1
|
Gorostidi M, Lekuona A, Juaristi A, Baiocchi G. Vaginal carcinoma after cervical dysplasia. Int J Gynecol Cancer 2020; 30:265-273. [PMID: 31911538 DOI: 10.1136/ijgc-2019-001062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/11/2019] [Indexed: 11/03/2022] Open
Affiliation(s)
- Mikel Gorostidi
- Gynecology Oncology Section, Hospital Universitario de Donostia, San Sebastian, País Vasco, Spain
| | - Arantza Lekuona
- Obstetrics and Gynecology, Hospital Universitario de Donostia, San Sebastian, País Vasco, Spain
| | - Arantxa Juaristi
- Pathology Department, Hospital Universitario de Donostia, San Sebastian, País Vasco, Spain
| | | |
Collapse
|
2
|
Curry SJ, Krist AH, Owens DK, Barry MJ, Caughey AB, Davidson KW, Doubeni CA, Epling JW, Kemper AR, Kubik M, Landefeld CS, Mangione CM, Phipps MG, Silverstein M, Simon MA, Tseng CW, Wong JB. Screening for Cervical Cancer: US Preventive Services Task Force Recommendation Statement. JAMA 2018; 320:674-686. [PMID: 30140884 DOI: 10.1001/jama.2018.10897] [Citation(s) in RCA: 681] [Impact Index Per Article: 113.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
IMPORTANCE The number of deaths from cervical cancer in the United States has decreased substantially since the implementation of widespread cervical cancer screening and has declined from 2.8 to 2.3 deaths per 100 000 women from 2000 to 2015. OBJECTIVE To update the US Preventive Services Task Force (USPSTF) 2012 recommendation on screening for cervical cancer. EVIDENCE REVIEW The USPSTF reviewed the evidence on screening for cervical cancer, with a focus on clinical trials and cohort studies that evaluated screening with high-risk human papillomavirus (hrHPV) testing alone or hrHPV and cytology together (cotesting) compared with cervical cytology alone. The USPSTF also commissioned a decision analysis model to evaluate the age at which to begin and end screening, the optimal interval for screening, the effectiveness of different screening strategies, and related benefits and harms of different screening strategies. FINDINGS Screening with cervical cytology alone, primary hrHPV testing alone, or cotesting can detect high-grade precancerous cervical lesions and cervical cancer. Screening women aged 21 to 65 years substantially reduces cervical cancer incidence and mortality. The harms of screening for cervical cancer in women aged 30 to 65 years are moderate. The USPSTF concludes with high certainty that the benefits of screening every 3 years with cytology alone in women aged 21 to 29 years substantially outweigh the harms. The USPSTF concludes with high certainty that the benefits of screening every 3 years with cytology alone, every 5 years with hrHPV testing alone, or every 5 years with both tests (cotesting) in women aged 30 to 65 years outweigh the harms. Screening women older than 65 years who have had adequate prior screening and women younger than 21 years does not provide significant benefit. Screening women who have had a hysterectomy with removal of the cervix for indications other than a high-grade precancerous lesion or cervical cancer provides no benefit. The USPSTF concludes with moderate to high certainty that screening women older than 65 years who have had adequate prior screening and are not otherwise at high risk for cervical cancer, screening women younger than 21 years, and screening women who have had a hysterectomy with removal of the cervix for indications other than a high-grade precancerous lesion or cervical cancer does not result in a positive net benefit. CONCLUSIONS AND RECOMMENDATION The USPSTF recommends screening for cervical cancer every 3 years with cervical cytology alone in women aged 21 to 29 years. (A recommendation) The USPSTF recommends screening every 3 years with cervical cytology alone, every 5 years with hrHPV testing alone, or every 5 years with hrHPV testing in combination with cytology (cotesting) in women aged 30 to 65 years. (A recommendation) The USPSTF recommends against screening for cervical cancer in women younger than 21 years. (D recommendation) The USPSTF recommends against screening for cervical cancer in women older than 65 years who have had adequate prior screening and are not otherwise at high risk for cervical cancer. (D recommendation) The USPSTF recommends against screening for cervical cancer in women who have had a hysterectomy with removal of the cervix and do not have a history of a high-grade precancerous lesion or cervical cancer. (D recommendation).
Collapse
Affiliation(s)
| | | | - Alex H Krist
- Fairfax Family Practice Residency, Fairfax, Virginia
- Virginia Commonwealth University, Richmond
| | - Douglas K Owens
- Veterans Affairs Palo Alto Health Care System, Palo Alto, California
- Stanford University, Stanford, California
| | | | | | | | | | | | | | | | | | | | | | | | | | - Chien-Wen Tseng
- University of Hawaii, Honolulu
- Pacific Health Research and Education Institute, Honolulu, Hawaii
| | | |
Collapse
|
3
|
Wu CJ, Tseng CW, Wu MP. Laparoscopic subtotal hysterectomy in the era of minimally invasive surgery. Gynecol Minim Invasive Ther 2015. [DOI: 10.1016/j.gmit.2014.05.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
|
4
|
Saslow D, Runowicz CD, Solomon D, Moscicki AB, Smith RA, Eyre HJ, Cohen C. American cancer society guideline for the early detection of cervical neoplasia and cancer. J Low Genit Tract Dis 2013; 7:67-86. [PMID: 17051049 DOI: 10.1097/00128360-200304000-00001] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
An update to the American Cancer Society (ACS) guideline regarding screening for the early detection of cervical neoplasia and cancer, based on recommendations from a formal review and recent workshop, is presented. The new screening recommendations address when to begin screening, when screening may be discontinued, whether to screen women who have had a hysterectomy, appropriate screening intervals, and new screening technologies, including liquid-based cytology and HPV DNA testing.
Collapse
Affiliation(s)
- Debbie Saslow
- 1Breast and Gynecologic Cancer, American Cancer Society, Atlanta, GA; 2Department of Obstetrics and Gynecology, St. Lukes-Roosevelt Hospital Center, New York, NY; 3ASCUS/LSIL Triage Study, National Cancer Institute, Rockville, MD; 4Teen Colposcopy Clinic and Division of Adolescent Medicine, University of California, San Francisco, CA; 5Cancer Screening, American Cancer Society, Atlanta, GA; 6Research and Cancer Control, American Cancer Society, Atlanta, GA, and Editor in Chief of CA; and 7Division of Gynecologic Oncology, Department of Obstetrics, Gynecology, and Reproductive Science, The Mount Sinai Medical Center, New York, NY
| | | | | | | | | | | | | |
Collapse
|
5
|
Nicolas F, Vandenbroucke L, Voltzenlogel MC, Lavoué V, Henno S, Levêque J. [Are vaginal pap smear necessary after total hysterectomy for CIN3?]. ACTA ACUST UNITED AC 2013; 41:196-200. [PMID: 23499311 DOI: 10.1016/j.gyobfe.2013.01.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2012] [Accepted: 01/29/2013] [Indexed: 11/29/2022]
Abstract
The practice of vaginal smears after total hysterectomy should be discussed according to the indication for hysterectomy. We have thus performed a literature review using PubMed medical database with selection of articles presenting a practical interest for clinicians. The practice of vaginal smears after endometrial cancer can be abandoned, but in case of cervical cancer it improves the performance of clinical examination in the early follow-up (in the first 5 years of follow-up) especially in early diagnosis of subclinical recurrence. After this period, the interest of vaginal smears drop drastically and the follow-up is mainly clinical. When hysterectomy is proposed as part of cervical intraepithelial neoplasia (particularly when associated uterine lesions and cervical conization not accessible), the risk of vaginal recurrence of HPV-induced pathology fully justifies an annual monitoring (recurrences or virus-induced lesions are seen up to 25 years after surgery). Finally, after hysterectomy for benign uterine non-HPV-induced, there is no need to propose a systematic follow-up cytology.
Collapse
Affiliation(s)
- F Nicolas
- Service de gynécologie, CHU Anne-de-Bretagne, 16, boulevard de Bulgarie, BP 90347, 35203 Rennes cedex 2, France
| | | | | | | | | | | |
Collapse
|
6
|
Saslow D, Solomon D, Lawson HW, Killackey M, Kulasingam SL, Cain JM, Garcia FAR, Moriarty AT, Waxman AG, Wilbur DC, Wentzensen N, Downs LS, Spitzer M, Moscicki AB, Franco EL, Stoler MH, Schiffman M, Castle PE, Myers ER, Chelmow D, Herzig A, Kim JJ, Kinney W, Herschel WL, Waldman J. American Cancer Society, American Society for Colposcopy and Cervical Pathology, and American Society for Clinical Pathology screening guidelines for the prevention and early detection of cervical cancer. J Low Genit Tract Dis 2012; 16:175-204. [PMID: 22418039 PMCID: PMC3915715 DOI: 10.1097/lgt.0b013e31824ca9d5] [Citation(s) in RCA: 237] [Impact Index Per Article: 19.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
An update to the American Cancer Society (ACS) guideline regarding screening for the early detection of cervical precancerous lesions and cancer is presented. The guidelines are based on a systematic evidence review, contributions from six working groups, and a recent symposium co-sponsored by the ACS, American Society for Colposcopy and Cervical Pathology (ASCCP), and American Society for Clinical Pathology (ASCP), which was attended by 25 organizations. The new screening recommendations address age-appropriate screening strategies, including the use of cytology and high-risk human papillomavirus (HPV) testing, follow-up (e.g., management of screen positives and screening interval for screen negatives) of women after screening, age at which to exit screening, future considerations regarding HPV testing alone as a primary screening approach, and screening strategies for women vaccinated against HPV16/18 infections.
Collapse
Affiliation(s)
- Debbie Saslow
- Breast and Gynecologic Cancer, Cancer Control Science Department, American Cancer Society, Atlanta, GA 30303, USA.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
7
|
Saslow D, Solomon D, Lawson HW, Killackey M, Kulasingam SL, Cain J, Garcia FAR, Moriarty AT, Waxman AG, Wilbur DC, Wentzensen N, Downs LS, Spitzer M, Moscicki AB, Franco EL, Stoler MH, Schiffman M, Castle PE, Myers ER. American Cancer Society, American Society for Colposcopy and Cervical Pathology, and American Society for Clinical Pathology screening guidelines for the prevention and early detection of cervical cancer. CA Cancer J Clin 2012; 62:147-72. [PMID: 22422631 PMCID: PMC3801360 DOI: 10.3322/caac.21139] [Citation(s) in RCA: 781] [Impact Index Per Article: 65.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
An update to the American Cancer Society (ACS) guideline regarding screening for the early detection of cervical precancerous lesions and cancer is presented. The guidelines are based on a systematic evidence review, contributions from 6 working groups, and a recent symposium cosponsored by the ACS, the American Society for Colposcopy and Cervical Pathology, and the American Society for Clinical Pathology, which was attended by 25 organizations. The new screening recommendations address age-appropriate screening strategies, including the use of cytology and high-risk human papillomavirus (HPV) testing, follow-up (eg, the management of screen positives and screening intervals for screen negatives) of women after screening, the age at which to exit screening, future considerations regarding HPV testing alone as a primary screening approach, and screening strategies for women vaccinated against HPV16 and HPV18 infections.
Collapse
Affiliation(s)
- Debbie Saslow
- Cancer Control Science Department, American Cancer Society, Atlanta, GA 30303, USA.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
8
|
Saslow D, Solomon D, Lawson HW, Killackey M, Kulasingam SL, Cain J, Garcia FAR, Moriarty AT, Waxman AG, Wilbur DC, Wentzensen N, Downs LS, Spitzer M, Moscicki AB, Franco EL, Stoler MH, Schiffman M, Castle PE, Myers ER. American Cancer Society, American Society for Colposcopy and Cervical Pathology, and American Society for Clinical Pathology screening guidelines for the prevention and early detection of cervical cancer. Am J Clin Pathol 2012; 137:516-42. [PMID: 22431528 DOI: 10.1309/ajcptgd94evrsjcg] [Citation(s) in RCA: 526] [Impact Index Per Article: 43.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
An update to the American Cancer Society (ACS) guideline regarding screening for the early detection of cervical precancerous lesions and cancer is presented. The guidelines are based on a systematic evidence review, contributions from 6 working groups, and a recent symposium cosponsored by the ACS, the American Society for Colposcopy and Cervical Pathology, and the American Society for Clinical Pathology, which was attended by 25 organizations. The new screening recommendations address age-appropriate screening strategies, including the use of cytology and high-risk human papillomavirus (HPV) testing, follow-up (eg, the management of screen positives and screening intervals for screen negatives) of women after screening, the age at which to exit screening, future considerations regarding HPV testing alone as a primary screening approach, and screening strategies for women vaccinated against HPV16 and HPV18 infections.
Collapse
|
9
|
Kendall BS, Zahn CM. The use of reflex high-risk human papillomavirus testing for atypical squamous cells of undetermined significance interpretations on vaginal specimens. Cancer 2009; 117:27-31. [PMID: 19347826 DOI: 10.1002/cncy.20012] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND The use of reflex high-risk human papillomavirus (hrHPV) testing as a triage method for cervical specimens with an interpretation of atypical squamous cells of undetermined significance (ASC-US) is well established. To the authors' knowledge, very little has been reported regarding the utility of this approach in vaginal specimens in women with a prior hysterectomy. The current study evaluated the results of hrHPV testing in women with vaginal specimens interpreted as ASC-US in the authors' laboratory. METHODS Follow-up information, including results of hrHPV testing, was sought for all vaginal smears reported as ASC-US from the authors' cytology laboratory during the calendar years 2005 and 2006. RESULTS For the 2 years reviewed, 254 ASC-US vaginal specimens were available for assessment. Reflex hrHPV testing was requested on 236 (92.9%), with sufficient residual material available in 193 specimens. hrHPV was detected in 44 (22.8%). Follow-up results were available for 136 specimens, with a squamous intraepithelial lesion (SIL, all but 1 of which was low grade) found to be present in 21 (15.4%). SIL was identified in significantly more women in whom hrHPV was detected compared with those in whom hrHPV was not detected (41.9% vs 4.2%; P < .001 by the Fisher exact test). CONCLUSIONS Rates of detection of squamous abnormalities in women with ASC-US on vaginal preparations in whom hrHPV was detected were found to be higher than in those without hrHPV. These findings suggest that clinical follow-up is needed for women in whom hrHPV is detected. hrHPV testing may be clinically useful as a method of triage for women with ASC-US vaginal smears.
Collapse
Affiliation(s)
- Brian S Kendall
- Department of Pathology, Wilford Hall Medical Center, San Antonio, TX, USA.
| | | |
Collapse
|
10
|
Stokes-Lampard HJ, Macleod J, Wilson S. Variation in NHS utilisation of vault smear tests in women post-hysterectomy: A study, using routinely collected datasets. BMC WOMENS HEALTH 2008; 8:6. [PMID: 18373859 PMCID: PMC2329610 DOI: 10.1186/1472-6874-8-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/12/2008] [Accepted: 03/28/2008] [Indexed: 11/17/2022]
Abstract
Background 20% of women living in the UK have a hysterectomy during their lifetime, levels are higher in the USA, making it one of the most commonly performed major surgical procedures. Understanding of the indications for hysterectomy and of the rationale for follow-up of women post hysterectomy is currently limited. Guidelines concerning follow-up by means of vaginal vault cytology tests exist but these are not based on 'gold standard' evidence. Furthermore, the extent to which current practice reflects these guidelines is unclear. This study aims to determine the factors associated with variability in hysterectomy rates and subsequent follow-up after surgery by use of the vaginal vault smear cytology test. Methods/Design All women resident in the West Midlands region, of the United Kingdom, who had a hysterectomy operation between 1st April 2002 and 30th March 2003 will be identified from the Hospital Episodes Statistics database which also contains proxy data on deprivation status, derived from postcode and self declared ethnicity. These data will be linked to regional cervical screening records for each woman and histopathology laboratory records from the relevant hospitals. Study objectives are to describe: Indications for the hysterectomy operation, histology at hysterectomy, subsequent follow-up by use or non-use of vaginal vault cytology tests and variation between histological groups. Additionally the data will be categorised according to a woman's cytology screening history prior to surgery (i.e. always normal, borderline, resolved abnormalities, CIN etc) and these different groups compared. Variations in these outcomes according to age, deprivation and ethnic group will also be examined. Analysis will be undertaken using SPSS. Discussion This study will clarify patterns of current practice in one large English region and determine whether this practice reflects existing guidelines. The study will also strengthen the evidence base for future guidelines. Study registration National Research Register N0138173331
Collapse
Affiliation(s)
- Helen J Stokes-Lampard
- Department of Primary Care and General Practice, University of Birmingham, Edgbaston, Birmingham, West Midlands, B15 2TT, UK.
| | | | | |
Collapse
|
11
|
Gnanadesigan N, Fung CH. Quality Indicators for Screening and Prevention in Vulnerable Elders. J Am Geriatr Soc 2007; 55 Suppl 2:S417-23. [PMID: 17910565 DOI: 10.1111/j.1532-5415.2007.01350.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|
12
|
Abstract
Laparoscopic supracervical hysterectomy is a minimally invasive procedure that was developed during the 1990s as a treatment for abnormal uterine bleeding. The literature regarding this procedure, mainly case series and retrospective comparisons, suggests that laparoscopic supracervical hysterectomy results in reduced operating time and blood loss and a quicker return to normal activity, compared with laparoscopic-assisted vaginal hysterectomy. A randomized, controlled trial that compared laparoscopic supracervical hysterectomy with hysteroscopic endometrial resection found that laparoscopic supracervical hysterectomy resulted in significantly better patient satisfaction at 2 years for similar costs. Unfortunately, there are no randomized trials that have compared laparoscopic supracervical hysterectomy to vaginal or abdominal hysterectomy. Given the lack of appropriate randomized, controlled trials and the limitations of the existing research, the laparoscopic supracervical hysterectomy's true value and appropriate clinical indications remain unknown. Well-designed randomized, controlled trials that compare laparoscopic supracervical hysterectomy with laparoscopic-assisted vaginal hysterectomy, total vaginal hysterectomy, and total abdominal hysterectomy, with attention to short- and long-term morbidity, postoperative vaginal bleeding, postoperative cervical disease, sexual function, urinary symptoms, and pelvic prolapse are needed. The purpose of this article was to review the existing literature regarding laparoscopic supracervical hysterectomy and to evaluate the evidence regarding the proposed risks and benefits of the procedure.
Collapse
Affiliation(s)
- Todd R Jenkins
- Department of Obstetrics and Gynecology, Carolinas Medical Center, Charlotte, NC, USA
| |
Collapse
|
13
|
Paramsothy P, Duerr A, Heilig CM, Cu-Uvin S, Anderson JR, Schuman P, Klein RS. Abnormal Vaginal Cytology in HIV-Infected and At-Risk Women After Hysterectomy. J Acquir Immune Defic Syndr 2004; 35:484-91. [PMID: 15021313 DOI: 10.1097/00126334-200404150-00006] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To determine the frequency of and risk factors for abnormal vaginal Papanicolaou smears in HIV-infected women after hysterectomy. METHODS Data were from the HIV Epidemiology Research (HER) study, a prospective multisite study of HIV-infected and uninfected women. Semiannual vaginal Papanicolaou smears and colposcopy data were obtained from 102 HIV-infected and 46 at-risk women who had hysterectomy either before or during the study. Analytic models used include Cox proportional hazards (women with hysterectomy during the study) and multiple logistic regressions, which corrected for repeated measures (all women). RESULTS Among the HIV-infected women, evidence of cervical intraepithelial neoplasia before or at hysterectomy was associated with abnormal cytology during follow-up; 63% had squamous intraepithelial lesions (SIL) on vaginal Papanicolaou smears following hysterectomy. CD4 counts of <200 cells/microL at hysterectomy and HIV viral load of >10,000 copies/mL at hysterectomy were predictive of SIL vaginal cytology. Prevalent SIL vaginal cytology was associated with low CD4 count and human papillomavirus risk type. Of the 102 HIV-infected women, 16 (16%) had vaginal intraepithelial neoplasia on biopsy. CONCLUSIONS The high rate of SIL on vaginal Papanicolaou smears and the presence of high-grade vaginal intraepithelial neoplasia among HIV-infected women after hysterectomy demonstrate the need for continued follow-up for lower genital tract lesions.
Collapse
Affiliation(s)
- Pangaja Paramsothy
- Contraceptive Research and Development (CONRAD) Program, Arlington, VA, USA
| | | | | | | | | | | | | |
Collapse
|
14
|
|
15
|
|
16
|
Women's Health LiteratureWatch. JOURNAL OF WOMEN'S HEALTH & GENDER-BASED MEDICINE 1999; 8:1121-7. [PMID: 10565672 DOI: 10.1089/jwh.1.1999.8.1121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
|