Cervical Cancer Screening.
TL;DR: Providing women with affordable, easily accessible screening, follow-up of abnormal tests, and timely treatment will result in the greatest impact of screening on cervical cancer incidence and mortality.
About: This article is published in Medical Clinics of North America.The article was published on 2017-07-01 and is currently open access. It has received 191 citations till now. The article focuses on the topics: Cervical cancer & Cervix.
Citations
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Louisiana State University1, University of Virginia2, University of Minnesota3, University of Washington4, Fred Hutchinson Cancer Research Center5, University of Texas MD Anderson Cancer Center6, University at Albany, SUNY7, University of Pennsylvania8, Durham University9, University of California, San Francisco10, Harvard University11, American Cancer Society12, Thomas Jefferson University13
TL;DR: The American Cancer Society recommends that individuals aged >65 years who have no history of cervical intraepithelial neoplasia grade 2 or more severe disease within the past 25 years, discontinue all cervical cancer screening (qualified recommendation).
Abstract: The American Cancer Society (ACS) recommends that individuals with a cervix initiate cervical cancer screening at age 25 years and undergo primary human papillomavirus (HPV) testing every 5 years through age 65 years (preferred); if primary HPV testing is not available, then individuals aged 25 to 65 years should be screened with cotesting (HPV testing in combination with cytology) every 5 years or cytology alone every 3 years (acceptable) (strong recommendation). The ACS recommends that individuals aged >65 years who have no history of cervical intraepithelial neoplasia grade 2 or more severe disease within the past 25 years, and who have documented adequate negative prior screening in the prior 10 years, discontinue all cervical cancer screening (qualified recommendation). These new screening recommendations differ in 4 important respects compared with the 2012 recommendations: 1) The preferred screening strategy is primary HPV testing every 5 years, with cotesting and cytology alone acceptable where access to US Food and Drug Administration-approved primary HPV testing is not yet available; 2) the recommended age to start screening is 25 years rather than 21 years; 3) primary HPV testing, as well as cotesting or cytology alone when primary testing is not available, is recommended starting at age 25 years rather than age 30 years; and 4) the guideline is transitional, ie, options for screening with cotesting or cytology alone are provided but should be phased out once full access to primary HPV testing for cervical cancer screening is available without barriers. Evidence related to other relevant issues was reviewed, and no changes were made to recommendations for screening intervals, age or criteria for screening cessation, screening based on vaccination status, or screening after hysterectomy. Follow-up for individuals who screen positive for HPV and/or cytology should be in accordance with the 2019 American Society for Colposcopy and Cervical Pathology risk-based management consensus guidelines for abnormal cervical cancer screening tests and cancer precursors.
417 citations
TL;DR: The effects of surgical smoke on carcinogenesis, mutagenesis, and infection in gynecologists are highlighted and how to prevent the surgical smoke via using high-filtration masks and smoke evacuation systems is discussed.
Abstract: Surgical smoke is the gaseous by-product produced by heat generating devices in various surgical operations including laser conization and loop electrosurgical procedures that often are performed by gynecologists. Surgical smoke contains chemicals, blood and tissue particles, bacteria, and viruses, which has been shown to exhibit potential risks for surgeons, nurses, anesthesiologists, and technicians in the operation room due to long term exposure of smoke. In this review, we describe the detailed information of the components of surgical smoke. Moreover, we highlight the effects of surgical smoke on carcinogenesis, mutagenesis, and infection in gynecologists. Furthermore, we discussed how to prevent the surgical smoke via using high-filtration masks and smoke evacuation systems as well as legal guidelines for protection measures among the gynecologists.
120 citations
Cites background from "Cervical Cancer Screening."
...Therefore, to obtain the better treatment outcomes, the prevention is imperative via early detection of precancerous and high-grade cervical intraepithelial neoplasia (known as cervical dysplasia, CINII and CINIII), which is the potentially premalignant transformation and abnormal growth (dysplasia) of squamous cells on the surface of the cervix [2-4]....
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...Especially, patients with infection of HPV strains 16 and 18 cause about 70% of CINII, CINIII, and cervical cancer [3, 5, 6]....
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TL;DR: Different health education methods are effective in modifying cervical cancer screening behavior of women and health behavior change frameworks provide an effective base for cervical cancer prevention.
Abstract: Background: Cervical cancer is the second most common cancer in women worldwide; early detection can play a key role in reducing the associated morbidity. The objective of this study was to systematically assess the effects of educational interventions on cervical cancer screening (CCS) behavior of women. Methods: In this review the Cochrane library, Web of Science, Science Direct, PubMed, Scopus and search engine of Google scholar were searched for all interventional studies (trails, pre- and post-test or quasi-experimental) published in 2000-2017 for a systematic review, The search was based on the following keywords: cervix cancer, uterine cervical neoplasms, screening, prevention and control, Papanicolaou Test, pap test, pap smear, education, intervention, systematic review. Due to the heterogeneity of the data, a qualitative analysis was performed. Results: Thirty seven articles with 15,658 female participants in different parts of world were included in the review. About three quarters of the articles covered behavior change interventions. About one fourth of the articles were based on health education methods. The heath belief model is the most popular used framework for cervical cancer screening interventions. The results of our study showed that different health education methods (such as calls, mailed postcards, mother/daughter education. consultation sessions, picture books, videos, PowerPoint slides, small group discussions, educational brochures, radio broadcast education, lecture presentations, tailored counseling and a fact sheet, Self-learning package, face-to- face interviews and etc) are effective in modifying cervical cancer screening behavior of women. Conclusions: Our results showed that the different interventions and health behavior change frameworks provide an effective base for cervical cancer prevention. Heath providers can chose educational methods based on the particular client situations.
111 citations
TL;DR: Sensitivity and cost-effectiveness of new cervical cancer screening methods were the main outcome measures and the see-and-treat model is a sensitive, efficient, and low-cost vision for the future.
Abstract: Introduction Cervical cancer is the leading cause of cancer deaths in women in the developing world. New technologies have been developed to allow for more rapid, cost-effective, and sensitive cervical cancer screening and treatment. Aim The aim of this study was to describe methods for detection and treatment of human papillomavirus (HPV), cervical dysplasia (CD), and cervical cancer. New technologies and updated screening strategies will be emphasized. Methods A literature search was conducted using PubMed to identify publications relevant to the subject. Main Outcome Measure Sensitivity and cost-effectiveness of new cervical cancer screening methods were the main outcome measures. Results HPV and cervical cancer have a significant global impact. Research and innovations related to detection and treatment are key in reducing their burden worldwide. Conclusion Screening a woman for HPV and CD can dramatically decrease her risk of dying from cervical cancer. New, rapid, low-cost, HPV testing can allow for high-volume screening for the approximately 1.5 billion women who have never been screened. HPV screening can then be combined with high resolution digital colposcopy to detect CD. In the near future, these colposcopic images will be interpreted by artificial intelligence software. Detected lesions can then be treated easily and effectively with thermocoagulation. This see-and-treat model is a sensitive, efficient, and low-cost vision for the future. Bedell SL, Goldstein LS, Goldstein AR, et al. Cervical Cancer Screening: Past, Present, and Future. Sex Med Rev 2020;8:28–37.
92 citations
TL;DR: The committee for cervical cancer screening in Korea updated the recommendation statement established in 2002, and the new version of the guideline was developed by the committee using evidence-based methods.
Abstract: The incidence rate of cervical cancer in Korea is still higher than in other developed countries, notwithstanding the national mass-screening program. Furthermore, a new method has been introduced in cervical cancer screening. Therefore, the committee for cervical cancer screening in Korea updated the recommendation statement established in 2002. The new version of the guideline was developed by the committee using evidence-based methods. The committee reviewed the evidence for the benefits and harms of the Papanicolaou test, liquid-based cytology, and human papillomavirus (HPV) testing, and reached conclusions after deliberation. The committee recommends screening for cervical cancer with cytology (Papanicolaou test or liquid-based cytology) every three years in women older than 20 years of age (recommendation A). The cervical cytology combined with HPV test is optionally recommended after taking into consideration individual risk or preference (recommendation C). The current evidence for primary HPV screening is insufficient to assess the benefits and harms of cervical cancer screening (recommendation I). Cervical cancer screening can be terminated at the age of 74 years if more than three consecutive negative cytology reports have been confirmed within 10 years (recommendation D).
59 citations
Cites background from "Cervical Cancer Screening."
...Results of literature search Five hundred and three cervical cancer screening related records were searched and 9 of 503 literatures were evidencebased screening guidelines [2-10]....
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...Among them, eight guidelines were subjected to adaptation and one literature received low score in rigor of development by AGREE II [2-9]....
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...Consequently new screening guidelines including adjusted timing of cervical cancer screening are being published in multiple nations and organizations [2-10]....
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References
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American Cancer Society1, National Institutes of Health2, Emory University3, Memorial Sloan Kettering Cancer Center4, University of Minnesota5, University of Massachusetts Medical School6, University of Arizona7, University of New Mexico8, Harvard University9, Cornell University10, University of California, San Francisco11, McGill University12, University of Virginia13, American Society for Clinical Pathology14, Duke University15
TL;DR: An update to the ACS guideline regarding screening for the early detection of cervical precancerous lesions and cancer is presented, addressing age‐appropriate screening strategies, including the use of cytology and high‐risk human papillomavirus (HPV) testing.
Abstract: An update to the American Cancer Society (ACS) guideline regarding screening for the early detection of cervical precancerous lesions and cancer is presented. The guidelines are based on a systematic evidence review, contributions from 6 working groups, and a recent symposium cosponsored by the ACS, the American Society for Colposcopy and Cervical Pathology, and the American Society for Clinical Pathology, which was attended by 25 organizations. The new screening recommendations address age-appropriate screening strategies, including the use of cytology and high-risk human papillomavirus (HPV) testing, follow-up (eg, the management of screen positives and screening intervals for screen negatives) of women after screening, the age at which to exit screening, future considerations regarding HPV testing alone as a primary screening approach, and screening strategies for women vaccinated against HPV16 and HPV18 infections.
1,621 citations
"Cervical Cancer Screening." refers background in this paper
...Preventive Services Task Force,(7) the American College of Obstetricians and Gynecologists,(1) and the American Cancer Society–American Society for Colposcopy and Cervical Pathology–American Society for Clinical Pathology.(8) * Recommendations apply to women with no prior diagnosis of cervical intraepithelial neoplasia grade 2 or a more severe lesion or cervical cancer, women who are not immunocompromised (eg, not infected with human immunodeficiency virus), and women with no in utero exposure to diethylstilbestrol....
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...Services Task Force,7 the American College of Obstetricians and Gynecologists,1 and the American Cancer Society–American Society for Colposcopy and Cervical Pathology–American Society for Clinical Pathology.8 * Recommendations apply to women with no prior diagnosis of cervical intraepithelial neoplasia grade 2 or a more severe lesion or cervical cancer, women who are not immunocompromised (eg, not infected with human immunodeficiency virus), and women with no in utero exposure to diethylstilbestrol....
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TL;DR: All the excisional procedures to treat cervical intraepithelial neoplasia present similar pregnancy-related morbidity without apparent neonatal morbidity, andCaution in the treatment of young women with mild cervical abnormalities should be recommended.
1,046 citations
TL;DR: The reproducibility of cytologic, colposcopic histologic, and loop electrosurgical excision procedure (LEEP) histologic cervical specimen interpretations among multiple well-trained observers was evaluated in the ASCUS-LSIL Triage Study as mentioned in this paper.
Abstract: ContextDespite a critical presumption of reliability, standards of interpathologist
agreement have not been well defined for interpretation of cervical pathology
specimens.ObjectiveTo determine the reproducibility of cytologic, colposcopic histologic,
and loop electrosurgical excision procedure (LEEP) histologic cervical specimen
interpretations among multiple well-trained observers.Design and SettingThe Atypical Squamous Cells of Undetermined Significance–Low-grade
Squamous Intraepithelial Lesion (ASCUS-LSIL) Triage Study (ALTS), an ongoing
US multicenter clinical trial.SubjectsFrom women enrolled in ALTS during 1996-1998, 4948 monolayer cytologic
slides, 2237 colposcopic biopsies, and 535 LEEP specimens were interpreted
by 7 clinical center and 4 Pathology Quality Control Group (QC) pathologists.Main Outcome Measuresκ Values calculated for comparison of the original clinical center
interpretation and the first QC reviewer's masked interpretation of specimens.ResultsFor all 3 specimen types, the clinical center pathologists rendered
significantly more severe interpretations than did reviewing QC pathologists.
The reproducibility of monolayer cytologic interpretations was moderate (κ
= 0.46; 95% confidence interval [CI], 0.44-0.48) and equivalent to the reproducibility
of punch biopsy histopathologic interpretations (κ = 0.46; 95% CI, 0.43-0.49)
and LEEP histopathologic interpretations (κ = 0.49; 95% CI, 0.44-0.55).
The lack of reproducibility of histopathology was most evident for less severe
interpretations.ConclusionsInterpretive variability is substantial for all types of cervical specimens.
Histopathology of cervical biopsies is not more reproducible than monolayer
cytology, and even the interpretation of LEEP results is variable. Given the
degree of irreproducibility that exists among well-trained pathologists, realistic
performance expectations should guide use of their interpretations.
990 citations
TL;DR: Significant issues surrounding the natural history of HPV infection, including viral persistence versus clearance, immune response, development of lesions and development of cancer are discussed.
990 citations
01 Jan 2017
TL;DR: Investigating the reproducibility of cytologic, colposcopic histologic, and loop electrosurgical excision procedure (LEEP) histologic cervical specimen interpretations among multiple well-trained observers found Interpretive variability is substantial for all types of cervical specimens.
956 citations