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Información sobre el tratamiento del cáncer incluyendo quirúrgica, quimioterapia, radioterapia, estudios clínicos, terapia con protón, medicina complementaria avanzadas.
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Maneras que los pacientes de cáncer y las personas que le cuidan puedan enfrentar el cáncer, los efectos secundarios, nutrición, cuestiones en general sobre el apoyo para el cáncer, duelo/decisiones sobre el termino de vida, y experiencias compartidas por sobrevivientes.
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Abramson Cancer Center 
NCI CANCERLIT® Search: Screening and Prevention of Gynecologic Neoplasms - February 2002
National Cancer Institute®
Ultima Vez Modificado: 1 de febrero del 2002
Table of Contents
1
UI - 9409538
AU - Anonymous
TI -
Regulatory closure of cervical cytology laboratories: recommendations
for a public health response.
SO - MMWR Recomm Rep 1997 Dec 19;46(RR-17):1-19
The Papanicolaou test--or Pap smear test--is one of the most effective
cancer screening tests available, and its ability to detect premalignant
conditions has contributed to the decline in cervical cancer morbidity
and mortality in the United States since its development in 1941. The
success of this screening test has created confidence among women,
health-care providers, and public health officials. However, this
screening tool is not perfect: false-negative findings are a special
concern because they can delay necessary follow-up of and treatment for
women who have cervical cancer precursor lesions or invasive cervical
cancer. Recent media attention has focused on cytology laboratories that
have been closed as a result of deficiencies (including a high
proportion of false-negative reports), and in some states legal action
has been taken against individual laboratories. With the advent of
revised federal regulations implementing the Clinical Laboratory
Improvement Amendments (CLIA) of 1988, scrutiny of the quality of
cytology laboratory practice has increased. Between 1992 and 1994, a
total of 10 cytology laboratories were closed by regulatory action of
the Health Care Financing Administration because they were considered a
threat to the public's health. Although such closures represent <1% of
CLIA-certified cytology laboratories, the attendant publicity may
trigger anxiety among women. Public health officials must respond to
those concerns with appropriate clinical and community actions to ensure
the health and safety of women whose Pap smears were evaluated by the
closed laboratories. There are no published recommendations to help
develop a public health response to the regulatory closure of a cervical
Territorial Public Health Laboratory Directors, through a cooperative
agreement with CDC, convened a working group to provide background on
the current practice of clinical cervical cytology in the United States,
summarize the CLIA regulations that established specific quality
assurance standards for this specialty, and recommend actions that a
public health agency may initiate to deliver a measured response to
laboratory closings and other regulatory sanctions. This report includes
this background and summary of the workshop. The working group made
three recommendations: (a) public health officials should plan for a
cervical cytology laboratory closure, then, when a laboratory is closed
by regulatory action, they should (b) assess the severity of the
situation and determine an appropriate response and (c) provide
accurate, timely information to the public.
2
UI - 9461053
AU - Anonymous
TI -
1998 guidelines for treatment of sexually transmitted diseases. Centers
for Disease Control and Prevention.
SO - MMWR Recomm Rep 1998 Jan 23;47(RR-1):1-111
These guidelines for the treatment of patients who have sexually
transmitted diseases (STDs) were developed by CDC staff members after
consultation with a group of invited experts who met in Atlanta on
February 10-12, 1997. The information in this report updates the "1993
Sexually Transmitted Diseases Treatment Guidelines" (MMWR 1993;42[no.
RR-14]). Included are new recommendations for treatment of primary and
recurrent genital herpes and management of pelvic inflammatory disease;
a new patient-applied medication for treatment of genital warts; and a
revised approach to the management of victims of sexual assault. Revised
sections describe the evaluation of urethritis and the diagnostic
evaluation of congenital syphilis. These guidelines also include
expanded sections concerning STDs among infants, children, and pregnant
women and the management of patients who have asymptomatic human
immunodeficiency virus infection, genital warts, and genital herpes.
Guidelines are provided for vaccine-preventable STDs, including
recommendations for the use of hepatitis A and hepatitis B vaccines.
3
UI - 11668306
AU - Pregliasco P
TI -
[Youth center]
SO - Minerva Pediatr 2001 Oct;53(5):528-9
AD - ASL n. 2, Savona, Italy.
4
UI - 11747215
AU - Giard RW
TI -
False-negative rate of cervical cytology: sense and sensitivity.
SO - Diagn Cytopathol 2001 Nov;25(5):275-7
5
UI - 10885351
AU - Meijers-Heijboer EJ; Verhoog LC; Brekelmans CT; Seynaeve C;
TI -
Tilanus-Linthorst MM; Wagner A; Dukel L; Devilee P; van den Ouweland AM;
van Geel AN; Klijn JG
Presymptomatic DNA testing and prophylactic surgery in families with a
BRCA1 or BRCA2 mutation.
SO - Lancet 2000 Jun 10;355(9220):2015-20
AD - Department of Clinical Genetics, Erasmus University, Rotterdam, The
Netherlands.
BACKGROUND: Germline mutations in the BRCA1 and BRCA2 genes highly
predispose to breast and ovarian cancer. In families with BRCA1 or BRCA2
mutations, identification of mutation carriers is clinically relevant in
view of the options for surveillance and prevention. METHODS: We
assessed presymptomatic DNA testing and prophylactic surgery in 53
consecutive families presenting to the Rotterdam Family Cancer Clinic
with a known BRCA1 or BRCA2 mutation. We identified predictors for DNA
testing and prophylactic surgery with univariate and multivariate
analysis. FINDINGS: 682 unaffected individuals with a 50% risk (275
women and 271 men) or with a 25% risk (136 women) for carrying a
mutation were identified and offered a DNA test. Presymptomatic DNA
testing was requested by 48% (198 of 411) of women and 22% (59 of 271)
of men (odds ratio for difference between sexes 3.21 [95% CI 2.27-4.51];
p<0.001). In women, DNA testing was significantly more frequent at young
age, in the presence of children, and at high pre-test genetic risk for
a mutation. Of the unaffected women with an identified mutation who were
eligible for prophylactic surgery, 51% (35 of 68) opted for bilateral
mastectomy and 64% (29 of 45) for oophorectomy. Parenthood was a
predictor for prophylactic mastectomy but not for prophylactic
oophorectomy. Age was significantly associated with prophylactic
oophorectomy, but not with prophylactic mastectomy, although there was a
tendency towards mastectomy at younger ages. INTERPRETATION: In a
clinical setting, we show a high demand for BRCA1 and BRCA2 testing by
unaffected women at risk, and of prophylactic surgery by unaffected
women with the mutation. Young women with children especially opt for
DNA testing and prophylactic mastectomy.
6
UI - 11584486
AU - Dunn TS; Stamm CA; Delorit M; Goldberg G
TI -
Clinical pathway for evaluating women with abnormal uterine bleeding.
SO - J Reprod Med 2001 Sep;46(9):831-4
AD - Departments of Obstetrics and Gynecology, Denver Health Medical Center,
University of Colorado Health Science Center, 777 Bannock Street, M/C
0660, Denver, CO 80204, USA. tdunn@dhha.org
OBJECTIVE: To devise a clinical pathway for evaluating women with
abnormal uterine bleeding. STUDY DESIGN: One thousand women with the
complaint of abnormal uterine bleeding were enrolled. All would have
undergone endometrial biopsy based on older recommendations. The
patients followed a clinical pathway to determine if an endometrial
biopsy was necessary. The pathway divided women into the categories of
premenopausal, postmenopausal, low risk and high risk. If one risk
factor was present, the patient underwent endometrial biopsy. If there
were no risk factors, the patient continued down the pathway with
medical therapy. RESULTS: Five hundred seventy endometrial biopsies were
performed. Five cases of endometrial cancer and three of complex
atypical hyperplasia, both in the postmenopausal, high-risk group, were
discovered. Subsequent reviews revealed that no cases of endometrial
cancer were missed or developed in the two years following the initial
complaint. CONCLUSION: Utilization of a clinical pathway reduced the
number of endometrial biopsies by 50%. The introduction of clinical
pathways at our institution was done successfully in the evaluation of
abnormal uterine bleeding.
7
UI - 11814067
AU - Smith RA; Cokkinides V; von E; Levin B; Cohen C; Runowicz CD; Sener S;
TI -
Saslow D; Eyre HJ; American Cancer Society
American Cancer Society guidelines for the early detection of cancer.
SO - CA Cancer J Clin 2002 Jan-Feb;52(1):8-22
AD - Cancer Control Department, American Cancer Society, Atlanta, GA, USA.
Each year the American Cancer Society publishes a summary of existing
recommendations for early cancer detection, including updates, and/or
emerging issues that are relevant to screening for cancer. In last
year's article, the guidelines regarding screening for the early
detection of prostate, colorectal, and endometrial cancers were updated,
as was the narrative pertaining to testing for early lung cancer
detection. Although none of the ACS's guidelines were updated in 2001,
work is proceeding on an update of screening recommendations for breast
and cervical cancer and an update of these guidelines will be announced
review recommendations for the "cancer-related check-up," in which
clinical encounters provide case-finding and health counseling
opportunities. Finally, we provide an update of the most recent data
pertaining to participation rates in cancer screening by age, gender,
and ethnicity from the Centers for Disease Control and Prevention's
Behavioral Risk Factor Surveillance System (BRFSS) and National Health
Interview Survey (NHIS).
8
UI - 11826455
AU - Skjeldestad FE
TI -
[A new strategy for prevention of cervical cancer approaching?]
SO - Tidsskr Nor Laegeforen 2001 Nov 20;121(28):3263
9
UI - 11831084
AU - Lynge E
TI -
[Recommendations on cancer screening in the European Union. Advisory
Committee on Cancer Prevention]
SO - Ugeskr Laeger 2002 Jan 7;164(2):176-8
AD - Kobenhavns Universitet, Institut for Folkesundhedsvidenskab.
elsebeth@pubhealth.ku.dk
10
UI - 11763141
AU - Watanabe S; Iwase Y; Kikuchi Y
TI -
Baseline data of reproductive system in the JPHC study. Japan Public
Health Center-based Prospective Study on Cancer and Cardiovascular
Diseases.
SO - J Epidemiol 2001 Oct;11(6 Suppl):S75-80
AD - Department of Applied Bioscience, Tokyo University of Agriculture,
Japan.
Hormonal status in the body is closely related to the occurrence of
estrogen-related cancers. Baseline survey data about the female
reproductive system in JPHC study showed different gynecological and
gestational profiles in each study area. Late menarche (15-16 y/o) was
characteristic in the rural areas. Earlier gestational age and larger
number of children were also more common in the rural areas. Baseline
survey data, including gynecological past history, frequency of
examination for uterine cancers, and so forth, showed some profile of
middle aged women in the different areas in Japan.
11
UI - 11807889
AU - Hughes C; Lerman C; Schwartz M; Peshkin BN; Wenzel L; Narod S; Corio C;
TI -
Tercyak KP; Hanna D; Isaacs C; Main D
All in the family: evaluation of the process and content of sisters'
communication about BRCA1 and BRCA2 genetic test results.
SO - Am J Med Genet 2002 Jan 15;107(2):143-50
AD - Department of Psychiatry, University of Pennsylvania, Philadelphia,
Pennsylvania 19104, USA. chanita@mail.med.upenn.edu
Despite the potential importance of family communication, little is
known about the process and content of communicating BRCA1/2 test
results to relatives. The objectives of this observational study were to
describe the process and content of communicating BRCA1/2 test results
to sisters, and to evaluate whether the proband's carrier status
influenced communication outcomes. Participants were 43 women who were
the first family member to have genetic testing (probands). Probands
reported on communication outcomes for 81 sisters. Process and content
variables were evaluated 1-month after receipt of BRCA1/2 test results
using the Family Communication Questionnaire (FCQ). Overall, BRCA1/2
test results were communicated to 85% of sisters, and carriers
communicated their results to significantly more sisters compared to
uninformative (96% vs. 76%, FET = 0.02). The most important reason for
communicating results was to provide genetic risk information; however,
compared to uninformatives, carriers communicated their results to
significantly more sisters to obtain emotional support (74%) and to get
advice about medical decisions (42%) (FET = 0.001). Carriers also
discussed the possibility of discrimination and recommendations for
cancer management with significantly more sisters. Among sisters to whom
BRCA1/2 test results were not communicated, the most important reason
for not sharing test results was because of emotionally distant
relationships. The results of this study suggest that probands are
likely to quickly communicate their BRCA1/2 test results to relatives
and that although needs for social support may motivate family
communication, emotionally distant relationships may be a barrier to
communication with relatives. Copyright 2001 Wiley-Liss, Inc.
12
UI - 11588939
AU - Sturdee DW
TI -
Endometrial safety.
SO - Climacteric 2001 Sep;4(3):177-8
13
UI - 11253990
AU - Cohen I
TI -
Levonorgestrel-releasing intrauterine devices.
SO - Lancet 2001 Mar 10;357(9258):801
14
UI - 11749095
AU - Valanis BG; Glasgow RE; Mullooly J; Vogt TM; Whitlock EP; Boles SM;
TI -
Smith KS; Kimes TM
Screening HMO women overdue for both mammograms and pap tests.
SO - Prev Med 2002 Jan;34(1):40-50
AD - Kaiser Permanente Northwest Center for Health Research, Portland, Oregon
97227, USA. Barbara.Valanis@KPCHR.org
BACKGROUND: Regular screening has the potential to reduce breast and
cervical cancer mortality, but despite health plan programs to encourage
screening, many women remain unscreened. Tailored communications have
been identified as a promising approach to promote mammography and Pap
test screening. METHODS: The study used a four-group randomized design
to compare with Usual Care the separate and combined effects of two
tailored, motivational interventions to increase screening-a clinical
office In-reach intervention and a sequential letter/telephone Outreach
intervention. Subjects were 510 female HMO members ages 52-69 who had
had no mammogram in the past 2 years and no Pap smear in the past 3
years. Primary outcomes were the percentage of women in each condition
who received a mammogram, a Pap smear, or both screening tests during
the 14-month study period. RESULTS: Thirty-two percent of the Combined
group, 39% of the Outreach group, and 26% of the In-reach group obtained
both services versus 19% of Usual Care participants. Overall, compared
with Usual Care, both Outreach (P = 0.006) and Combined (P = 0.05)
screened significantly more women. For subjects ages 65-69, Outreach
rates were lower than those of Usual Care. CONCLUSION: A tailored
letter-telephone Outreach appears to be more effective at screening
women ages 52-64 than a tailored office-based intervention, in large
part because most In-reach women did not have clinic visits at which to
receive the intervention. Copyright 2002 American Health Foundation and
Elsevier Science.
15
UI - 11814493
AU - Connor JP; Elam G; Goldberg JM
TI -
Empiric vaginal metronidazole in the management of the ASCUS
Papanicolaou smear: a randomized controlled trial.
SO - Obstet Gynecol 2002 Feb;99(2):183-7
AD - Department of Obstetrics and Gynecology, University of Illinois at
Chicago, Chicago, Illinois, USA. jpconnor@facstaff.wisc.edu
OBJECTIVE: To determine whether empiric treatment with vaginal
metronidazole in women with atypical squamous cells of undetermined
significance (ASCUS) on Papanicolaou smear increases the number of cases
that regress to normal on repeated cytologic studies. METHODS: A
randomized double-masked trial was designed to compare women with ASCUS
on screening Papanicolaou smear who received vaginal metronidazole, 37.5
mg twice daily, or placebo gel twice daily, for 5 days. Normalization of
repeated Papanicolaou smear at 3 months was the primary end point.
Regression to normal between the two groups was compared by chi2
analysis. Power analysis required 45 women per study arm to demonstrate
a 50% improvement in regression to normal among the
metronidazole-treated women, at alpha = 0.05 and 80% power. RESULTS: One
hundred and six tubes of gel were dispensed, 54 metronidazole and 52
placebo. Eighty-four women (79%) returned for repeated cytologic
examination at a mean of 6.5 months. Overall, 50 women (60%) had normal
findings on repeated cytologic examination, and 34 (40%) had persistent
abnormal findings. Twenty-two women had repeated ASCUS, and 11 had
squamous intraepithelial lesions (SIL) on repeated cytologic
examination. Regression to normal was found in 22 (54%)
metronidazole-treated women and 28 (65%) placebo recipients. The number
of cases of repeated ASCUS (31% versus 25%) or SIL (15% versus 10%) were
similar between the two groups. CONCLUSIONS: Empiric vaginal
metronidazole does not improve the management of women with ASCUS on
Papanicolaou smear and should be discouraged.
16
UI - 11706377
AU - Hopenhayn-Rich C; Stump ML; Browning SR
TI -
Regional assessment of atrazine exposure and incidence of breast and
ovarian cancers in Kentucky.
SO - Arch Environ Contam Toxicol 2002 Jan;42(1):127-36
AD - Department of Preventive Medicine and Environmental Health, University
of Kentucky College of Medicine, 1141 Red Mile Rd. Suite 202, Lexington,
Kentucky 40504, USA. cmhope0@pop.uky.edu
The association between breast and ovarian cancers with endogenous
estrogen or hormonally related events has led to the hypothesis that
exposures to exogenous estrogenic compounds in the environment may
increase the risk of these cancers. Atrazine, the most commonly used
herbicide in the United States, belongs to this group of compounds and
is widely used in corn production. This study is an expansion of a
previous investigation conducted in Kentucky. Using secondary data, we
derived several indices of environmental exposure to atrazine and
examined the association between these measures and the incidence of
breast and ovarian cancer in Kentucky over a 5-year period (1993-97).
Exposure indices to atrazine were derived based on public water
measurements, acres of corn planted, and pounds of atrazine sold. Data
on breast and ovarian cancer incidence were obtained from the Kentucky
Cancer Registry by county and by the 15 Area Development Districts
(ADDs) in which the 120 counties are grouped. Poisson regression
analyses adjusted for education and race were conducted separately for
each index of exposure and for a combined total exposure score. All
exposure measures were divided in quartiles for analysis. A null
association was found for breast cancer across all exposure indices,
both by county and by ADD. For ovarian cancer, the data suggest an
inverse association, with increasing exposure linked to decreasing
incidence rates, both at the county and ADD level. The following are the
rate ratios (RR) and corresponding 95% confidence intervals, for the
summary exposure scores in the three upper quartiles, using the lowest
quartile as baseline (RR = 1.0), and the county as the unit of analysis:
1.01 (0.83-1.21), 0.77 (0.66-0.90), and 0.76 (0.65-0.88). Due to the
ecologic nature of this study and inherent limitations, it is possible
that other factors may be contributing to these findings. Studies using
individual-level data are recommended to elucidate the relationships
between estrogenic environmental exposures and female reproductive
cancers.
17
UI - 11832788
AU - Hubacher D; Grimes DA
TI -
Noncontraceptive health benefits of intrauterine devices: a systematic
review.
SO - Obstet Gynecol Surv 2002 Feb;57(2):120-8
AD - Family Health International, Research Triangle Park, North Carolina
27709, USA. dhubacher@fhi.org
Most women and their clinicians are unaware that IUDs confer important
noncontraceptive health benefits. This review summarizes the evidence
from published articles on this topic. We conducted a series of
systematic literature searches to identify articles on the
noncontraceptive health benefits of IUD use. We reviewed the potentially
pertinent ones for content, grouped them according to type of IUD, and
evaluated them using the U.S. Preventive Services Task Force rating
system. Over 500 titles were identified and several hundred abstracts
were reviewed. Use of nonhormonal IUDs (plastic and copper) was
associated with a decrease in endometrial cancer. The levonorgestrel
intrauterine system can treat a variety of gynecological disorders,
including menorrhagia and anemia. The levonorgestrel system has also
been used successfully as part of hormone replacement therapy, as
adjuvant therapy with tamoxifen, and as an alternative to hysterectomy
for women with bleeding problems. Like oral contraceptives, intrauterine
contraceptives confer important noncontraceptive health benefits.
18
UI - 11181763
AU - zur Hausen H
TI -
Cervical carcinoma and human papillomavirus: on the road to preventing a
major human cancer.
SO - J Natl Cancer Inst 2001 Feb 21;93(4):252-3
19
UI - 11535713
AU - Bosch FX; Munoz N; de Sanjose S; Franco EL; Lowy DR; Schiffman M;
TI -
Franceschi S; Kjaer SK; Meijer CJ; Frazer IH; Cuzick J
Re: Cervical carcinoma and human papillomavirus: on the road to
preventing a major human cancer.
SO - J Natl Cancer Inst 2001 Sep 5;93(17):1349-50
20
UI - 11824983
AU - Tideman RL; Marks C; Knight VM; Berry G; Fethers K; Mindel A
TI -
Opting off the New South Wales Pap Test Register in a sexual health
setting.
SO - Aust N Z J Public Health 2001 Dec;25(6):501-4
AD - Sexually Transmitted Infections Research Centre, Marion Villa, Westmead
Hospital, Sydney, New South Wales.
OBJECTIVES: To determine the proportion of women having a Pap smear at
Sydney Sexual Health Centre (SSHC) who opted off the NSW Pap Test
Register (PTR) and to establish the characteristics of these women.
DESIGN: Retrospective cross sectional study involving three time periods
during 1996 and 1997. SETTING: A public sexual health centre in Sydney.
PARTICIPANTS: 985 women who had a Pap smear at SSHC. Main outcome
measures: The participant's decision to opt on or off, and the
demographic and behavioural characteristics associated with opting off
the PTR. RESULTS: 590 (59.9%) women opted off the PTR. Using logistic
regression, young age (p=0.005), birth outside Australia and New Zealand
(p=0.0001), not speaking English at home (p=0.005) and being a
commercial sex worker (CSW) (p=0.0001) were variables associated with
opting off the PTR. Women from countries outside of Australia and New
Zealand were more likely to opt off, whether or not they were a CSW and
CSWs were more likely to opt off the PTR irrespective of their country
of birth (p=0.013). CONCLUSION: The majority of women (60%) attending
the SSHC opted off the PTR. Studies to evaluate culturally appropriate
health promotion material particularly for CSWs and women with poor
English skills living in Australia are needed and if successful may
improve uptake on the PTR.
21
UI - 11812938
AU - Agoff SN; Mendelin JE; Grieco VS; Garcia RL
TI -
Unexpected gynecologic neoplasms in patients with proven or suspected
BRCA-1 or -2 mutations: implications for gross examination, cytology,
and clinical follow-up.
SO - Am J Surg Pathol 2002 Feb;26(2):171-8
AD - Department of Cytology, Harborview Medical Center/University of
Washington Medical Center, 1959 NE Pacific Street, Seattle, WA
98195-6100, U.S.A. agoff@u.washington.edu
Identification of inheritable mutations associated with the development
of malignancy has led to prophylactic surgeries to remove tissues at
risk. We report seven unrelated patients with family histories of breast
and/or ovarian cancer, five of whom underwent prophylactic
salpingo-oophorectomy with hysterectomy. Four had proven BRCA-1 or -2
mutations. Malignant cells were found unexpectedly in the peritoneal
washings of two patients, leading to the discovery of early-stage
fallopian tube carcinoma. After changing the sampling technique at our
institution, two more cases of unexpected fallopian tube carcinoma in
situ were discovered. Another patient had a significant family history
and underwent hysterectomy for uterine fibroids, leading to the
discovery of fallopian tube carcinoma. Another patient with BRCA-1
mutation had unexpected widespread primary peritoneal papillary serous
adenocarcinoma. The final patient had a borderline malignant clear cell
adenofibroma. These cases underscore the importance of peritoneal
cytology and thorough sampling in the management of patients undergoing
hysterectomy with a family history of breast/ovarian cancer and/or known
BRCA-1/BRCA-2 mutations. As prophylactic surgeries are becoming more
common secondary to advances in molecular diagnostics, pathologists need
to be aware that surgical specimens from these patients may require more
rigorous examination to uncover early neoplastic changes.
22
UI - 11547641
AU - Reuss E; Price J; Koonings P
TI -
Atypical glandular cells of undetermined significance. Subtyping as a
predictor of outcome.
SO - J Reprod Med 2001 Aug;46(8):701-5
AD - Department of Reproductive Medicine, University of California, San
Diego, Medical Center, 200 West Arbor Drive, #8434, San Diego, CA
92103-8434, USA.
OBJECTIVE: To determine whether subtyping of atypical glandular cells of
undetermined significance (AGUS) cervical smears into reactive process
favored (AGUS-RPF) and not otherwise specified (AGUS-NOS) correlates
with rates of underlying pathology. STUDY DESIGN: We performed a
retrospective chart review of 129,676 routine Pap smears at Kaiser
fifty of the 129,676 were evaluated as AGUS (0.12%). Subjects with
concomitant AGUS/SIL Pap smears, a prior history surgery for dysplasia,
prior AGUS, a history of cancer or prior hysterectomy were excluded from
the study. The remaining AGUS smears were then subtyped into AGUS-NOS
and AGUS-RPF based on the criteria of the 2nd Workshop of the Bethesda
System. Sixty-eight subjects with an initial AGUS smear underwent
evaluation with colposcopy, endocervical curettage, endometrial biopsy
and directed cervical biopsies. Significant pathology was determined to
be any tissue diagnosis that required further treatment more than a
follow-up Pap smear. AGUS subclassifications and underlying pathology
were then compared using the chi 2 test with Fisher's Exact Test.
RESULTS: Twenty-seven patients (40%) had AGUS-NOS, and 41 (60%) had
AGUS-RPF. There were no significant differences between the groups in
regard to age, race, parity, menopause status, HRT use or tobacco use.
CONCLUSION: Subtyping AGUS cervical smears correlates with underlying
rates of pathology. However, AGUS-RPF smears were still associated with
an approximately 10% incidence of significant underlying pathology.
Patients with AGUS on cervical smears need thorough evaluation,
regardless of subtyping.
The above citations and abstracts reflect those newly added to CANCERLIT for the month and topic listed in the title. The citations have been retrieved from CANCERLIT using a predefined search strategy of indexed subject terms. Although the search strategy has been refined as best as possible, citations may appear that are not directly related to the topic, and occasionally relevant references may be omitted.
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