scholarly journals Oncoprevention in Gynecology

2010 ◽  
Vol 49 (178) ◽  
Author(s):  
S Dhakal
Keyword(s):  
Breast Cancer ◽  
High Risk ◽  
Pap Smear ◽  
Endometrial Thickness ◽  
Transvaginal Ultrasound ◽  
Genetic Disorder ◽  
Screening Tests ◽  
High Risk Population ◽  
Screening Methods ◽  
Dilation And Curettage

Gynaecological cancers are one of the preventive cancers. There are some preventive factors like change in life style, food habits and some screening tests. Cancer can be prevented and premalignant conditions can be detected before invasion. Cervical cancer can be detected early by VIA, VILI, Pap smear, colposcopy and HPV testing. Identifying high risk population, transvaginal ultrasound to determine endometrial thickness and endometrial sampling by endocervical curettage, dilation and curettage, fractional curettage and hysteroscopy guided endometrial biopsy are the various modalities for earlier detection of endometrial cancers. For ovarian cancer, prevention or early diagnosis is done by identifying high risk factors, creating awareness in women, routine pelvic examination, ultrasonogram, checking tumour marker and prophylactic oophorectomy in indicated cases. The main screening methods for early detection of breast cancer are clinical breast examination and mammography. Oral contraceptive and HRT are associated with small increase in breast cancer risk. Vulval and vaginal carcinomas are not so common. All molar pregnancies should be followed after evacuation to look for malignant transformation. Hereditary/familial gynaecological cancer like ovarian and breast cancer are manifestation of genetic disorder. Mass screening for gene mutation is very expensive so it is not recommended.

scholarly journals Cisplatin +/− rucaparib after preoperative chemotherapy in patients with triple-negative or BRCA mutated breast cancer

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Maitri Kalra ◽  
Yan Tong ◽  
David R. Jones ◽  
Tom Walsh ◽  
Michael A. Danso ◽  
...  
Keyword(s):  
Breast Cancer ◽  
High Risk ◽  
Neoadjuvant Therapy ◽  
Triple Negative ◽  
Residual Disease ◽  
Disease Free Survival ◽  
Parp Inhibition ◽  
High Risk Population ◽  
Risk Population ◽  
The Impact

AbstractPatients with triple-negative breast cancer (TNBC) who have residual disease after neoadjuvant therapy have a high risk of recurrence. We tested the impact of DNA-damaging chemotherapy alone or with PARP inhibition in this high-risk population. Patients with TNBC or deleterious BRCA mutation (TNBC/BRCAmut) who had >2 cm of invasive disease in the breast or persistent lymph node (LN) involvement after neoadjuvant therapy were assigned 1:1 to cisplatin alone or with rucaparib. Germline mutations were identified with BROCA analysis. The primary endpoint was 2-year disease-free survival (DFS) with 80% power to detect an HR 0.5. From Feb 2010 to May 2013, 128 patients were enrolled. Median tumor size at surgery was 1.9 cm (0–11.5 cm) with 1 (0–38) involved LN; median Residual Cancer Burden (RCB) score was 2.6. Six patients had known deleterious BRCA1 or BRCA2 mutations at study entry, but BROCA identified deleterious mutations in 22% of patients with available samples. Toxicity was similar in both arms. Despite frequent dose reductions (21% of patients) and delays (43.8% of patients), 73% of patients completed planned cisplatin. Rucaparib exposure was limited with median concentration 275 (82–4694) ng/mL post-infusion on day 3. The addition of rucaparib to cisplatin did not increase 2-year DFS (54.2% cisplatin vs. 64.1% cisplatin + rucaparib; P = 0.29). In the high-risk post preoperative TNBC/BRCAmut setting, the addition of low-dose rucaparib did not improve 2-year DFS or increase the toxicity of cisplatin. Genetic testing was underutilized in this high-risk population.

Financial Anxiety is Associated With Cancer Screening Adherence in Women at High Risk of Breast Cancer

2021 ◽  
Author(s):  
Salene M W Jones ◽  
Tammy A Schuler ◽  
Tasleem J Padamsee ◽  
M Robyn Andersen
Keyword(s):  
Breast Cancer ◽  
Cancer Screening ◽  
High Risk ◽  
Pap Smear ◽  
Clinical Breast Examination ◽  
Lower Odds ◽  
Breast Examination ◽  
Clinical Breast ◽  
Financial Anxiety ◽  
Screening Adherence

Abstract Background Previous studies have examined the impact of material financial hardship on cancer screening but without focusing on the psychological aspects of financial hardship. Purpose This study examined the effects of different types of financial anxiety on adherence to breast cancer screening in women at high risk of breast cancer. Adherence to cervical cancer screening was also examined to determine whether associations between financial anxiety and screening adherence were unique to breast cancer screening or more general. Methods Women (n = 324) aged 30–50 and at high risk for inherited breast cancer completed a survey on general financial anxiety, worry about affording healthcare, financial stigma due to cancer risk, and adherence to cancer screening. Multivariate analyses controlled for poverty, age, and race. Results More financial anxiety was associated with lower odds of mammogram adherence (odds ratio [OR] = 0.97, confidence interval [CI] = 0.94, 0.99), Pap smear adherence (OR = 0.98, CI = 0.96, 0.996), and clinical breast examination adherence (OR = 0.98, CI = 0.96, 0.995). More worry about affording healthcare was associated with lower odds of clinical breast examination adherence (OR = 0.95, CI = 0.91, 0.9992) but not mammogram or Pap smear adherence (p > .05). Financial stigma due to cancer risk was associated with lower odds of Pap smear adherence (OR = 0.87, CI = 0.77, 0.97) but no other cancer screenings (p > .07). Conclusions Financial anxiety may impede cancer screening, even for high-risk women aware of their risk status. Clinical interventions focused on social determinants of health may also need to address financial anxiety for women at high risk of breast cancer.

scholarly journals Knowledge and Awareness about Colorectal Cancer and Its Screening Guidelines among Doctors in Al Ahsa, Eastern Province, Kingdom of Saudi Arabia

2016 ◽  
Vol 9 (6) ◽  
pp. 145
Author(s):  
Bathula Surendra ◽  
Muhammad Mujtaba Hashir ◽  
Fahad Salman Al Harbi ◽  
Mohammed Jassim Al Nuwaysir ◽  
Khalid Majed Al Khaldi ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Saudi Arabia ◽  
High Risk ◽  
Public Health Problem ◽  
Screening Tests ◽  
High Risk Population ◽  
Major Public Health Problem ◽  
Eastern Province ◽  
Risk Population ◽  
Screening Guidelines

INTRODUCTION: Cancer is a major public health problem. Worldwide, colorectal cancer (CRC) is a leading cause of deaths due to cancer in both men and women. Among, Saudi men, CRC is the most common malignancy while it is the third most common among Saudi women. Over, two decades the incidence and deaths due to CRC have been steadily increasing in Saudi Arabia. Regular and timely screening has the potential in reducing the incidence and deaths due to colorectal cancer. The present study is conducted to evaluate the knowledge and awareness about colorectal cancer and its screening among the doctors.OBJECTIVES: To measure the frequency of knowledge and awareness about colorectal cancer and its screening guidelines among doctors in Al-Ahssa.METHODS: A questionnaire based survey of the doctors (Specialists & residents), working in different hospitals and primary health centers under the Ministry of Health in Al Ahssa region, Eastern province, KSA.  Knowledge and awareness about colorectal cancer and its screening among the doctors is evaluated.RESULTS: Over 80% of the doctors knew, screening reduces deaths due to CRC. Only 60% were aware about the risk factors and less than 50% knew the clinical features of CRC. About 60% doctors agreed Colonoscopy is gold standard screening test. While, less than 60% knew the ideal age to initiate screening and the actual interval of screening tests in the standard risk and high-risk population. Fewer than 25% doctors were aware about the American cancer society recommended screening guidelines. Majority of the doctors expressed keen interest to know and receive information about CRC and its screening guidelines. CONCLUSIONS: Regular and timely screening reduces deaths due to CRC. There is a need for improving knowledge and awareness of doctors about CRC and its screening. Awareness among the doctors improves uptake of screening by the general and high-risk population.

Comparing effectiveness of COBAS HPV test with VIA/VILI, pap smear and colposcopy for screening of cancer cervix

2021 ◽  
Vol 8 (4) ◽  
pp. 525-530
Author(s):  
Lalitha Subramanian ◽  
T V Indirani ◽  
Igena Sharo Suji I
Keyword(s):  
High Risk ◽  
Radiation Oncology ◽  
Pap Smear ◽  
Screening Tests ◽  
Cancer Cervix ◽  
Pap Screening ◽  
Medical College ◽  
Hpv Test ◽  
Short Period ◽  
High Risk Hpv

 Cancer cervix is the second leading cancer causing 21% of all cancer deaths. Cervical cancer can be prevented if detected by premalignant changes and is curable in its earliest stage. Various procedures including VIA/VILI, pap smear have been routinely used for the purpose of screening cervical cancers. Infection with Human Papilloma virus is the principal cause of cancer cervix. Roche COBAS HPV test was approved by US FDA on April 24, 2014 as one of the first line primary screening method for cancer cervix based on the presence of high risk HPV DNA. The FOGSI guidelines in January 2018 has suggested cobas HPV test for cancer cervix screening. This study was conducted on 100 women with high risk cervical lesions during the period of 18 months. Women attending the NCD clinic of Government Thoothukudi Medical college hospital were taken for the study. The women were to undergo VIA/VILI, Pap smear study and subjected to COBAS HR HPV Test after their consent. Cervical specimens collected in PreservCyt solution using an endocervical brush/ spatula or collected in SurePath preservative fluid using a cervical broom were sent for COBAS HR HPV test. Collected sample kits were recruited in Department of Radiation oncology, Government Thoothukudi medical college for storage at low temperature for a short period, after pooling of samples, these were sent through the Department of radiation oncology to Adayar cancer institute, Chennai, with which the department has treated with for COBAS HPV test. The results were analysed and proceeded.This study has proven that screening for high risk HPV test in cervical specimen can easily pickup the premalignant lesion with high sensitivity, specificity when compared with other screening tests. Hence, this study emphasizes the importance of implementing HPV tests that can provide a 3-year screening free interval, compared to yearly pap screening. The other advantage is that the results are available immediately reducing the frequency of visits to hospital for further follow up on colposcopy/biopsy.

Neonatal Screening for Cystic Fibrosis: Position Paper

PEDIATRICS ◽  
1983 ◽  
Vol 72 (5) ◽  
pp. 741-745 ◽  
Author(s):  
◽  
Lynn M. Taussig ◽  
Thomas F. Boat ◽  
Delbert Dayton ◽  
Norman Fost ◽  
...  
Keyword(s):  
Cystic Fibrosis ◽  
Newborn Screening ◽  
Neonatal Screening ◽  
Task Force ◽  
Genetic Disorder ◽  
Clinical Manifestations ◽  
Screening Tests ◽  
Current Status ◽  
Screening Methods ◽  
Asymptomatic Patients

Neonatal screening represents the search for a disorder in a general newborn population. The purpose of screening may be to improve the health of the affected infant, to provide counseling, or for research. Screening tests have been widely accepted for conditions such as phenylketonuria, hypothyroidism, and other metabolic conditions. Cystic fibrosis (CF) is the most common lethal genetic disorder among the white population (with a lower incidence among blacks), and thus there has been interest in screening newborns for CF1 However, proposals emanating from this interest have remained controversial.2-4 The recent development of a relatively simple test—the dried blood immuno-reactive trypsinogen (IRT) assay—has increased this interest.5-12 Besides considering technical reliability and validity of newborn screening methods, it is crucial that all other aspects of screening (including medical, ethical, psychosocial, and economic aspects) be rigorously examined before implementing mass screening.13-15 To address these issues the Cystic Fibrosis Foundation convened a Task Force on Neonatal Screening. Although the Task Force considered the current status of the IRT test, it focused on the generally accepted criteria for newborn screening, summarized in the Table,14 and the relationship of these criteria to the present state of knowledge related to CF. The issues identified by the Task Force, are summarized in this paper, and recommendations are presented at the conclusion. EFFECTIVENESS OF PRESYMPTOMATIC TREATMENT Evidence suggesting that the initiation of treatment before clinical manifestations of CF first appear improves prognosis has been controversial. Whereas some studies have yielded supportive data,16 others have not.4 There are no generally accepted treatment protocols for use in symptomatic or asymptomatic patients.

scholarly journals A REVIEW ON SCREENING METHODS OF BREAST CANCER, CANCER BIOMARKERS AND PHYTOCONSTITUENTS AGAINST BREAST CANCER

2017 ◽  
Vol 10 (12) ◽  
pp. 17
Author(s):  
Jayashree Venugopal ◽  
Priyanka S ◽  
Reshma A
Keyword(s):  
Breast Cancer ◽  
Cancer Biomarkers ◽  
The Body ◽  
Screening Tests ◽  
Imaging Biomarkers ◽  
Screening Methods ◽  
Specific Response ◽  
Predictive Tool ◽  
Epidermal Growth ◽  
Screening Ultrasound

  A cancer biomarker refers to a substance or process that is used as an indicative the presence of cancer in the body. A biomarker may be a molecule secreted by a tumor or a specific response of the body to the presence of cancer. Biomarkers are utilized in three elementary ways as a diagnostic tool, prognostic tool, and predictive tool. The screening tests employed are clinical and breast exams, mammography, hereditary screening, ultrasound, and attractive reverberation imaging. Biomarkers involved in breast cancer are human epidermal growth factor-2, estrogen receptor, progesterone receptor, Cyclin D1, and Cyclin E. Specific bioactive phytoconstituents used as anticancer include curcumin, genistein, resveratrol, isothiocyanates, silymarin, diallyl sulfisoxazole, lycopene, apigenin, and gingerol. Hence, this review indicates the study of screening methods, various biomarkers in breast cancer and phytoconstituents against breast cancer.

scholarly journals Incidental gynaecological malignancy in women who underwent hysterectomy for utero-vaginal prolapse: a 3-year institutional case study

2018 ◽  
Vol 7 (9) ◽  
pp. 3625
Author(s):  
Fathima M. Seles ◽  
Rajavelu Indira
Keyword(s):  
Pap Smear ◽  
Histopathological Examination ◽  
Transvaginal Ultrasound ◽  
Endometrial Adenocarcinoma ◽  
Lower Abdominal Pain ◽  
Cervical Squamous Cell Carcinoma ◽  
Endometrial Biopsy ◽  
Vaginal Prolapse ◽  
Screening Tests ◽  
Malignant Lesions

Background: Pelvic organ prolapse is common is almost 50% of women over the age of 50years. The objective of the present study was to estimate the number of incidental gynaecological malignancies in women who underwent hysterectomy for utero-vaginal prolapse.Methods: 354 women who presented with asymptomatic utero-vaginal prolapse were included in this study. Women who were symptomatic with bleeding per vaginum, lower abdominal pain or excessive white discharge and preoperative screening tests such as VIA/VILI, colposcopy, Pap smear and radio-imaging showing any gynaecological lesions were excluded from this study.Results: Histopathological examination of the hysterectomy specimen showed premalignant lesion in 13 cases accounting to 3.7% (11 cases of CIN I, 1 case of CIN II, 1 case of CIN III) and malignant lesions in 5cases accounting for 1.4% (4 cases of endometrial adenocarcinoma and 1 case of cervical squamous cell carcinoma).Conclusions: Asymptomatic women with utero-vaginal prolapse may have pre-existing premalignant and malignant lesions. Therefore, all women undergoing hysterectomy should be preoperatively screened with transvaginal ultrasound, endometrial biopsy and pap smear to rule out malignancy, as the management differs for patients with co-existing gynecological malignancies.

scholarly journals Cost-effectiveness of MRI compared to mammography for breast cancer screening in a high risk population

2009 ◽  
Vol 9 (1) ◽  
Author(s):  
Susan G Moore ◽  
Pareen J Shenoy ◽  
Laura Fanucchi ◽  
John W Tumeh ◽  
Christopher R Flowers
Keyword(s):  
Breast Cancer ◽  
Cost Effectiveness ◽  
Cancer Screening ◽  
High Risk ◽  
Breast Cancer Screening ◽  
High Risk Population ◽  
Risk Population

Relationship between Oncotype DX testing and the use of chemotherapy in high-risk patients (pts).

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 6098-6098
Author(s):  
Winston Wong ◽  
Joseph Cooper ◽  
Steve Richardson ◽  
Bruce A. Feinberg
Keyword(s):  
Breast Cancer ◽  
High Risk ◽  
Adjuvant Chemotherapy ◽  
Risk Groups ◽  
Oncotype Dx ◽  
Molecular Diagnostic ◽  
Risk Category ◽  
High Risk Population ◽  
Unexpected Finding ◽  
High Risk Category

6098 Background: CareFirst BlueCross BlueShield (CFBCBS) insurance network partnered with Cardinal Health Specialty Solutions (CHSS) to develop a cancer care pathway for network physicians in 2008. The program included a recommendation for molecular diagnostic testing with the Oncotype DX assay for pts with early-stage estrogen receptor-positive breast cancer. Based on NCCN guidelines, the pathway suggested adjuvant chemotherapy for all pts with Oncotype DX Recurrence Scores (RS) in the high-risk category. We aimed to determine the RS risk distribution among pts who received Oncotype DX testing and assess the patterns of care that followed. Methods: Using data from CFBCBS, CHSS proprietary claims software, and Genomic Health, we retrospectively identified a cohort of women with breast cancer who were treated on the CFBCBS clinical care pathways program from 8/2008 to 6/2011 and received Oncotype DX testing. We determined the number of pts with a RS value in the low- (RS <18), intermediate- (RS 18-30), and high-risk (RS ≥31) groups along with the number of pts who subsequently received chemotherapy in each category. Results: Of 1174 women who received Oncotype DX testing, 53% of pts were in the low-, 35% in intermediate-, and 12% in the high-risk groups. Five percent of low-, 41% of intermediate-, and 74% percent of pts in the high-risk category were treated with chemotherapy. Twenty-six percent of pts in the high-risk group did not receive chemotherapy. Conclusions: The proportionate use of chemotherapy in the low and intermediate risk groups was as expected based on adjuvant chemotherapy guidelines; however, the underuse of chemotherapy in 26% of high-risk pts was an unexpected finding. Further study is needed to determine: (1) why physicians avoided chemotherapy in 26% of high-risk pts; (2) the overall number of appropriate pts who underwent Oncotype DX testing; and, (3) the tumor characteristics that may have driven the underutilization of chemotherapy in the high-risk population.

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