone a prophylactic oophorectomy during the 3-year follow-up period
were compared to 73 women (76.9%) who did not have a prophylactic
oophorectomy. Twelve women (12.6%) who had the procedure prior to study
entry were also assessed for psychological adjustment and associated
information needs. RESULTS: Age emerged as a significant predictor of
uptake of prophylactic oophorectomy (chi(2) = 7.13, P = 0.009). Among
those who had the procedure after study entry, a significant reduction
in ovarian cancer anxiety was observed (Z = -2.19, P = 0.029). Of the 22
women who had undergone a prophylactic oophorectomy in total (both
before and after study entry), 86.4% reported a high degree of
satisfaction with their decision to have the procedure. A low level of
screening uptake was also reported by women who did not have a
prophylactic oophorectomy but for whom screening was recommended.
CONCLUSION: Findings demonstrate that prophylactic oophorectomy is
successful in reducing anxiety about ovarian cancer. The results also
suggest that women perceive that the benefit of anxiety reduction may
outweigh the potentially adverse effects of the procedure, given that
women expressed a high level of satisfaction with their decision.
11
UI - 12092058
AU - Persson E; Andrae B; Strander B
TI -
[HPV testing--the effect must be evaluated prior to clinical use!]
SO - Lakartidningen 2002 May 30;99(22):2552
AD - elisabeth.persson@ks.se
12
UI - 12186605
AU - Nelson HD; Humphrey LL; Nygren P; Teutsch SM; Allan JD
TI -
Postmenopausal hormone replacement therapy: scientific review.
SO - JAMA 2002 Aug 21;288(7):872-81
AD - Oregon Health and Science University, Mail Code BICC 504, 3181 SW Sam
Jackson Park Rd, Portland, OR 97201, USA. nelsonh@ohsu.edu
CONTEXT: Although postmenopausal hormone replacement therapy (HRT) is
widely used in the United States, new evidence about its benefits and
harms requires reconsideration of its use for the primary prevention of
chronic conditions. OBJECTIVE: To assess the benefits and harms of HRT
for the primary prevention of cardiovascular disease, thromboembolism,
osteoporosis, cancer, dementia, and cholecystitis by reviewing the
literature, conducting meta-analyses, and calculating outcome rates.
DATA SOURCES: All relevant English-language studies were identified in
MEDLINE (1966-2001), HealthSTAR (1975-2001), Cochrane Library databases,
and reference lists of key articles. Recent results of the Women's
Health Initiative (WHI) and the Heart and Estrogen/progestin Replacement
Study (HERS) are included for reported outcomes. STUDY SELECTION AND
DATA EXTRACTION: We used all published studies of HRT if they contained
a comparison group of HRT nonusers and reported data relating to HRT use
and clinical outcomes of interest. Studies were excluded if the
population was selected according to prior events or presence of
conditions associated with higher risks for targeted outcomes. DATA
SYNTHESIS: Meta-analyses of observational studies indicated summary
relative risks (RRs) for coronary heart disease (CHD) incidence and
mortality that were significantly reduced among current HRT users only,
although risk for incidence was not reduced when only studies that
controlled for socioeconomic status were included. The WHI reported
increased CHD events (hazard ratio [HR], 1.29; 95% confidence interval
[CI], 1.02-1.63). Stroke incidence but not mortality was significantly
increased among HRT users in the meta-analysis and the WHI. The
meta-analysis indicated that risk was significantly elevated for
thromboembolic stroke (RR, 1.20; 95% CI, 1.01-1.40) but not subarachnoid
or intracerebral stroke. Risk of venous thromboembolism among current
HRT users was increased overall (RR, 2.14; 95% CI, 1.64-2.81) and was
highest during the first year of use (RR, 3.49; 95% CI, 2.33-5.59)
according to a meta-analysis of 12 studies. Protection against
osteoporotic fractures is supported by a meta-analysis of 22 estrogen
trials, cohort studies, results of the WHI, and trials with bone density
outcomes. Current estrogen users have an increased risk of breast cancer
that increases with duration of use. Endometrial cancer incidence, but
not mortality, is increased with unopposed estrogen use but not with
estrogen with progestin. A meta-analysis of 18 observational studies
showed a 20% reduction in colon cancer incidence among women who had
ever used HRT (RR, 0.80; 95% CI, 0.74-0.86), a finding supported by the
WHI. Women symptomatic from menopause had improvement in certain aspects
of cognition. Current studies of estrogen and dementia are not
definitive. In a cohort study, current HRT users had an age-adjusted RR
for cholecystitis of 1.8 (95% CI, 1.6-2.0), increasing to 2.5 (95% CI,
2.0-2.9) after 5 years of use. CONCLUSIONS: Benefits of HRT include
prevention of osteoporotic fractures and colorectal cancer, while
prevention of dementia is uncertain. Harms include CHD, stroke,
thromboembolic events, breast cancer with 5 or more years of use, and
cholecystitis.
The above citations and abstracts reflect those newly added to CANCERLIT for the month and topic listed in the title. The citations have been retrieved from CANCERLIT using a predefined search strategy of indexed subject terms. Although the search strategy has been refined as best as possible, citations may appear that are not directly related to the topic, and occasionally relevant references may be omitted.
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