Preventing mortality and morbidity from cervical cancer:
Gespeichert in:
| Format: | Buch |
|---|---|
| Sprache: | English |
| Veröffentlicht: |
Philadelphia [u.a.]
Saunders
2002
|
| Schriftenreihe: | Obstetrics and gynecology clinics of North America
29,4 |
| Schlagworte: | |
| Online-Zugang: | Inhaltsverzeichnis |
| Beschreibung: | XII S., S. 599 - 885 Ill., graph. Darst. |
Internformat
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| 245 | 1 | 0 | |a Preventing mortality and morbidity from cervical cancer |c Neal M. Lonky guest ed. |
| 264 | 1 | |a Philadelphia [u.a.] |b Saunders |c 2002 | |
| 300 | |a XII S., S. 599 - 885 |b Ill., graph. Darst. | ||
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| 490 | 1 | |a Obstetrics and gynecology clinics of North America |v 29,4 | |
| 650 | 7 | |a Baarmoederhalskanker |2 gtt | |
| 650 | 7 | |a Preventie |2 gtt | |
| 650 | 7 | |a Sterfte |2 gtt | |
| 650 | 7 | |a Ziektecijfer |2 gtt | |
| 650 | 4 | |a Cervix Neoplasms | |
| 650 | 4 | |a Cervix Neoplasms |x prevention & control | |
| 650 | 4 | |a Cervix neoplasms | |
| 650 | 4 | |a Vaginal smears | |
| 700 | 1 | |a Lonky, Neal M. |e Sonstige |4 oth | |
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Datensatz im Suchindex
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| adam_text | PRfcVENTIlSfG fcWSfiXOfi y AND lifOrifflDlTY FROM CERVICAL CANCER
CONTENTS
Preface xi
Neal M. Lonky
Introduction
Reducing Death from Cervical Cancer: Examining the
Prevention Paradigms 599
Neal M. Lonky
The prevention of morbidity and mortality from cervical cancer
will hinge upon our understanding of the epidemiology, the
molecular basis, and natural history of the disease and its associa¬
ted precursors. This article serves as an introduction and presents
our current challenge to prevent or find all women at risk, and
alter the course of disease to effect a regression or a cure.
Paying for Prevention: Standardizing the Measurement of the
Value of the Health Care Interventions 613
Steven A. Vasilev
It is not clear if spending more on tests that enhance the accuracy
of Pap smears would lead to a greater reduction in cancer inci¬
dence than if the money were spent to include a greater proportion
of women in primary screening. The cost effectiveness of tests
beyond the Pap smear has not been clearly demonstrated. There is
the question of whether cervical cancer incidence can be decreased
more by improving the tests for patients who are already screened
or by improving access to the unscreened population. Cervical
cancer screening represents only one of many public health issues
competing for resources. Given that there are choices to be made,
the optimal yardstick against which all resource competing
programs are measured should be marginal benefit versus
marginal cost.
VOLUME 29 • NUMBER 4 • DECEMBER 2002 v
Tertiary Prevention of Invasive Cervical Cancer
Traditional Management of Invasive Cervical Cancer 645
David O. Holtz and Charles Dunton
Cervical cancer continues to be one of the most frequent and deadly
cancers affecting women worldwide. In developed countries with
implemented screening programs, the incidence of this cancer is
markedly decreased, while the incidence of cervical intraepithelial
neoplasia (CIN) rises. Effective treatment of CIN decreases the
incidence of and the mortality from cervical cancer. In the United
States in 2001, it is estimated that there will be approximately
15,000 cases of and 4,000 deaths from invasive cervical cancer. This
article reviews the current state of the art of treatment in the
United States for cervical cancer.
New Developments in the Treatment of Invasive
Cervical Cancer 659
Samuel S. Im and Bradley J. Monk
Early stage cervical cancer has an excellent prognosis. With more
advanced disease, however—the survival rate is poor. Newer
chemotherapeutic agents are being evaluated and innovative bio¬
logic therapies are under investigation. With rapid advances in
molecular and human cancer biology, novel treatment for cervical
cancer appear to be on the horizon. These future advances will
hopefully translate into significant survival benefits.
Secondary Prevention
In Vitro Conventional Cytology: Historical Strengths and
Current Limitations 673
Mark Spitzer
Despite the fact that cervical cytology screening programs have
dramatically reduced the prevalence of cervical cancer in the
United States, women continue to develop and die from the disease.
Sixty percent of women with invasive cancer did not have a Pap
smear in the previous 5 years (or have never had one). The most
clinically effective and cost effective approach to reducing the inci¬
dence of cervical cancer is screening the unscreened population.
The sensitivity of conventional cytology is also much lower than
previously believed. Only by improving the sensitivity of cervical
cancer screening and participation in screening programs can
the prevalence, morbidity, and mortality from cervical cancer be
further reduced.
vi CONTENTS
In Vitro Adjuncts to the Pap Smear 685
Juan C. Felix and Charles Amezcua
The Pap smear has been recognized widely as the most effective
cancer screening test in the history of medicine. It is widely
believed that the use of this test has been responsible for the dras¬
tic reduction in the incidence and mortality of cervical cancer in the
United States, Canada, and much of Western Europe in the last 50
years. Several adjuncts to the Pap smear including liquid based
cytology, computer assisted screening, human papilloma virus
and molecular testing are discussed.
Use of Visual Screening Methods for Cervical 701
Cancer Screening
Thomas C. Wright, Jr, Lynette Denny, Louise Kuhn,
and Sue Goldie
This article considers recent advances in visual screening methods.
Devices that use electro optical sensors offer great potential in va¬
rious clinical roles, but considerable additional work is required to
develop these devices and it is unlikely that they will come into
widespread clinical use in the next 5 years. Considerable data
demonstrate that simple visual screening methods have a sensiti¬
vity for the detection of women with biopsy confirmed high grade
SIL (CIN 2,3) and cancer that is equivalent to that of conventional
cervical cytology. Currently numerous studies are evaluating the
best strategies for incorporating visual screening methods into cer¬
vical cancer screening programs. In the near future we should be
able to determine whether these approaches should be incorpora¬
ted into routine clinical care.
Efficient Triage of the Screen Positive At Risk Patient 735
Ramon M. Cestero and W. Benson Harer, Jr
Current efforts to develop a vaccine against HPV are certainly
promising. In the meantime, a better understanding and utilization
of the technologies at hand will result in a successful, organized
approach to the detection of early cervical cancer and its precur¬
sors. The adoption of any new screening technologies must result
in a documented reduction in the incidence of cervical cancer.
Until then, colposcopy, with the addition of HPV DNA testing
when indicated, appears to remain as the undisputed gold stan¬
dard in the evaluation of the patient at risk.
Management of Precursor Lesions of Cervical Carcinoma:
History, Host Defense, and a Survey of Modalities 751
J. Thomas Cox
Before the initiation of screening and treatment for cervical cancer
precursors, approximately 3% to 4% of women were destined to
CONTENTS vii
develop cervical cancer. During the last 50 years the rate of cervi¬
cal cancer incidence and mortality has decreased by more that 75%
primarily because of the widespread availability of cervical cyto
logic screening and of treatment for documented cervical precan
cer. Successful screening of the entire population and appropriate
treatment of lesions could theoretically reduce this risk to one
tenth of the risk of an unscreened population. The relatively recent
understanding of the etiology of cervical cancer precursor lesions,
cervical cancer, and the immune response to them has given new
direction to management options that incorporate healthy habits
and dietary measures as part of traditional ablative or excisional
treatment options.
Management of Women with Cervical Cancer 787
Precursor Lesions
J. Thomas Cox
There are a number of guiding principles that can be applied to the
management of all women with cervical intraepithelial neoplasia
(CIN), as well as for women not found to have CIN but who are
likely to be at some continued risk due to the probability that the
inability to document disease at colposcopy most likely reflects
cellular changes secondary to human papillomavirus that may
regress, persist, or progress. The management guidelines dis¬
cussed in this article are either evidence based or are based on
expert opinion where the published literature is scant or inconclu¬
sive. Therefore, guiding principles are not based on definitive
scientific validation yet may be helpful. These include proactive
dietary measures aimed to improve the immune response and
educational measures designed to reduce anxiety and empower
the patient with a sense of control.
Primary Prevention
Risk Factors Related to the Development and Mortality
from Invasive Cervical Cancer: Clinical Utility and Impact
on Prevention 817
Neal M. Lonky
The focus of this article is to explore the various risk factors rela¬
ted to cervical cancer and the practical context in which they can
be applied. The ability to link clinical outcomes (disease presence,
persistence, progression, and recurrence) with antecedent risk fac¬
tors is strengthened by a new understanding of the molecular
mechanisms that are responsible for malignant transformation.
viii CONTENTS
Primary Prevention of Uterine Cervix Cancer: Focus on
Vaccine History and Current History 843
Krishnansu Sujata Tewari and Philip John DiSaia
Primary prevention of uterine cervix cancer spans the gamut of
human papillomavirus vaccine development, dietary adjustment,
chemoprevention, and risk reduction. Lifestyle and social beha¬
viors impact on risk for cervical cancer. Before examining the
growing body of molecular evidence, animal studies, and phase I
clinical trials that suggest that a virus based vaccine for cervical
cancer may soon become a reality, one must reflect on what has
gone before in the vaccine based battle with viral disease.
Cumulative Index 2002 869
Statement of Ownership
Subscription Information
CONTENTS ix
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| spelling | Preventing mortality and morbidity from cervical cancer Neal M. Lonky guest ed. Philadelphia [u.a.] Saunders 2002 XII S., S. 599 - 885 Ill., graph. Darst. txt rdacontent n rdamedia nc rdacarrier Obstetrics and gynecology clinics of North America 29,4 Baarmoederhalskanker gtt Preventie gtt Sterfte gtt Ziektecijfer gtt Cervix Neoplasms Cervix Neoplasms prevention & control Cervix neoplasms Vaginal smears Lonky, Neal M. Sonstige oth Obstetrics and gynecology clinics of North America 29,4 (DE-604)BV000617486 29,4 HBZ Datenaustausch application/pdf http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=010166759&sequence=000002&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA Inhaltsverzeichnis |
| spellingShingle | Preventing mortality and morbidity from cervical cancer Obstetrics and gynecology clinics of North America Baarmoederhalskanker gtt Preventie gtt Sterfte gtt Ziektecijfer gtt Cervix Neoplasms Cervix Neoplasms prevention & control Cervix neoplasms Vaginal smears |
| title | Preventing mortality and morbidity from cervical cancer |
| title_auth | Preventing mortality and morbidity from cervical cancer |
| title_exact_search | Preventing mortality and morbidity from cervical cancer |
| title_full | Preventing mortality and morbidity from cervical cancer Neal M. Lonky guest ed. |
| title_fullStr | Preventing mortality and morbidity from cervical cancer Neal M. Lonky guest ed. |
| title_full_unstemmed | Preventing mortality and morbidity from cervical cancer Neal M. Lonky guest ed. |
| title_short | Preventing mortality and morbidity from cervical cancer |
| title_sort | preventing mortality and morbidity from cervical cancer |
| topic | Baarmoederhalskanker gtt Preventie gtt Sterfte gtt Ziektecijfer gtt Cervix Neoplasms Cervix Neoplasms prevention & control Cervix neoplasms Vaginal smears |
| topic_facet | Baarmoederhalskanker Preventie Sterfte Ziektecijfer Cervix Neoplasms Cervix Neoplasms prevention & control Cervix neoplasms Vaginal smears |
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