National Cancer Institute®
Last Modified: October 1, 2002
UI - 10942474
AU - Denny L; Kuhn L; Risi L; Richart RM; Pollack A; Lorincz A; Kostecki F;
TI - Wright TC Jr Two-stage cervical cancer screening: an alternative for resource-poor settings.
SO - Am J Obstet Gynecol 2000 Aug;183(2):383-8
AD - Department of Obstetrics and Gynecology, University of Cape Town, South Africa.
OBJECTIVE: We sought to introduce 2-stage cervical cancer screening in which 2 screening tests are performed sequentially (the second test is performed only if the first result is positive), followed by treatment if both test results are abnormal. STUDY DESIGN: A total of 1423 women from Cape Town, South Africa, were screened by direct visual inspection, human papillomavirus deoxyribonucleic acid testing, cytologic testing, and cervicography. If an abnormality was identified with any test, women were referred for colposcopy. RESULTS: Direct visual inspection, cytologic testing, human papillomavirus deoxyribonucleic acid testing, and cervicography, when used alone, identified 24, 26, 23, and 23 cases of disease (high-grade squamous intraepithelial lesion or cancer) per 1000 women, respectively, and would classify 182, 71, 137, and 112 women without disease as having abnormal results. Two-stage screening with direct visual inspection first, followed by cytologic testing, human papillomavirus deoxyribonucleic acid testing, or cervicography, would detect 18, 16, and 18 cases per 1000 women, respectively, and would substantially reduce the number of women without disease who were classified as having abnormal results. CONCLUSION: Two-stage screening for cervical cancer provides an attractive alternative to conventional screening for low-resource settings.
UI - 10994279
AU - Parashari A; Singh V; Sehgal A; Satyanarayana L; Sodhani P; Gupta MM
TI - Low-cost technology for screening uterine cervical cancer.
SO - Bull World Health Organ 2000;78(8):964-7
AD - Institute of Cytology and Preventive Oncology, New Delhi, India.
We report on an illuminated, low-cost (Rs 1500 (US$ 36)) magnifying device (Magnivisualizer) for detecting precancerous lesions of the uterine cervix. A total of 403 women attending a maternal and child health care clinic who had abnormal vaginal discharge and related symptoms were referred for detailed pelvic examination and visual inspection by means of the device after the application of 5% (v/v) acetic acid. Pap smears were obtained at the same time. The results were compared with those obtained using colposcopy and/or histology. The Magnivisualizer improved the detection rate of early cancerous lesions from 60%, for unaided visual inspection, to 95%. It also permitted detection of 58% of cases of low-grade dysplasia and 83% of cases of high-grade dysplasia; none of these cases were detectable by unaided visual inspection. For low-grade dysplasia the sensitivity of detection by means of the Magnivisualizer was 57.5%, in contrast with 75.3% for cytological examination. However, the two methodologies had similar sensitivities for higher grades of lesions. The specificity of screening with the Magnivisualizer was 94.3%, while that of cytology was 99%. The cost per screening was approximately US$ 0.55 for the Magnivisualizer and US$ 1.10 for cytology.
UI - 11016148
AU - Ananth R
TI - Downstaging of cervical cancer.
SO - J Indian Med Assoc 2000 Feb;98(2):41-4
Globally cervical cancer is the fifth most common cancer and of estimated 460,000 new cases each year three quarters occur in developing countries. In India annually 16% of the world's total cases occur and only 5% are reported in the early stages. Downstaging is defined as a process of screening for cancer using clinical approaches for early detection of this disease. This is distinct from screening test and results in detection of the disease at a less advanced stage in the absence of screening. This experimental approach is applicable in developing countries where cytological screening is not possible in the near future. In this method paramedical staff trained for minimum period will be able to identify any abnormality including suspicious cervix and refer the case early to centres where facilities exist for treatment of premalignant and malignant lesions, including educating the women regarding risk factors, symptoms of the disease and prophylaxis. This experimental methodology recommended by WHO for developing countries like India has to be evaluated by monitoring various ongoing projects where visual inspection screening method is used. The results are collected which include feasibility, compliance, costing, referral methodology, difficulties in implementation, specificity, sensitivity, positive predictive value and drawbacks. The methodology of visual inspection and modified aided visual inspection, frequency and results of various studies in the Indian scenario is for recommendation of downstaging in MCH care. This is to be implemented in rural areas taking into consideration their cultural background and available infrastructure since cytology screening is not possible to cover even 20% of the existing cases in the near future.
UI - 11016150
AU - Shanta V; Krishnamurthi S; Gajalakshmi CK; Swaminathan R; Ravichandran K
TI - Epidemiology of cancer of the cervix: global and national perspective.
SO - J Indian Med Assoc 2000 Feb;98(2):49-52
AD - Cancer Institute (WIA), Chennai.
Cancer of the uterine cervix is one of the leading causes of cancer death among women worldwide. The estimated new cancer cervix cases per year is 500,000 of which 79% occur in the developing countries. Cancer cervix occupies either the top rank or second among cancers in women in the developing countries, whereas in the affluent countries cancer cervix does not even find a place in the top 5 leading cancers in women. The truncated rate (TR) in the age group 35-64 years in Chennai, India, is even higher (99.1/100,000; 1982-95) than rate reported from Cali, Colombia (77.4/100,000, 1987-91). The cervical cancer burden in India alone is estimated as 100,000 in 2001 AD. The differential pattern of cervical cancer and the wide variation in incidence are possibly related to environmental differences. Aetiologic association and possible risk factors for cervical carcinoma have been extensively studied. The factors are: Sexual and reproductive factors, socio-economic factors (education and income), viruses e.g., herpes simplex virus (HSV), human papillomavirus (HPV), human immunodeficiency virus (HIV) in cervical carcinogenesis and other factors like smoking, diet, oral contraceptives, hormones, etc. The accumulated evidence suggests that cervical cancer is preventable and is highly suitable for primary prevention. Sexual hygiene, use of barrier contraceptives and ritual circumcision can undoubtedly reduce cervical cancer incidence. Education, cervical cancer screening of high risk groups and improvement in socio-economic status can reduce cervical cancer morbidity and mortality significantly.
UI - 11016153
AU - Bhattacharyya SK; Basu S; Banerjee S; Dastidar AG; Bagchi SR
TI - An epidemiological survey of carcinoma cervix in north Bengal zone.
SO - J Indian Med Assoc 2000 Feb;98(2):60-1, 66
AD - Department of Radiotherapy, North Bengal Medical College & Hospital, Darjeeling.
Correlation between various epidemiological factors and carcinoma cervix patients in North Bengal zone has been studied for the first time. Significant correlation between elderly women (41-50 years age group), low socio-economic status (SES), first coitus before 17 years of age, low literacy rate and this illness has been established. Suggestion has been made for improvement of the picture. Oncology and radiotherapy department of North Bengal Medical College and Hospital should be utilised as the centre for National Cancer Registration Project in North Bengal zone.
UI - 12255037
AU - Hertz R; Bailar JC 3RD
TI - Estrogen-progestogen combination for contraception.
SO - J Am Med Assoc 1966 November 28;198(9):136-42
UI - 12332978
AU - Koss LG
TI - Detection of carcinoma of the uterine cervix.
SO - J Am Med Assoc 1972 November 6;222(6):699-700
UI - 12336893
AU - Keith L; Berger GS; Jackson M
TI - [Vaginal contraception. Pt. 1 (author's transl)]
SO - Contracept Fertil Sex (Paris) 1981 Apr;9(4):253-60
UI - 12279633
AU - Edgren RA
TI - [Oral contraceptives: recent safety studies (author's transl)]
SO - Contracept Fertil Sex (Paris) 1983 Sep;11(9):975-83
UI - 12280145
AU - Le MG; Bachelot A; Doyen F; Kramar A
TI - [A study on the association between the use of oral contraception and cancer of the breast or cervix: preliminary findings of a French study]
SO - Contracept Fertil Sex (Paris) 1985 Mar;13(3):553-8
UI - 12280204
AU - Vessey MP
TI - [Cancers of the uterus and ovary and the contraceptive pill]
SO - Contracept Fertil Sex (Paris) 1985 Jan;13(1 Suppl):339-43
UI - 12340276
AU - Gorins A
TI - [The cervix and hormonal contraception]
SO - Contracept Fertil Sex (Paris) 1985 Jul-Aug;13(7-8):895-9
UI - 12267399
AU - Zhuang LQ; Yang BY
TI - [Duration of use for stainless steel ring--15 years of follow-up for 6250 cases]
SO - Shengzhi Yu Biyun 1983 Aug;3(3):36-40
This study was to observe the longterm safety in using stainless steel ring (metal ring). 6250 cases have been followed up for 15 years. The net cumulative pregnancy rate was 5.51, expulsion rate 17.74, rate of removal due to medical reasons 21.74, continuation rate 6.48/women (life table) after 15 years of insertion. Events took place more frequently in the 1st year of insertion, gradually decreased in the second, and tended to be stabilized to a low level thereafter. The removal rate for nonmedical reasons had been increasing with the increase in the period of insertion. 5 cases of cervical cancer and 2 of endometrial carcinoma occurred within the 15 years of observation. The incidence was not higher than that in the 1971-72 general survey at Shanghai. Among the 6250 cases, there were 43 cases (0.85%) of removal due to infection, and 9 cases of ectopic pregnancy, of which 6 cases occurred within the first 2 years of insertion, and 2 cases of intraperitoneal metal ring were found but with no severe complications. The duration of using the metal ring was also discussed. According to clinical and pathological observations, the metal ring did not increase the risk of uterine cancer and caused only a few mild complications. Therefore, it can be used for 15-20 years, provided there are no clinical symptoms. The relationship between the IUD and ectopic or PID remains to be further explored.
UI - 12341549
AU - Anonymous
TI - Most clinicians feel DES exposure does not contraindicate OC use.
SO - Contracept Technol Update 1987 Oct;8(10):127-9
UI - 12317790
AU - Anonymous
TI - Veto -- or threat thereof -- prevails over majority as 102nd Congress adjourns.
SO - Wash Memo Alan Guttmacher Inst 1992 Oct 12;(15):2-4
UI - 12344620
AU - Anonymous
TI - FDA gives final approval to Depo amid concerns over safety, cost and coercion.
SO - Wash Memo Alan Guttmacher Inst 1992 Nov 12;(17):2-3
UI - 12287020
AU - Diczfalusy E
TI - Oral contraception: where do we stand?
SO - Contemp Rev Obstet Gynaecol 1992 Jul;4(3):148-53
UI - 12288487
AU - Agrawal A; Swain S; Dubey S; Rastogi BL
TI - Cervical cytologic profile of family planning acceptors aged around thirty years.
SO - Indian J Matern Child Health 1992 Apr-Jun;3(2):43-7
UI - 12305556
AU - Diddle AW; Watts GF; Gardner WH; Williamson PJ
TI - Control of fertility with oral medication.
SO - West J Surg Obstet Gynecol 1964 July-August;72():222-9
UI - 12276776
AU - Ovens JM
TI - Carcinoma in situ of the uterine cervix. (Letter to the editor).
SO - J Am Med Assoc 1973 January 8;223(2):195
In the October 30 issue of the Journal of the American Medical Association the question was asked how much time can safely elapse from the diagnosis of carcinoma in situ of the uterine cervix until a hysterectomy is done. The reply by the consultant indicated that hysterectomy could be done immediately, or a certain length of time up to 6-8 weeks could be allowed. There is another very definite possibility in the treatment of carcinoma of the cervix not mentioned by the consultant. With a suspicious result for a Papanicolaou smear, quadrant biopsies, or Schiller's stains being used, a cold conization of the cervix can be done. Examination of the specimen removed at the cold cone may show carcinoma of the cervix in situ surrounded by normal tissue. If the coned site of the cervix is then allowed to heal, which it will do in about 6 weeks, Papanicolaou smears may then reveal normal findings and the entire in situ cervical carcinoma may have been removed with the cold cone. If normal findings on smears persist in the future, hysterectomy may never be indicated for this condition. At times, squamous carcinoma in situ of the cervix can be cured by less radical means than hysterectomy. full text
UI - 12259009
AU - Terris M; Oalmann MC
TI - Carcinoma of the cervix: an epidemiologic study.
SO - J Am Med Assoc 1960 December 3;174(14):1847-51
UI - 12309434
AU - Robert HG; Dupre-froment J
TI - [Of the cervix intra-epithelial cancer in pill users and non-users]
SO - Contracept Fertil Sex (Paris) 1979 January;7(1):9-16
UI - 12319236
AU - Singh M; Dwivedi S; Singh G; Bajpai M
TI - Serum copper levels in different stages of carcinoma cervix uteri.
SO - Indian J Matern Child Health 1990 Jan-Mar;1(1):12-4
UI - 12292697
AU - Hesperian Foundation; Program for Appropriate Technology in Health PATH
TI - Cancer of the cervix: a training guide to promote awareness.
SO - Hesperian Found News 1997 Spring-Summer;Suppl():1-4
UI - 12294650
AU - Anonymous
TI - Cayman Islands: cervical cancer increases.
SO - Caribb Health 1999 Jan;1(4):4
A recent study of the incidence of cervical cancer in the Cayman Islands found that there had been a dramatic increase in the rate from 19.2/100,000 women during the first year of the 6 years studied to 62.6/100,000 women during the last year of the study. Well over 50% of the cases (58.6%) were women under the age of 40 years. 75% of the cases (75.9%) did not have a Pap smear within 5 years of the diagnosis. The mean annual age-adjusted incidence of cervical cancer during the study period was 42.7/100,000 women over 20 years of age, which is the highest reported incidence in the Caribbean. Further details of the study can be obtained from Dr. P. Maoris, George Twon Hospital, PO Box 915, Grand Cayman, Cayman Islands; phone: 0135 949 0190; e-mail: firstname.lastname@example.org full text
UI - 11874862
AU - Pilch H; Hohn H; Neukirch C; Freitag K; Knapstein PG; Tanner B; Maeurer
TI - MJ Antigen-driven T-cell selection in patients with cervical cancer as evidenced by T-cell receptor analysis and recognition of autologous tumor.
SO - Clin Diagn Lab Immunol 2002 Mar;9(2):267-78
AD - Department of Gynecology and Obstetrics, Johannes Gutenberg University, Mainz, Germany. HPilch3920@aol.com
We characterized the T-cell receptor (TCR) repertoire in freshly harvested tumor lesions, in short-term-expanded CD4(+) tumor infiltrating lymphocytes (TIL) as well as in CD4(+) and CD8(+) peripheral blood lymphocytes (PBL) from three patients with cervical cancer. Skewing of the T-cell repertoire as defined by measuring the length of the complementarity-determining region 3 (CDR3) of the TCR VA and VB chains was observed in CD8(+) PBL, in freshly harvested tumor tissue, as well as in CD4(+) TIL. Comparative analysis of the TCR repertoire revealed unique monoclonal TCR transcripts within the tumor lesion which were not present in PBL, suggesting selection of TCR clonotypes due to antigenic stimulation. TCR repertoire analysis of the short-term (7-day) CD4(+) TIL lines revealed that the TCR composition is markedly different from that in CD4(+) PBL or in the freshly harvested tumor tissue. Only one-third of CD4(+) TIL lines showed HLA-DR-restricted recognition of autologous tumor cells as defined by cytolysis. These data provide support for the antigen-driven selection of T cells within cervical cancer lesions and suggest that analysis of the TCR repertoire may aid in obtaining an objective description of the immune response in patients with cervical cancer who are undergoing epitope-based immunotherapy.
UI - 12287877
AU - Kim SJ; Namkoong SE; Lee JM; Ahn WS; Park JS; Kim JW; Bae SN; Han SK
TI - Cervical cancer control in Korea: colposcopy / cervicograph / cytology.
SO - Arch AIDS Res 1994;8(1-2):101-11