Women's Health and Education Center (WHEC)

Gynecologic Oncology

List of Articles

  • Cervical Cancer Prevention: Managing High-Grade Cervical Neoplasia
    Given that infections with the human papillomavirus (HPV) can lead to cervical cancer, screening and diagnostic programs involving Papanicolaou smears (Pap test) and colposcopy are the standard of care in North America. As more than 80% of cervical cancers are preventable by routine screening, the United States has clearly been successful in reducing HPV-related cancers with the implementation of the cervical cancer screening programs. The purpose of this review is to discuss the current management and summarize recommendations for managing high-grade cervical neoplasia (CIN2, 3+). Areas in which improvement can be made in the recognition of high-risk features during colposcopy are also discussed. Once colposcopic technique is improved, accuracy for detection of high-risk premalignant disease increases. Carcinogenic or "high-risk" human papillomavirus (high-risk HPV) testing has become the standard triage worldwide for women with atypical squamous cells of undermined significance (ASC-US) cytology and is designated as a stand-alone follow-up option in a number of post-colposcopy and post-treatment clinical management scenarios.

  • Cervical Glandular Carcinomas: Early Detection & Prevention
    When different histologic types of cervical cancer are considered and trends are reexamined, it becomes apparent that observed declines are reflective of squamous cell carcinomas predominately; the rates for adenocarcinomas continue to rise. This rise in incidence may be due to the greater difficulty in screening for glandular precursor lesions that often arise high within the endocervical canal. These strategies reflect new information concerning the natural history of cervical carcinogenesis and the performance of screening and diagnostic tests, and they take into account the cost and efficacy of various treatment and follow-up options. This document will describe staging criteria and treatment for cervical glandular carcinomas. For practical purposes, it will focus on the glandular cells and adenocarcinoma histologies only

  • Cervical Cancer: Early Detection and Prevention
    Worldwide, cervical cancer is the second most common malignancy in women and a major cause of morbidity and mortality. Cervical cancer is gender-specific disease that disproportionately affects women in the lowest socioeconomic classes throughout the world. In 2004, the 57th World Health Assembly adopted World Health Organization's global reproductive health strategy, which identified five priority areas including "combating sexually transmitted infections"; the strategy also specifically addressed cervical cancer prevention. Screening programs have successfully reduced disease rates in developed countries that support cytology-based services; these services are too complex for most developing countries to implement. Many important advances have also taken place in the diagnosis and treatment of cervical cancer. This review also defines the strategies for diagnosis and management of abnormal cervical cytology and histology. These strategies reflect new information concerning the natural history of cervical carcinogenesis and the performance of screening and diagnostic tests. The most important component in the management of cervical cancer will always be primary prevention.

  • Cervical Carcinomas: Diagnosis and Management
    Globally, cervical cancer is a major health problem, with a yearly incidence of 371,000 cases and an annual death rate of 190,000. 78% of cases occur in developing countries where cervical cancer is the second most frequent cause of cancer-related death in women. Invasive cervical carcinoma, once the most common reproductive-tract cancer in the United States, has recently fallen to the rank of third most common. The purpose of this document is to describe staging criteria and treatment for cervical carcinoma. For practical purposes, it will focus on the squamous and adenocarcinoma histologies only. In addition, new evidence has documented conclusively that survival rates for women with cervical cancer improve when radiotherapy is combined with cisplatin-based chemotherapy in advanced cases.

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