- Cancer Types
Information about risk, prevention, screening, symptoms, diagnosis, treatment, and support for all cancers Cancer A to Z - Cancer Treatment
Cancer Treatment
Information about cancer treatment, including surgery, chemotherapy, radiation therapy, clinical trials, proton therapy, complementary medicine, and cutting edge technologies.
- Risk and Prevention
- Cancer Drugs
- Support
Support
Ways for cancer patients and caregivers to cope with cancer, side effects, nutrition, general cancer support issues, grief/end of life issues, and shared survivor's experiences.
- Healthcare Professionals
- Clinical Trials
My Patient Treatment Binder
OncoLink Blogs
What's My Cancer Risk?
OncoPilot: Navigating Your Cancer Journey
Community Events Calendar
OncoLink eNews
Abramson Cancer Center
NCI CANCERLIT® Search: Diagnosis-Histopathology-Pathogenesis of Cervical Cancer - September 2002
National Cancer Institute®
Last Modified: September 1, 2002
- Assessment of the cervix after acetic acid wash: inter-rater agreement using photographs.
- ASCUS LSIL Triage Study (ALTS) conclusions reaffirmed: response to a November 2001 commentary.
- The cellular response associated with cervical intraepithelial neoplasia in HIV+ and HIV- subjects.
- HPV-direct in situ PCR: an advanced molecular tool in the screening of cervical cancer.
- Parliament calls for organised cervical cancer screening and HPV research.
- Factors predicting disease outcome in early stage adenocarcinoma of the uterine cervix.
- Optimal surgery and diagnostic approach of stage IA2 squamous cell carcinoma of the cervix.
- Lessons from the audit of invasive cervical cancer.
- Bethesda 2001.
- 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?
- Detection of disseminated tumor cells in patients with cervical cancer.
- Interim assessment of a community intervention to improve breast and cervical cancer screening among Korean American women.
- Nutritional and genetic inefficiencies in one-carbon metabolism and cervical cancer risk.
- Improving adherence to regular pap smear screening among Asian women: a population-based study in Singapore.
- [Cytological history of 148 women presenting with invasive cervical cancer]
- [Adenocarcinoma of the cervix uteri: a retrospective study of 83 cases]
- [In situ adenocarcinoma of the uterus cervix: difficulties of its cytohistological diagnosis]
- Low-income minority women at risk for cervical cancer: a process to improve adherence to follow-up recommendations.
- Microglandular hyperplasia of the uterine cervix. Cytologic diagnosis in cervical smears.
- Combined Pap smear, cervicography and HPV DNA testing in the detection of cervical intraepithelial neoplasia and cancer.
- Risks for incident human papillomavirus infection and low-grade squamous intraepithelial lesion development in young females.
- Cervical cancer screening by simple visual inspection after acetic acid.
- Should the law require doctors to make records available for audit of cervical screening?
- HIV-1 infection and risk of vulvovaginal and perianal condylomata acuminata and intraepithelial neoplasia: a prospective cohort study.
- Both TPA and SCC-Ag levels are prognostic even in high-risk stage Ib-IIa cervical carcinoma as determined by a stratification analysis.
- Detection of high-risk HPV (16, 18, 33) in situ cancer of the cervix by PCR technique.
- Neoadjuvant treatment with docetaxel and the effects of irradiation for human ovarian adenocarcinoma and cervical squamous cell carcinoma in
- Breast and cervical cancer screening and disease incidence and stage in New Mexico.
- [Cervix cancer]
- Cancer of the cervix.
- Quality of care from a patient perspective in population-based cervical cancer screening.
- Human papillomavirus. To screen or not to screen.
- Presence of human papillomavirus infection of the uterine cervix as determined by different detection methods in a low-risk community-based
- Lactoferrin-induced up-regulation of zeta (zeta) chain expression in peripheral blood T lymphocytes from cervical cancer patients.
- Autofluorescence spectroscopy for the diagnosis of cervical intraepithelial neoplasia.
- Cervical cancer. Summary of the National Institutes of Health (NIH) Consensus.
- Integrating mental health screening and abnormal cancer screening follow-up: an intervention to reach low-income women.
- Cervical screening.
- Survey of human papillomavirus infection in cervical intraepithelial neoplasia in Thai women.
- Screening for cervical disease in mature women: strategies for improvement.
- Diagnostic value, feasibility, and validity of preparing cell blocks from fluid-based gynecologic cytology specimens.
- Measuring sensitivity in gynecologic cytology: a review.
- Cervical smear interpretations in women with a histologic diagnosis of severe dysplasia: factors associated with discrepant interpretations.
- ACOG practice bulletin. Diagnosis and treatment of cervical carcinomas, number 35, May 2002.
- Cervical cancer should be considered as a rare complication of oncogenic HPV infection rather than a STD.
- Immature glandular features in squamous cell carcinoma of the uterine cervix as an independent indicator of resistance to radiotherapy.
- Localization of deletion to a 300 Kb interval of chromosome 11q13 in cervical cancer.
- Initial neural net construction for the detection of cervical intraepithelial neoplasia by fluorescence imaging.
- Screening for cervical intraepithelial neoplasia.
- Increase in incidence of invasive cervical cancer.
- Identification of a 6-cM minimal deletion at 11q23.1-23.2 and exclusion of PPP2R1B gene as a deletion target in cervical cancer.
- Distribution of cervical glandular intraepithelial neoplasia: are hysterectomy specimens sampled appropriately?
- A review of the literature: interventions to maximize capacity to consent and reduce anxiety of women with learning disabilities preparing
- Selective silencing of viral gene expression in HPV-positive human cervical carcinoma cells treated with siRNA, a primer of RNA
- The merits of new alternatives to the Papanicolaou test.
- Cervical intraepithelial dysplasia (CIN 3) and history of herpes genitalis (HSV2) in women living in Attica, Greece.
- The effectiveness of NHS cervical screening.
- Interventions targeted at women to encourage the uptake of cervical screening.
- Comprehensive analysis of human leukocyte antigen class I alleles and cervical neoplasia in 3 epidemiologic studies.
- Genome amplification of human papillomavirus types 16 and 18 in cervical carcinomas is related to the retention of E1/E2 genes.
- Molecular biology of cervical cancer and its precursors.
- Analysis of E2 amino acid variants of human papillomavirus types 16 and 18 and their associations with lesion grade and HLA DR/DQ type.
- Risk of invasive cervical cancer associated with polymorphic HLA DR/DQ haplotypes.
- Human papillomavirus genotype prevalence in high-grade squamous intraepithelial lesions and colposcopically normal women from Zimbabwe.
- [Human papillomavirus: a vaccine against cervical carcinoma uterine]
- 2001 Consensus Guidelines for the management of women with cervical cytological abnormalities.
- HLA-DQBl alleles and susceptibility to cervical squamous cell carcinoma in Southern Iranian patients.
- Outcomes of a community-based three-year breast and cervical cancer screening program for medically underserved, low income women.
- The pathology and molecular biology of anal intraepithelial neoplasia: comparisons with cervical and vulvar intraepithelial carcinoma.
- Views of Irish general practitioners on screening for cervical cancer.
- Knowledge of cervical cancer screening and use of cervical screening facilities among women from various socioeconomic backgrounds in Durban,
- Recurrent cervical cancer: detection and prognosis.
- Location-guided screening of liquid-based cervical cytology specimens: a potential improvement in accuracy and productivity is demonstrated in a
- Only one quarter of women with learning disability in Exeter have cervical screening.
- Cervical screening for women with learning disability. Numbers screened can be optimised by using a focused initiative.
- Cervical screening for women with learning disability. Concerted effort is needed to ensure these women use preventive services.
- Cervical screening for women with learning disability. Sefton has multidisciplinary group to promote sexual health care for these women.
- Physicians urged to recommend Pap tests to women ages 65 and older--new educational materials now available from NCI.
- [Operable stage IB and II cancer of the uterine neck: retrospective comparison between preoperative utero-vaginal curietherapy and initial
- Endocervical status is not predictive of the incidence of cervical cancer in the years after negative smears.
- [Efficacy of organized screening in comparison to spontaneous Pap samples in the prevention of invasive cervical cancer]
- Endocervical cells, pathology of the cervix, and time.
- Effect of oral contraceptives on risk of cervical cancer in women with human papillomavirus infection: the IARC multicentric case-control
- Role of parity and human papillomavirus in cervical cancer: the IARC multicentric case-control study.
- Oral contraceptives and cervical cancer.
- Oral contraceptives and cervical cancer.
- Oral contraceptives and cervical cancer.
- A model for co-expression pattern analysis of genes implicated in angiogenesis and tumour cell invasion in cervical cancer.
- Localization and staging of cervical intraepithelial neoplasia using double ratio fluorescence imaging.
- ACOG practice bulletin. Diagnosis and treatment of cervical carcinomas. Number 35, May 2002. American College of Obstetricians and
- Early cervical cancer rescreening.
- The Pap smear: a victim of its own success?
Table of Contents
1
UI - 12039126
AU - Sellors JW; Jeronimo J; Sankaranarayanan R; Wright TC; Howard M;
TI -
Blumenthal PD
Assessment of the cervix after acetic acid wash: inter-rater agreement
using photographs.
SO - Obstet Gynecol 2002 Apr;99(4):635-40
AD - Program for Appropriate Technology in Health (PATH), Seattle,
Washington, USA. jsellors@path.org
OBJECTIVE: To estimate the inter-rater agreement on the assessment of
cervical photographs after acetic acid wash, using visual inspection
with acetic acid categories. METHODS: Three raters individually assessed
144 photographs as negative, positive, or suspicious for cancer. The
inter-rater agreement was analyzed using the unweighted and weighted
kappa coefficient. To explore the reasons for concordancy and
discordancy, photographs were compared on histologic evidence of
cervical intraepithelial neoplasia and on testing for oncogenic types of
human papillomavirus. RESULTS: Overall raw agreement among the three
raters was 66.7% (96 of 144) with a kappa of 0.57 (95% confidence
interval 0.48, 0.66). Pair-wise agreement using unweighted and weighted
kappa was moderate to substantial: 0.54-0.60 and 0.56-0.63,
respectively. There was concordance on negative in 25.7% (37 of 144) and
on positive or suspicious for cancer in 41.0% (59 of 144). Cervical
intraepithelial neoplasia II or III was not present on biopsy if
photographs were concordant-negative, and the human papillomavirus test
was less likely to be positive (relative risk 0.3; 95% confidence
interval 0.2, 0.6) in concordant-negatives compared with
concordant-positives, including suspicious for cancer. Cervical
intraepithelial neoplasia II or III was more common in photographs that
were concordant-positive, including suspicious for cancer, compared with
discordants (relative risk 3.4, 95% confidence interval 1.5, 7.6).
CONCLUSION: Based on photographs of the cervix taken after acetic acid
wash, the level of agreement among raters using visual inspection with
acetic acid categories was moderate to substantial, consistent with
other commonly used tests.
2
UI - 12039132
AU - Solomon D; Schiffman M; Tarone R
TI -
ASCUS LSIL Triage Study (ALTS) conclusions reaffirmed: response to a
SO - Obstet Gynecol 2002 Apr;99(4):671-4
AD - Division of Cancer Prevention, National Cancer Institute, Maryland, USA.
ds87v@nih.gov
3
UI - 12121440
AU - Ahmed SM; Al H; Reid WM; Johnson MA; Poulter LW
TI -
The cellular response associated with cervical intraepithelial neoplasia
in HIV+ and HIV- subjects.
SO - Scand J Immunol 2002 Aug;56(2):204-11
AD - Department of Immunology, Royal Free and University College Medical
School, London, UK. lenpee@btclick.com
This study investigates local alterations in T-cell and macrophage
subsets that occur in cervical epithelial neoplasia (CIN), in the
presence and absence of human immunodeficiency virus (HIV) infection.
Ectocervical biopsies from 10 women with CIN who were infected with HIV,
and 10 women with CIN but no HIV infection were studied by
immunocytochemistry. Significantly increased proportions of activated
CD8+ T cells were seen in all CIN biopsies, and these proportions were
further increased in the presence of HIV infection. Levels of CD8+TIA-1+
cells were particularly increased in the CIN+HIV+ group. There was a
lack of expression of CD28 on the CD8+ cells of the epithelium of
CIN+HIV+ samples. A significant reduction in the proportion of
epithelial inductive D1+ macrophages and an increase in
D1+D7+-suppressive cells were observed in the CIN+HIV+ cohort. The lack
of expression of CD28 on the CD8+ cells of the epithelium of CIN+HIV+
samples in combination with the reduced CD4+ T-cell numbers seen in the
presence of HIV infection may contribute to the development of higher
grade CIN in this susceptible group. This may be aggravated by the
reduction in the D1+ epithelial inductive macrophages, which might
reflect recruitment of more suppressive D1+D7+ cells. This would further
compromise the ability of the local T-cell system to respond to antigens
and thus contribute to the development of neoplasia at this site. These
results suggest that the increase in activated CD8+ T cells is a
consequence rather than a cause of CIN.
4
UI - 11852544
AU - Comar M; Wiesenfeld U; Variola F; Campello C
TI -
HPV-direct in situ PCR: an advanced molecular tool in the screening of
cervical cancer.
SO - Ann Ig 2001 Nov-Dec;13(6):581-6
AD - Dip. di Scienze di Medicina Pubblica, UCO Igiene e Medicina Preventiva,
Universita degli Studi di Trieste, IRCCS Burlo Garofolo, Trieste.
5
UI - 11981939
AU - Arbyn M; Temmerman M
TI -
Parliament calls for organised cervical cancer screening and HPV
research.
SO - Eur J Obstet Gynecol Reprod Biol 2002 Mar 10;101(2):101-2
6
UI - 11858896
AU - Erzen M; Mozina A; Bertole J; Syrjanen K
TI -
Factors predicting disease outcome in early stage adenocarcinoma of the
uterine cervix.
SO - Eur J Obstet Gynecol Reprod Biol 2002 Mar 10;101(2):185-91
AD - Unit of Gynaecological Pathology and Cytology, Department of Obstetrics
and Gynaecology, University Medical Centre, Ljubljana, Slajmerjeva 3,
1105, Ljubljana, Slovenia. mojca.erzen@amis.net
CONTEXT: Adenocarcinoma (AC) and adenosquamous carcinoma (ASC) comprise
the second principal histological types of cervical carcinoma. As
compared with the squamous cell cancer (SCC), these lesions are far less
frequent, and their epidemiology, natural history and prognostic
determinants are less well understood. OBJECTIVE: Patients with an early
stage AC of the uterine cervix diagnosed in our clinic were subjected to
detailed analysis for the prognostic determinants. STUDY SUBJECTS: A
series of 94 women with early stage (adenocarcinoma in situ (AIS) to
IIB) cervical ACs or ASCs diagnosed and treated in our department during
1995-1999 and subsequently followed-up for a mean of 43.1 +/- 16.2
(S.D.) months. MAIN OUTCOME MEASURES: Patients were examined by
colposcopy, Papanicolaou (PAP) smear and biopsy. The stage of the
disease (FIGO) and tumour histology in operative specimens were
recorded, and univariate (Kaplan-Meier) and multivariate survival
analysis (Cox) were run to explore the factors predicting disease
outcome. RESULTS: Mean age of the women was 44.2 +/- 2.5 (S.D.) years
(range 24-81 years), which is significantly (P=0.000) lower than that
(49.9 +/- 14.2) of 464 SCC patients in our material. Minority of the
women (38.2%) reported any clinical symptoms, but these correlated with
the stage (P=0.041). Screening history was acceptable (i.e. screening
interval 3 to 4 years) in 56 women, whereas 28 (29.8%) had no previous
PAP smear taken. Interpretation errors were established in 17 (23.6%)
and sampling errors in 6 (8.3%) of the 72 smears available for
re-screening. No colposcopic lesions were found in 29 (30.9%) women.
Follow-up data were available from 72 patients, of whom the disease
progressed in four (one died), whereas 68 patients are alive and well at
the moment. Patient's age (P=0.000), screening history (P=0.0127), FIGO
stage (P=0.001), mode of therapy (P=0.0187), and presence of co-existent
squamous cell lesions (P=0.0184) were significant prognostic indicators
in univariate survival analysis. Cox's multivariate survival analysis
disclosed FIGO stage (P=0.001) and screening history (P=0.006) as the
only significant independent predictors of the disease outcome.
CONCLUSIONS: The present data emphasise the importance of early cervical
AC as a disease of younger women, making early detection of its
precursors (AIS) by regular PAP smear screening mandatory in prevention
of disease progression. This can only be achieved by increasing the
sensitivity of the PAP smear in detecting abnormal glandular cells in
asymptomatic women.
7
UI - 11858897
AU - Kodama J; Mizutani Y; Hongo A; Yoshinouchi M; Kudo T; Okuda H
TI -
Optimal surgery and diagnostic approach of stage IA2 squamous cell
carcinoma of the cervix.
SO - Eur J Obstet Gynecol Reprod Biol 2002 Mar 10;101(2):192-5
AD - Department of Obstetrics and Gynecology, Okayama University Medical
School, 2-5-1 Shikata-cho, 700-8558, Okayama, Japan.
kodama@cc.okayama-u.ac.jp
BACKGROUND: Most patients with International Federation of Gynecology
and Obstetrics (FIGO) stage IA2 squamous cell carcinoma of the cervix,
opt for radical surgery at present. Objective: To review surgical and
diagnostic approaches in such patients. STUDY DESIGN: Our patient
population consisted of 394 patients with a diagnosis of stage I
squamous cell cervical carcinoma (with depth of stromal invasion 10mm or
less) according to the 1995 FIGO definition. Biopsy and surgical
specimen slides were reassessed retrospectively in all cases. The
findings of T2-weighted MR imaging were available from the individual
medical charts. RESULTS: None of the patients with stromal invasion of
5mm depth or less showed pelvic lymph node metastasis. However,
metastasis to the parametrial connective tissue was found in one case
with stage IA1 exhibiting marked lymph-vascular space involvement. There
were no deaths due to disease in cases with stromal invasion of 5mm
depth or less. The lesions were detected in all 20 cases exhibiting
stromal invasion of greater than 5mm in depth. In contrast, the lesions
were not detected with T2 imaging in four of six cases (67%) with stage
IA2. CONCLUSION: Simple or modified radical hysterectomy with pelvic
lymph node dissection may be sufficient for cases of stage IA2 cervical
squamous cell carcinoma where lymph-vascular space involvement is
absent. T2-weighted MR imaging with no detectable tumor would prove
beneficial in the selection of these patients.
8
UI - 11985562
AU - Shaw PA
TI -
Lessons from the audit of invasive cervical cancer.
SO - Cytopathology 2002 Feb;13(1):1-3
9
UI - 11985563
AU - Smith JH
TI -
Bethesda 2001.
SO - Cytopathology 2002 Feb;13(1):4-10
AD - Department of Histopathology, Royal Hallamshire Hospital, Sheffield, UK.
John.Smith@sth.nhs.uk
The Bethesda system (TBS) for reporting cervical/vaginal cytological
diagnoses was originally developed in 1988 at a National Cancer
Institute (NCI) workshop convened to consider the benefits of increased
standardization in the diagnostic reports provided by cytology
laboratories. It rapidly gained acceptance in laboratory practice in the
USA and beyond and three years later the NCI sponsored another workshop
to assess the use of TBS in practice and consider areas for improvement.
Subsequently an illustrated guide was published.
10
UI - 11985571
AU - Kitchener HC
TI -
Is it reality or an illusion that liquid-based cytology is better than
conventional cervical smears?
SO - Cytopathology 2002 Feb;13(1):64-5
11
UI - 11985572
AU - Linder J
TI -
Is it reality or an illusion that liquid-based cytology is better than
conventional cervical smears?
SO - Cytopathology 2002 Feb;13(1):66
12
UI - 12073052
AU - Scheungraber C; Muller B; Kohler C; Possover M; Leistritz S; Schneider
TI -
A; Durst M
Detection of disseminated tumor cells in patients with cervical cancer.
SO - J Cancer Res Clin Oncol 2002 Jun;128(6):329-35
AD - Klinik fur Frauenheilkunde und Geburtshilfe der
Friedrich-Schiller-Universitat Jena, Abteilung Frauenheilkunde, Germany.
PURPOSE: Detection of disseminated tumor cells in a cohort of patients
presenting the entire spectrum of invasive cervical cancer. METHODS:
Disseminated tumor cells were detected in blood samples taken at
different times during surgery or in bone marrow aspirates by a HPV
type-specific nested PCR enzyme immunoassay (n-PCR-EIA). A group of 24
patients with HPV-positive cervical cancers representing early and late
stages were evaluated, and 15 patients with breast cancer and without
HPV-related genital disease served as controls. RESULTS: Disseminated
tumor cells were detected in blood samples and/or bone marrow aspirates
of 6 of 24 patients. A significant association was found between
detectable disseminated tumor cells and recurrent disease ( P=0.013) and
between disseminated tumor cells and survival of the patients (
P=0.0054). There was also a clear association between the presence of
disseminated tumor cells and tumor size and/or positive lymph node
status which, however, was not statistically significant. There was no
evidence of increased shedding of tumor cells during surgery.
CONCLUSION: Detection of disseminated tumor cells in blood or bone
marrow may prove to be of prognostic value, particularly for early-stage
cervical cancers.
13
UI - 12174401
AU - Wismer BA; Moskowitz JM; Min K; Chen AM; Ahn Y; Cho S; Jun S; Lew A; Pak
TI -
YM; Wong JM; Tager IB
Interim assessment of a community intervention to improve breast and
cervical cancer screening among Korean American women.
SO - J Public Health Manag Pract 2001 Mar;7(2):61-70
AD - Center for Family and Community Health, School of Public Health,
University of California, Berkeley, California, USA.
Breast and cervical cancer screening practices are suboptimal among
Korean American women. A community intervention program was launched in
1996 to improve breast and cervical cancer screening among Korean
American women in Alameda County, California. After 18 months, interim
program assessment revealed that mammograms improved, but Pap smears,
breast self-examinations, and clinical breast examinations did not
change significantly. However, results were similar for the control
county probably because the program was not implemented fully. Several
strategies for improving program implementation are discussed including
recommendations for researchers planning community intervention
projects.
14
UI - 12163690
AU - Ziegler RG; Weinstein SJ; Fears TR
TI -
Nutritional and genetic inefficiencies in one-carbon metabolism and
cervical cancer risk.
SO - J Nutr 2002 Aug;132(8 Suppl):2345S-2349S
AD - Epidemiology and Biostatistics Program, Division of Cancer Epidemiology
and Genetics, National Cancer Institute, Bethesda, MD 20892, USA.
zieglerr@mail.nih.gov
Folate deficiency has long been postulated to play a role in the
etiology of cervical cancer, the third most frequent cancer among women
worldwide. In a large, multiethnic community-based case-control study of
invasive cervical cancer in five U.S. areas, we assessed accepted and
postulated risk factors with an in-home interview and successfully
obtained blood samples, at least 6 mo after completion of cancer
treatment, from 51 and 68%, respectively, of interviewed cases and
controls. Cases with advanced disease (6%) and/or receiving chemotherapy
(4%) were excluded, leaving 183 cases and 540 controls. Serum and red
blood cell folate were measured with both microbiologic and radiobinding
assays. For all four folate measures, risk was moderately, but
nonsignificantly, elevated for women in the lowest quartile, compared to
the highest [fully adjusted relative risks (RR), including serologic
human papillomavirus (HPV)-16 status = 1.2-1.6]. However, for women in
the upper three homocysteine quartiles (>6.31 micro mol/L), risk of
invasive cervical cancer was substantially and significantly elevated
(fully adjusted RR, including serologic HPV-16 status = 2.4-3.2; P for
trend = 0.01). This strong relationship suggests that circulating
homocysteine may be 1) an especially accurate indicator of inadequate
folate, 2) an integratory measure of insufficient folate in tissues or
3) a biomarker of disruption of one-carbon metabolism. The contribution
of common polymorphisms in one-carbon pathway genes, as well as
inadequate vitamin B-6, vitamin B-12 and/or riboflavin, to elevated
homocysteine, inefficient one-carbon metabolism and increased cervical
cancer risk merits further exploration.
15
UI - 11942715
AU - Lee J; Seow A; Ling SL; Peng LH
TI -
Improving adherence to regular pap smear screening among Asian women: a
population-based study in Singapore.
SO - Health Educ Behav 2002 Apr;29(2):207-18
AD - Department of Community, Occupational and Family Medicine, Faculty of
Medicine, National University of Singapore. cofleejm@nus.edu.sg
This study addresses the issue of adherence to regular screening for
cervical cancer in Asian women and factors that would promote this. A
community-based cross-sectional survey was carried out among 726 women
(30-59 years) in Singapore. Although the overall screening prevalence
was 62.4%, only 42% reported having regular smears. Women in the
irregular group were more likely to have a Pap smear as part of
postnatal or family planning visits, whereas the primary reason for
attendance among the regular group was likely to be screening or a
health checkup. Chief barriers to regular screening were low perceived
susceptibility (46.5%) and low accessibility (37.1%). One third of women
who have ever had a smear do not return for regular screening.
Appropriate windows of opportunity in contact between women and the
health care services should be used to convey the importance of
adherence to screening.
16
UI - 11998209
AU - Mubiayi N; Bogaert E; Boman F; Leblanc E; Vinatier D; Leroy JL; Querleu
TI -
D
[Cytological history of 148 women presenting with invasive cervical
cancer]
SO - Gynecol Obstet Fertil 2002 Mar;30(3):210-7
AD - Clinique de gynecologie-obstetrique et neonatologie, hopital
Jeanne-de-Flandre, CHRU de Lille, 59037 Lille, France.
ndaye@club-internet.fr
OBJECTIVES: The aim of this study was to analyse the cytological history
of women presenting with invasive cervical cancer. MATERIAL AND METHODS:
Retrospective study of 148 patients treated for invasive cervical cancer
in three hospitals of the North Pas de Calais in France. RESULTS: The
average age of patients was 49 (26-86). Squamous carcinomas represented
81% of cases (120/148), adenocarcinomas 17% (25/148) and adenosquamous
carcinomas 2% (3/148). 36.5% of patients (54/148) had never had a Pap
smear. 34.5% (51/148) had had an occasional Pap smear (the last one
dated of more than three years). 8.1% (12/148) were lost for follow up
after a positive Pap smear. 3.4% (5/148) were treated for cervical
dysplasia less than three years before the diagnosis of the cervical
cancer. 17.5% (26/148) had had a Pap smear reported as negative less
than three years before the diagnosis of the cervical cancer. In this
last group, squamous carcinomas represented 57.7% of cases (15/26),
adenocarcinomas 38.5% (10/26) and adenosquamous carcinomas 3.8% (1/26).
18 Pap smears of 26 reported as negative less than three years before
the diagnosis of the cancer were reviewed. These Pap smears came from 11
patients presenting with squamous carcinoma and seven other presenting
with adenocarcinoma. After review, 15 Pap smears were reported as false
negatives and two as true negatives. The review was not possible in one
case. CONCLUSION: In this study, the failures of cervical cancer
screening were essentially attributed to the lack or the insufficiency
of screening and the existence of false negatives of the cytology.
17
UI - 12043504
AU - Sahraoui S; Bouras N; Acharki A; Benider A; Tawfiq N; Jouhadi H; Kahlain
TI -
A
[Adenocarcinoma of the cervix uteri: a retrospective study of 83 cases]
SO - Gynecol Obstet Fertil 2002 Apr;30(4):291-8
AD - Centre d'oncologie, CHU Ibn Rochd, Casablanca, Maroc.
souhasahraoui@yahoo.fr
The frequency of the adenocarcinoma of cervix uteri is increasing. AIM
OF THE STUDY: To define the characteristics of the entity. PATIENTS AND
METHODS: Between 1986 and 1992, 83 adenocarcinoma of cervix uteri, were
treated at the Ibn Rochd Oncology Centre in Casablanca. It's a
retrospective study with univariate analysis of the prognostic factors.
This analysis was done for patients who were followed until the death or
have 5 years or more follow up and the survival was calculated according
the Kaplan & Meier method at 5 years. The local and regional recurrence
factors were evaluated statically according the chi 2 and those for
survival rate according the Logrank test. RESULTS: The frequency
increased during the period with 2.1% in 1986 and 8.2% in 1992. The
median of aged was 49 years. Fifty one patients have localised stage.
Combined radiotherapy and surgery was performed in 66 cases and 17
received radiation alone. The loco-regional control was obtained in 83%
among 73 available patients for results. The univariate analysis showed
that the histological type was not a significant factor. However, age,
tumor size, stage, histological grade and lymph node involvement were
significant factors. These factors, the degree of differentiation and
the lymph node involvement were significant for the 5-years survival.
CONCLUSION: The prognosis factors of the cervix uteri adenocarcinoma
are, size tumor more than 4 cm, lymph node involvement, microscopic
involvement to the parameters and positives excision merges.
18
UI - 12043507
AU - Tranbaloc P
TI -
[In situ adenocarcinoma of the uterus cervix: difficulties of its
cytohistological diagnosis]
SO - Gynecol Obstet Fertil 2002 Apr;30(4):308-15
AD - Centre de pathologie, 19, rue de Passy 75016, Paris, France.
pathopassy@aol.com
In situ adenocarcinoma is regarded as the precursor of invasive
adenocarcinoma. It is asymptomatic and early diagnosis relies solely on
cytopathologist. It is usually discovered on a cone for squamous CIN.
When diagnosis is made by biopsy, conisation is required to exclude
invasive adenocarcinoma. Lesion is histologically characterised by
epitheliomatous transformation of endocervical glands without invasion
of the chorion. By the appearance of glandular cells, different
histological varieties are described. They have no influence on the
prognosis. Several benign lesions may mimic adenocarcinoma: tubal
metaplasia, glandular atypia due to inflammation or irradiation,
mesonephric remnants and microglandular hyperplasia. Precursor lesions
(atypical hyperplasia, glandular dysplasia, CIGNI and II) are badly
morphologically defined. Preferential location of in situ adenocarcinoma
is the transformation zone. Because of this topography, if the surgical
margins are disease free, conisation alone may be adequate therapy. HPV
infection (mainly HPV 18) are incriminated in its pathogenesis.
19
UI - 12196621
AU - Cardin VA; Grimes RM; Jiang ZD; Pomeroy N; Harrell L; Cano P
TI -
Low-income minority women at risk for cervical cancer: a process to
improve adherence to follow-up recommendations.
SO - Public Health Rep 2001 Nov-Dec;116(6):608-16
AD - University of Texas School of Public Health, PO Box 20186, Houston, TX
77225, USA.
OBJECTIVE: The Houston Department of Health and Human Services (HDHHS)
has a centralized process for notifying and setting up follow-up
appointments for women with abnormal Pap smears who are clients of HDHHS
health centers. Faculty and a student from the University of Texas
School of Public Health and HDHHS personnel jointly conducted a study to
evaluate the process and performance of the system. METHODS: The study
examined two subpopulations: women with atypical squamous cells of
undetermined significance or low-grade squamous intraepithelial lesions
(ASCUS/LGSIL) and women with high-grade squamous intraepithelial lesions
or atypical glandular cells of undetermined significance (HGSIL/AGCUS).
A retrospective study was conducted of data on women attending eight
Records of 1,216 women referred for evaluation of abnormal Pap smears
were reviewed. Process effectiveness was measured by the number of
successful contacts made and the number of appointments set up.
Performance was measured by compliance with referral appointments.
Predictors included race/ethnicity, age, co-existence of a sexually
transmitted disease, number of prior referrals, type of patient visit,
and health center attended. RESULTS: HDHHS staff successfully notified
95.6% of women with ASCUS/LGSIL and 97.9% of women with HGSIL/AGCUS.
Using performance criteria as outcome measures, high-risk women
requiring targeted interventions were identified. Overall, 84.2% of
women scheduled appointments. Among those with ASCUS/LGSIL, women
identified as African American were 53% less likely to accept an
appointment and 45% less likely to show up for the appointment than
those identified as Hispanic or "other." Age and type of patient visit
appeared to be significantly associated with patient compliance
behavior. CONCLUSION: The study describes the effectiveness of a
centralized patient follow-up process for women at risk for cervical
cancer.
20
UI - 10097694
AU - Alvarez-Santin C; Sica A; Rodriguez M; Feijo A; Garrido G
TI -
Microglandular hyperplasia of the uterine cervix. Cytologic diagnosis in
cervical smears.
SO - Acta Cytol 1999 Mar-Apr;43(2):110-3
AD - Department of Pathology, Facultad de Medicina, Universitad de la
Republica, Montevideo, Uruguay.
OBJECTIVE: To identify cytomorphologic features specific to
microglandular hyperplasia (MGH) in cervical cytologic smears. STUDY
DESIGN: Twenty-four cervical smears from 24 patients obtained before the
histologic diagnosis of MGH made on colposcopically directed biopsies
during a period of two years (1995-1997) were evaluated. RESULTS: Of
cases with MGH, 13/24 (54%) showed the presence of bidimensional or
tridimensional cellular clusters made up of cubic or cylindrical
glandular cells with vacuolated cytoplasm; cells with dense cytoplasm,
basaloid in appearance, corresponding to immature squamous metaplasia;
and subcylindrical reserve cells with small, round nuclei and scant
cytoplasm. Clusters showed microlumina or fenestrated spaces, preserved
polarity and absence of nuclear peripheral dispersion. In the control
group these cellular clusters were found in 6/100 (6%). Statistical
analysis (chi 2) showed a strong, highly significant association (P <
0.001) of the cytologic parameters selected and the histologic diagnosis
of MGH. CONCLUSION: Until now, no specific cytologic parameters were
described for MGH. This study underscored the value of cytomorphologic
parameters described for typical cellular clusters showing microlumina
or fenestrated spaces with shared party walls and an admixture of
glandular cells, and immature squamous metaplastic and subcylindrical
reserve cells in the cytologic diagnosis of MGH.
21
UI - 10833984
AU - Costa S; Sideri M; Syrjanen K; Terzano P; De Nuzzo M; De Simone P;
TI -
Cristiani P; Finarelli AC; Bovicelli A; Zamparelli A; Bovicelli L
Combined Pap smear, cervicography and HPV DNA testing in the detection
of cervical intraepithelial neoplasia and cancer.
SO - Acta Cytol 2000 May-Jun;44(3):310-8
AD - Department of Obstetrics and Gynecology, University of Bologna, Italy.
OBJECTIVE: The sensitivity of the Pap smear (PAP) continues to be the
subject of debate. During the past several years, cervicography (CER)
and HPV DNA testing have been suggested as optional tools in the
screening of cervical cancer precursors. STUDY DESIGN: The performance
characteristics of PAP, CER and HPV DNA testing (hybrid capture test
[HCT]) in all potential combinations were evaluated in a series of 1,030
women (aged 16-70, median, 33), subjected to colposcopy (COLPO) as the
reference tool. RESULTS: Of the 992 evaluable cases, 402/992 (41%) had
positive COLPO (i.e., an abnormal transformation zone). Of them, 298
women underwent directed punch biopsy, while of the COLPO negative
patients, 18/93 positive by at least one of the three tests had
endocervical curettage. Of the 402 COLPO positive women, 146 (36%)
remained negative on all tests, whereas 256 (64%) had at least one
positive test. There were 84 cervical intraepithelial neoplasia (CIN) 2
and 3 lesions and 6 invasive carcinomas. Of the former, 10 were detected
by PAP alone, 4 by CER alone and 3 by HCT alone. Three of the 6
carcinomas were HCT negative. The predictive value (PPV) of a positive
test was 45% for PAP, 51% for CER and 48% for HCT. The combinations of
PAP with CER (for PAP negative cases) and PAP with HCT were more
sensitive for CIN 2 and 3 (95% and 94%, respectively) as compared with
PAP alone but were associated with a significant decrease in specificity
(44% and 46% vs. 57%, respectively). However, both combinations retained
a PPV (43%) similar to that of PAP alone (45%). CONCLUSION: The
potential combinations of PAP with CER and with HCT were more sensitive
in detecting CIN 2 and 3 as compared with PAP alone and retained a PPV
similar to that of PAP.
22
UI - 11410098
AU - Moscicki AB; Hills N; Shiboski S; Powell K; Jay N; Hanson E; Miller S;
TI -
Clayton L; Farhat S; Broering J; Darragh T; Palefsky J
Risks for incident human papillomavirus infection and low-grade squamous
intraepithelial lesion development in young females.
SO - JAMA 2001 Jun 20;285(23):2995-3002
AD - Department of Pediatrics, University of California, San Francisco, USA.
CONTEXT: Low-grade squamous intraepithelial lesions (LSILs) have been
described as a benign cytological consequence of active human
papillomavirus (HPV) replication. Several studies have reported that
certain behavioral and biological risks exist for LSIL, suggesting that
HPV alone is not sufficient for the development of LSIL. However,
because most of these studies have been cross-sectional, it is not known
whether behavioral and biological risks are simply risks for HPV
infection itself. OBJECTIVE: To prospectively examine risks of incident
HPV infection in HPV-negative females and of incident LSIL development
in females with HPV infection. DESIGN: Prospective cohort study
conducted between 1990-2000, with a median follow-up of 50 months.
SETTING AND PARTICIPANTS: Females aged 13 to 21 years who attended 2
family planning clinics in the San Francisco bay area; 496 had prevalent
HPV infection and 105 were HPV-negative. MAIN OUTCOME MEASURE: Incident
development of HPV infection and LSIL, analyzed by various demographic,
behavioral, and clinical risk factors. RESULTS: Fifty-four incident HPV
infections occurred in the 105 females who were HPV-negative at study
entry (median duration of follow-up for those who remained HPV-negative
was 26 months). Multivariable analysis showed that risks of HPV included
sexual behavior (relative hazard [RH], 10.10; 95% confidence interval
[CI], 3.24-31.50 per new partner per month), history of herpes simplex
virus (RH, 3.54; 95% CI, 1.37-9.10), and history of vulvar warts (RH,
2.73; 95% CI, 1.27-5.87). Current use of oral contraceptives had a
significantly protective effect (RH, 0.49; 95% CI, 0.28-0.86). Among the
496 individuals who were HPV-positive at baseline or in follow-up, there
were 109 incident cases of LSIL during the follow-up interval, with a
median follow-up time of 60 months for those who never developed LSIL.
Human papillomavirus infection was the most significant risk factor for
development of LSIL. The multivariable model showed the following risks
for LSIL: HPV infection for less than 1 year (RH, 7.40; 95% CI,
4.74-11.57); HPV infection for 1 to 2 years (RH, 10.27; 95% CI,
5.64-18.69); HPV infection for 2 to 3 years (RH, 6.11; 95% CI,
1.86-20.06); and daily cigarette smoking (RH, 1.67; 95% CI, 1.12-2.48).
CONCLUSION: Our results indicate distinct risks for HPV and LSIL. In
addition, most women with HPV infection in our study did not develop
LSIL within a median follow-up period of 60 months. These findings
underscore the hypothesis that certain biological risks thought to be
associated with LSIL are, in fact, risks for acquisition of HPV.
Cigarette smoking was a risk specific to LSIL, supporting the role of
tobacco in neoplastic development.
23
UI - 11530126
AU - Belinson JL; Pretorius RG; Zhang WH; Wu LY; Qiao YL; Elson P
TI -
Cervical cancer screening by simple visual inspection after acetic acid.
SO - Obstet Gynecol 2001 Sep;98(3):441-4
AD - Department of Gynecology and Obstetrics, The Cleveland Clinic
Foundation, Cleveland, Ohio 44195, USA. belinsj@ccf.org
OBJECTIVE: To estimate the sensitivity and specificity of visual
inspection using acetic acid as a primary screen for cervical
intraepithelial neoplasia (CIN). METHODS: Visual inspection was done on
1997 women aged 35-45 years in a screening trial in rural China. Each
women had colposcopy and at least five cervical biopsies (directed
biopsy of lesions, one biopsy at 2, 4, 8, or 10 o'clock at the
squamocolumnar junction in each normal quadrant, and an endocervical
curettage). RESULTS: Forty-three women had biopsy-proven CIN II, 31 had
CIN III, and 12 had invasive cancer. In two women only the endocervix
was positive (one with CIN II and one with CIN III). Visual inspection
yielded normal results in 1445 women (72%), low-grade intraepithelial
neoplasia in 525 (26%), high-grade in 21 (1%), and cancer in six (0.3%).
With abnormal visual inspection defined as low-grade intraepithelial
neoplasia or worse, the sensitivity for detecting biopsy proven CIN II
or worse was 71% (61 of 86, 95% confidence interval [CI] 60%, 80%); the
specificity was 74% (1420 of 1911, 95% CI 72%, 76%); the sensitivity was
65% for smaller lesions (37 of 57, 95% CI 51%, 77%), and 89% for larger
lesions (24 of 27, 95% CI 71%, 98%) (P =.03). CONCLUSION: The
sensitivity of visual inspection equaled or exceeded reported rates for
conventional cervical cytology. Visual inspection and colposcopy have
similar specificity profiles for CIN II and greater. The benefit of an
inexpensive point-of-care diagnosis and treatment algorithm will be a
powerful incentive to pursue visual inspection for cervical cancer
screening in developing countries.
24
UI - 11797876
AU - Paul C
TI -
Should the law require doctors to make records available for audit of
cervical screening?
SO - N Z Med J 2001 Nov 9;114(1143):499-500
AD - Department of Preventive and Social Medicine, University of Otago
Medical School, Dunedin. charlotte.paul@stonebow.otago.ac.nz
25
UI - 11809252
AU - Conley LJ; Ellerbrock TV; Bush TJ; Chiasson MA; Sawo D; Wright TC
TI -
HIV-1 infection and risk of vulvovaginal and perianal condylomata
acuminata and intraepithelial neoplasia: a prospective cohort study.
SO - Lancet 2002 Jan 12;359(9301):108-13
AD - Division of HIV/AIDS Prevention, Surveillance, and Epidemiology,
National Center for HIV, STD, and TB Prevention, Centers for Disease
Control and Prevention, Public Health Service, US Department of Health
and Human Services, Atlanta, GA, USA.
BACKGROUND: Information about vulvovaginal and perianal condylomata
acuminata and intraepithelial neoplasia in women infected with HIV-1 is
needed to develop guidelines for clinical care. Our aim was to
investigate the incidence of these lesions in HIV-1-positive and
HIV-1-negative women and to examine risk factors for disease. METHODS:In
a prospective cohort study, 925 women had a gynaecological examination
twice yearly-including colposcopy and tests for human papillomavirus DNA
in cervicovaginal lavage-for a median follow-up of 3.2 years (IQR
0.98-4.87). FINDINGS: Vulvovaginal and perianal condylomata acuminata or
intraepithelial neoplasia were present in 30 (6%) of 481 HIV-1-positive
and four (1%) of 437 HIV-1-negative women (p<0.0001) at enrollment.
Women without lesions at enrollment were included in an incidence
analysis. 33 (9%) of 385 HIV-1-positive and two (1%) of 341
HIV-1-negative women developed vulvovaginal or perianal lesions,
resulting in an incidence of 2.6 and 0.16 cases per 100 person-years,
respectively (relative risk 16, 95% CI 12.9-20.5; p < 0.0001). Risk
factors for incident lesions included HIV-1 infection (p = 0.013), human
papillomavirus infection (p=0.0013), lower CD4 T lymphocyte count (p =
0.0395), and history of frequent injection of drugs (p=0.0199).
INTERPRETATION: Our results suggest that HIV-1-positive women are at
increased risk of development of invasive vulvar carcinoma. Thus, we
recommend that, as part of every gynaecological examination,
HIV-1-positive women should have a thorough inspection of the vulva and
perianal region, and women with abnormalities-except for typical,
exophytic condylomata acuminata-should undergo colposcopy and biopsy.
26
UI - 11876385
AU - Yuan CC; Wang PH; Ng HT; Tsai LC; Juang CM; Chiu LM
TI -
Both TPA and SCC-Ag levels are prognostic even in high-risk stage Ib-IIa
cervical carcinoma as determined by a stratification analysis.
SO - Eur J Gynaecol Oncol 2002;23(1):17-20
AD - Department of Obstetrics and Gynecology, Taipei Veterans General
Hospital and National Yang-Ming University School of Medicine, Taiwan.
OBJECTIVE: To determine the prognostic values of tissue polypeptide
antigen (TPA), squamous cell carcinoma antigen (SCC-Ag), and
carcinoembryonic antigen (CEA) in the sera of cervical carcinoma
patients, especially in those with a poor prognosis. METHODS: In this
retrospective study, the preoperative serum SCC-Ag, TPA, and CEA were
analyzed in 779 patients with cervical squamous cell carcinoma of stage
Ib-IIa who received radical hysterectomy and pelvic lymph node
dissection (RAH-PLND) between 1984 and 1994. RESULTS: Due to poor
predictive value and poor correlation between serum CEA and
clinico-pathological factors, CEA was abandoned in this study. Elevated
TPA and SCC-Ag levels, pelvic lymph node metastasis (PLNM),
lymphvascular space involvement (LVSI) and deep stromal invasion (DSI)
were associated with poor survival time by univariate analysis. The
correlation study showed that elevated serum TPA was significantly
related to PLNM, LVSI, and DSI (p = 0.004, 0.008, and 0.021,
respectively), and SCC-Ag was related to PLNM and bulky tumor size (p =
0.001 and 0.02, respectively). In the multivariate analysis, only PLNM
and LVSI remained independently significant indicating poor survival.
Further stratification studies by PLNM and LVSI showed that elevated TPA
levels could even indicate higher recurrence rates in patients with PLNM
(p = 0.045), as well as SCC-Ag in patients with LVSI (p = 0.038).
CONCLUSIONS: The results suggest that both elevated TPA and SCC-Ag
levels depicting poor prognosis in stage Ib-IIa cervical SCC, especially
indicates a group of high-risk patients who may need more aggressive
therapy.
27
UI - 11876400
AU - Pete I; Szirmai K; Csapo Z; Szantho A; Fule T; Gallai M; Kovalszky I
TI -
Detection of high-risk HPV (16, 18, 33) in situ cancer of the cervix by
PCR technique.
SO - Eur J Gynaecol Oncol 2002;23(1):74-8
AD - National Institute of Cancer, Gynecol. Dept., Budapest, Hungary.
OBJECTIVE: The purpose of this study was to collect data about the
incidence of high-risk HPV (16, 18, 33) types in in situ cervical
cancers, and to evaluate the reliability of the morphological signs of
HPV infection by comparing the presence of these signs to the PCR-proven
HPV virus infection. METHODS: Fifty patients who underwent conisation at
the Department of Obstetrics and Gynecology of Semmelweis University,
Budapest, Hungary because of in situ cervical cancer were examined
retrospectively for the presence of HPV infection by the PCR technique.
The direct and indirect morphological signs of HPV infection identified
in the histological and cytological samples were compared to the actual
results of virus DNA amplification by PCR in the identical histological
sections. The evaluation of the cytological smears and the histological
sections was accomplished independently by two different pathologists.
RESULTS: E6 open reading frame of HPV 16, 18 or 33 was detected by PCR
in 56% (28 cases) of the histological sections of the 50 examined
patients with in situ cancer. In 92% (26 patients) of the 28 HPV
positive patients one HPV type was detected, while in one of the
remaining two cases two HPV types (16/33), or all three types could be
detected. The direct morphological signs for HPV infection proved to be
75% sensitive and 50% specific when compared to the results of PCR.
Their predictive value for HPV infection was 65%. For the indirect HPV
signs the sensitivity was 64% and specificity 31%. The predictive value,
prognosticating the presence of HPV 16, 18, 33 infection was 54% in the
same sections. Using significance analysis no significant relationship
(p = 0.7728) could be detected between the positivity of indirect signs
and the presence of HPV 16, 18, 33 infection, while in case of direct
signs the relationship was almost significant (p = 0.0675). The joint
testing of the direct and indirect signs did not improve the results (p
= 0.1338). During the review of the cytological smears the specificity
of the cytology in predicting true HPV infections was found to be 68%
and sensitivity was 20%. The predictive value was only 50%. A
significance analysis was not accomplished by this diagnostic method
because of the missing data (see text). CONCLUSION: The method of Nawa
et al. seems to be a reliable approach for the detection of HPV DNA in
paraffin-embedded material. The three main types of HPV (16, 18, 33) are
probably represented in lower percentages in CIN III in Hungary, but a
larger survey is needed to obtain reliable data. The direct and indirect
morphological signs of HPV infection failed to show a significant
relationship with the PCR proven presence of HPV 16, 18, 33.
Cancer Types
Bone Cancer
Brain Tumors
Breast Cancer
Carcinoid Tumors
Endocrine System Cancers
Gastrointestinal Cancers
Gynecologic Cancers
Head and Neck Cancers
Leukemia
Lung Cancers
Lymphomas
Myelomas
Pediatric Cancers
Penile Cancer
Prostate Cancer
Sarcomas
Skin Cancers
Testicular Cancer
Thyroid Cancer
Urinary Tract Cancers
OncoLink Vet
Cancer Treatment
Biologic Therapy
Bone Marrow Transplants
Chemotherapy
Clinical Trials
Complementary Medicine
Gene Therapy
General Treatment Concerns
Hormone Therapy
PDT Center
Proton Therapy
Radiation Oncology
Surgical Oncology
Targeted Therapies
Vaccine Therapies
Cancer Support
Caregivers
Hospice Care and Bereavement
Nutrition and Cancer
Sexuality & Fertility
Side Effects
Support
Survivorship
Exercise and Cancer
Cancer Resources
Cancer News
OncoLink University
Nurses' Notes
Conferences
Newly Diagnosed Patients
Causes and Prevention
Legal and Financial Information for Patients
LGBT Resources
NCI Resources
Global Resources
Cancer Resource List
Resources for Young Adults
OncoLink Media Library
OncoLink TV
Book, Music and Video Reviews
Ask the Experts
Brown Bag Chat
Tracy's Corner
About OncoLink
About OncoLink
Giving to OncoLink
Contact Information
Usage Policy
Editorial Board
How to Partner with OncoLink
Link to OncoLink
Mission Statement
