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Most women who die from cervical cancer, particularly in developing countries, are in the prime of their life. They may be raising children, caring for their family, and contributing to the social and economic life of their town or village. Their death is both a personal tragedy, and a sad and unnecessary loss to their family and their community. Unnecessary, because there is compelling evidence, as this Guide makes clear, that cervical cancer is one of the most preventable and treatable forms of cancer, as long as it is detected early and managed effectively. Unfortunately, the majority of women in developing countries still do not have access to cervical cancer prevention programmes. The consequence is that, often, cervical cancer is not detected until it is too late to be cured. An urgent effort is required if this situation is to be corrected. This Guide is intended to help those responsible for providing services aimed at reducing the burden posed by cervical cancer for women, communities and health systems. It focuses on the knowledge and skills needed by health care providers, at different levels of care.
This book offers clear, up-to-date guidance on how to report cytologic findings in cervical, vaginal and anal samples in accordance with the 2014 Bethesda System Update. The new edition has been expanded and revised to take into account the advances and experience of the past decade. A new chapter has been added, the terminology and text have been updated, and various terminological and morphologic questions have been clarified. In addition, new images are included that reflect the experience gained with liquid-based cytology since the publication of the last edition in 2004. Among more than 300 images, some represent classic examples of an entity while others illustrate interpretative dilemmas, borderline cytomorphologic features or mimics of epithelial abnormalities. The Bethesda System for Reporting Cervical Cytology, with its user-friendly format, is a “must have” for pathologists, cytopathologists, pathology residents, cytotechnologists, and clinicians.
Recoge: 1. Epidemiological guidelines for quality assurance in cervical cancer screening - 2. Methods for screening and diagnosis - 3. Laboratory guidelines and quality assurance practices for cytology - 4. Techniques and quality assurance guidelines for histopathology - 5. Management of abnormal cervical cytology - 6. Key performance indicators - 7. Annexes.
Written with the busy practice in mind, this book delivers clinically focused, evidence-based gynecology guidance in a quick-reference format. It explores etiology, screening, tests, diagnosis, and treatment for a full range of gynecologic health issues. The coverage includes the full range of gynecologic malignancies, reproductive endocrinology and infertility, infectious diseases, urogynecologic problems, gynecologic concerns in children and adolescents, and surgical interventions including minimally invasive surgical procedures. Information is easy to find and absorb owing to the extensive use of full-color diagrams, algorithms, and illustrations. The new edition has been expanded to include aspects of gynecology important in international and resource-poor settings.
Despite the common perception that medicine is becoming specialty driven, there are many reasons for primary care providers to offer women’s health procedures in an office setting. Women feel more comfortable having procedures done by prov- ers whom they already know and trust. Continuity of care is still valued by patients, who trust their primary care providers to work with them as collaborators in the decision-making process. Women have found that their options for care have become limited, not by their own decision, but by the lack of training of their p- vider. In rural areas, the barriers of time, expense, and travel often prevent many women from obtaining necessary care; yet many of the procedures that these women are requesting are relatively easy to learn. Positive experiences are shared by women who then refer friends and family by word of mouth. This book has been designed to assist not only the clinician performing the pro- dures covered, but also the office staff with setting up the equipment tray prior to p- forming the procedure and with preparing office documents and coding information needed to complete the procedure. Most procedures covered can be done with a mi- mum investment in equipment and require minimal training.
This volume reviews the evidence for a causal link between sexually transmitted infection with human papillomavirus (HPV) and the occurrence of cervical cancer, from a variety of different angles. Epidemiological studies and clinical, pathological, and cytological aspects of HPV infection are reviewed. Modern methods for analyzing HPV-DNA types by molecular biological techniques are described, and the statistical problems to be overcome in epidemiological work are explained. The volume was prepared by a broad team of experts from around the world, who met in Copenhagen in March 1988 to reach a consensus on the present state of understanding and to establish directions for future work.
For many women in developing countries, such as sub-Saharan Africa, south and south-east Asia, and central and south America, there is a high risk of cervical cancer, but a lack of effective programmes to detect and treat such a problem. This introductory manual is intended to simply the learning of colposcopy (a diagnostic and evaluation method for cervical intraepithelia neoplasia, or cervical cancer).
This colposcopy manual was developed in the context of the cervical cancer screening research studies of the International Agency for Research on Cancer (IARC) and the related technical support provided to national programs. It is thus a highly comprehensive manual, both for the training of new colposcopists and for the continuing education and reorientation of those who are more experienced. This manual offers a valuable learning resource, incorporating recent developments in the understanding of the etiology and pathogenesis of cervical intraepithelial neoplasia (CIN), as well as in colposcopy and cervical pathology. Expertise in performing satisfactory, safe, and accurate colposcopic examinations requires high competence in the technical, interpretive, and cognitive aspects, and the capability to develop pragmatic and effective management plans and treatment. This comprehensive and concise manual covers all these aspects and serves as a useful handbook for acquiring the necessary skills for the visual recognition and interpretation of colposcopic findings and for developing the personal and professional attributes required for competence in colposcopy.
In 1984 the medical journal Obstetrics and Gynecology published a paper that would initiate an investigation into one of the greatest medical scandals of the late twentieth century. Titled "The Invasive Potential of Carcinoma in Situ of the Cervix", it discussed the results of an experiment that had been run at the National Women’s Hospital in Auckland, New Zealand, since 1955. The experiment looked at the natural history of cervical carcinoma in situ (CIS) – in other words, what happens if no treatment is initiated in a condition suspected (when the experiment began) to lead to cervical cancer. The paper divided participants into two groups, one that had negative results after biopsy or treatment, and one smaller group that continued to test positive. This second group had a significant rate of cervical cancer; some of these women were followed for twenty-five years without treatment, and in only 5% did the disease spontaneously resolve. For the other 95%, outcomes ranged from positive but localised results to metastatic disease and death. The authors said these results were in contrast with other, earlier papers about the experiment. After much research, Sandra Coney, one-time editor of a NZ feminist magazine, and Phyllida Bunkle, a women’s studies lecturer, wrote an article about the experiment, exposing the unauthorised research performed by one prominent gynaecologist in support of his belief that CIS was not associated with cervical cancer. Professor Herbert Green, a physician of considerable influence and power throughout New Zealand, persisted in his belief despite increasingly convincing proof of a progressive connection between the two conditions, never sought permission from his patients, or even told them what he was doing.