This document provides guidance on cervical cancer screening and management based on a presentation given by Dr. Barbara Apgar. It addresses screening recommendations for various patient populations based on age and risk factors. Key points discussed include:
- For women under 21, no screening is recommended. Annual screening can begin at age 21.
- Women ages 21-29 should have a Pap test alone every 3 years. Co-testing with HPV is not recommended under age 30.
- Women ages 30-65, co-testing every 5 years or Pap alone every 3 years is preferred.
- Screening can stop after age 65 for women with adequate negative prior screening in the last 10 years, with the most recent test in
This document provides an update on cervical cancer screening guidelines. It discusses the benefits of HPV testing over Pap testing in providing reassurance against future risk of cervical lesions. HPV testing identifies women at higher risk better than Pap and results in fewer unnecessary procedures. While 3-year Pap or 5-year co-testing intervals are acceptable, some argue annual screening should be the benchmark. Concerns include additional cancer risk with less frequent screening and women's reluctance to accept longer intervals. Future reductions in HPV infections may allow even longer safe screening intervals. Primary HPV screening starting at age 25 is now being considered.
4 prof james bently management guidelines 2014Tariq Mohammed
This document provides guidelines for colposcopy management from the IFCCP Jeddah Jan 2014 conference and the ASCCP Management Guidelines 2012 and SOGC SCC Colposcopy Guidelines 2012. It discusses recommendations and algorithms for evaluating and managing various abnormal cytology results and histological findings identified during colposcopy, including ASCUS, LSIL, ASC-H, HSIL, AGC, cervical intraepithelial neoplasia grades, and other conditions. Management may involve repeat testing, colposcopy, biopsy, excisional procedures, or return to routine screening depending on the abnormality, risk level, and other factors.
Mrs. Payne is a 45-year-old female presenting for her annual exam. She has not had a visit in over 5 years. The nurse practitioner will interview her, update her medical history, and perform a physical exam. Recommendations will address Mrs. Payne's smoking, weight, lack of exercise, and osteoporosis prevention. The practitioner will educate her on menopause, nutrition, physical activity, weight loss, smoking cessation, and cancer screenings. Mrs. Payne will schedule follow ups to review labs and monitor her progress.
Mrs. Payne is a 45-year-old female presenting for her annual exam. She has not had a visit in over 5 years. The nurse practitioner will interview her, update her medical history, conduct a physical exam, address recommendations regarding her smoking, weight, and lack of exercise. The patient will be educated on menopause, nutrition, physical activity, weight loss, smoking cessation, and cancer screenings. She is scheduled for follow up on lab results and a 3-week visit to monitor her progress.
Cervical cancer screening guidelines 2013 on 7th septLifecare Centre
The document summarizes the 2013 guidelines for cervical cancer screening in the United States. The key points are:
1. Screening should begin at age 21 with cytology alone every 3 years until age 30.
2. From ages 30-65, co-testing with cytology and HPV testing every 5 years is the preferred method. Cytology alone every 3 years is acceptable.
3. Screening can stop at age 65 for women with adequate negative prior screening and no history of CIN2 or worse. Screening after a hysterectomy also depends on whether the cervix was removed.
1) Cervical cancer is the third most common gynecologic cancer in the US and second most common in countries without screening programs. Human papillomavirus (HPV) infection is the main risk factor.
2) Screening guidelines recommend Pap smears begin at age 21, regardless of sexual history. Screening can stop at age 65 for women with prior normal smears.
3) Women who receive the HPV vaccine should still be screened according to standard guidelines, as vaccination does not eliminate all cancer risk.
The document discusses guidelines for cervical cancer screening, including incorporating HPV testing. It finds that HPV testing for women over 30 with ASCUS can reduce unnecessary colposcopies by identifying HPV-negative patients with very low risk. However, HPV testing also poses problems like increased anxiety and many HPV-positive women referred for colposcopy having normal results. Overall, HPV testing may help triage some abnormal pap results but also adds new issues to consider.
This document provides an update on cervical cancer screening guidelines. It discusses the benefits of HPV testing over Pap testing in providing reassurance against future risk of cervical lesions. HPV testing identifies women at higher risk better than Pap and results in fewer unnecessary procedures. While 3-year Pap or 5-year co-testing intervals are acceptable, some argue annual screening should be the benchmark. Concerns include additional cancer risk with less frequent screening and women's reluctance to accept longer intervals. Future reductions in HPV infections may allow even longer safe screening intervals. Primary HPV screening starting at age 25 is now being considered.
4 prof james bently management guidelines 2014Tariq Mohammed
This document provides guidelines for colposcopy management from the IFCCP Jeddah Jan 2014 conference and the ASCCP Management Guidelines 2012 and SOGC SCC Colposcopy Guidelines 2012. It discusses recommendations and algorithms for evaluating and managing various abnormal cytology results and histological findings identified during colposcopy, including ASCUS, LSIL, ASC-H, HSIL, AGC, cervical intraepithelial neoplasia grades, and other conditions. Management may involve repeat testing, colposcopy, biopsy, excisional procedures, or return to routine screening depending on the abnormality, risk level, and other factors.
Mrs. Payne is a 45-year-old female presenting for her annual exam. She has not had a visit in over 5 years. The nurse practitioner will interview her, update her medical history, and perform a physical exam. Recommendations will address Mrs. Payne's smoking, weight, lack of exercise, and osteoporosis prevention. The practitioner will educate her on menopause, nutrition, physical activity, weight loss, smoking cessation, and cancer screenings. Mrs. Payne will schedule follow ups to review labs and monitor her progress.
Mrs. Payne is a 45-year-old female presenting for her annual exam. She has not had a visit in over 5 years. The nurse practitioner will interview her, update her medical history, conduct a physical exam, address recommendations regarding her smoking, weight, and lack of exercise. The patient will be educated on menopause, nutrition, physical activity, weight loss, smoking cessation, and cancer screenings. She is scheduled for follow up on lab results and a 3-week visit to monitor her progress.
Cervical cancer screening guidelines 2013 on 7th septLifecare Centre
The document summarizes the 2013 guidelines for cervical cancer screening in the United States. The key points are:
1. Screening should begin at age 21 with cytology alone every 3 years until age 30.
2. From ages 30-65, co-testing with cytology and HPV testing every 5 years is the preferred method. Cytology alone every 3 years is acceptable.
3. Screening can stop at age 65 for women with adequate negative prior screening and no history of CIN2 or worse. Screening after a hysterectomy also depends on whether the cervix was removed.
1) Cervical cancer is the third most common gynecologic cancer in the US and second most common in countries without screening programs. Human papillomavirus (HPV) infection is the main risk factor.
2) Screening guidelines recommend Pap smears begin at age 21, regardless of sexual history. Screening can stop at age 65 for women with prior normal smears.
3) Women who receive the HPV vaccine should still be screened according to standard guidelines, as vaccination does not eliminate all cancer risk.
The document discusses guidelines for cervical cancer screening, including incorporating HPV testing. It finds that HPV testing for women over 30 with ASCUS can reduce unnecessary colposcopies by identifying HPV-negative patients with very low risk. However, HPV testing also poses problems like increased anxiety and many HPV-positive women referred for colposcopy having normal results. Overall, HPV testing may help triage some abnormal pap results but also adds new issues to consider.
The Papanicolaou test (also called Pap smear, Pap test, cervical smear, or smear test) is a screening test used in gynecology to detect premalignant and malignant (cancerous) processes in the ectocervix. http://docturs.com/dd/pg/groups/2392/cervical-smear-test-pap-test/
Women should see a gynecologist annually starting at age 13-15 even if a Pap test is not needed, to discuss health and lifestyle. The Pap test schedule depends on age and risk factors - it is recommended every 3 years from ages 21-30 and to begin co-testing with HPV at age 30. After age 65, Pap tests may not be needed if the last 3 tests were normal. Regular mammograms are essential to screen for breast cancer, even with clinical breast exams, as exams alone have not been shown to reduce breast cancer mortality.
This document provides guidelines for cervical cancer screening and management of abnormal findings according to the 2007 ASCCP guidelines. Key points include: initiating screening at age 21 or 3 years after first sexual intercourse; transitioning to every 3 year screening after age 30 with 3 normal annual pap smears; diagnostic excisional procedure is recommended for CIN II or III in adults but observation is preferred for adolescents; and endometrial biopsy is recommended for women over 35 with atypical glandular cells to evaluate for endometrial cancer.
The document summarizes the 2013 guidelines for cervical cancer screening in average-risk women. It recommends that screening should begin at age 21 with conventional or liquid-based cytology every 3 years. From ages 30-65, it is acceptable to continue cytology alone every 3 years, but preferred is co-testing with cytology and HPV testing every 5 years. Screening should stop at age 65 for women with adequate negative prior screening or after total hysterectomy with no history of precancerous lesions. The guidelines do not recommend annual screening or primary HPV testing alone for screening.
Cervical cancer prevention involves screening programs, proper sampling and reporting techniques, and management of abnormal Pap smear results. Effective screening programs screen women starting at age 30-35 and every 3-5 years until age 65, depending on country. Screening aims to detect precancerous lesions through Pap smears so they can be treated before developing into invasive cancer. Management of abnormal results involves tests like colposcopy and treatment such as cryotherapy or LEEP for higher grade lesions to prevent cancer progression. Regular screening can reduce lifetime cervical cancer risk by over 90% and is critical for prevention.
This document discusses various types of cancer screening. It begins by explaining the purpose and benefits of screening, as well as some limitations. It then outlines recommendations for breast, cervical, colorectal, genetic, lung, and prostate cancer screening. For each type of cancer, it provides details on screening modalities, intervals, and considerations for increased risk populations. The goal of screening is to detect cancer early before symptoms appear, but it must be weighed against potential harms.
This document discusses cancer screening guidelines for several common cancers. It recommends screening for breast cancer with annual mammograms and clinical exams starting at age 40, and beginning earlier or including MRI for those at high risk. Cervical cancer screening should begin at age 21 with Pap tests every 3 years or co-testing with HPV every 5 years. Colorectal cancer screening options include colonoscopy every 10 years, sigmoidoscopy every 5 years, or annual fecal tests. Genetic screening is recommended for those with a family history suggesting inherited cancer risk. Lung cancer screening with low-dose CT is advised for high-risk smokers aged 55-74. Prostate cancer screening involves PSA testing and DRE for men aged 50-69
This document provides guidelines for managing abnormal Pap smears, cervical dysplasia, and cervical cancer. It discusses evaluating Pap test results using the Bethesda system and determining appropriate follow up. It also outlines treatment options for cervical dysplasia like cryotherapy, LEEP, and cone biopsy. For invasive cervical cancer, it describes staging and evaluating and treating the disease in consultation with a gynecologic oncologist.
screening programme in breast and colorectal carcinomaYAJNADATTASARANGI1
- Screening is the presumptive identification of unrecognized disease in asymptomatic populations through tests or procedures.
- The document discusses screening guidelines for breast and colorectal cancer. Guidelines are based on risk factors like family history, personal medical history, genetic factors, and age.
- Screening tests for breast cancer include clinical breast exams, mammograms, MRI in high risk groups. Guidelines vary based on risk level. Colorectal cancer screening includes colonoscopy, stool tests, and is recommended starting at age 50 for average risk individuals.
The document provides updated guidelines from the American Society for Colposcopy and Cervical Pathology (ASCCP) for managing abnormal cervical cancer screening tests and cervical precancer. Key changes include new screening guidelines, management of HPV-positive women under 30, and updated recommendations for evaluating cytological abnormalities, cervical precancer, and histopathological diagnoses. The guidelines are based on evidence from over 1 million women and aim to help clinicians better manage cervical cancer screening and precancer treatment.
This document discusses screening for various gynecological cancers. It provides details about:
1. Screening for cervical cancer, noting the success of the Pap smear in reducing cervical cancer rates. It recommends screening with HPV testing, cytology, or VIA starting at age 30.
2. Screening for ovarian cancer, stating there is currently no role for organized screening but screening high risk women with CA-125 and ultrasound can be considered.
3. Screening for endometrial cancer is not routinely recommended due to a lack of evidence supporting its effectiveness in asymptomatic women.
The COLONPREV trial compared fecal immunochemical testing every 2 years to a one-time colonoscopy for colorectal cancer screening in asymptomatic adults ages 50-69. An interim analysis found that FIT was non-inferior to colonoscopy for detecting colon cancer, though colonoscopy identified more adenomas. The main criticism is that the study is not yet completed, with mortality data to be collected through 2021. A limitation of FIT is that it cannot identify adenomas like colonoscopy can.
Cervical cancer prevention involves screening programs using cervical cytology to detect precancerous lesions and early cancers. Screening guidelines recommend starting screening at age 25-30 and screening every 3-5 years until age 65-70 depending on screening test and risk factors. Abnormal Pap smears are managed based on the degree of abnormality from mild dysplasia to severe dysplasia and cancer as classified by reporting systems like Bethesda. Prevention aims to detect and treat precancerous lesions to prevent progression to invasive cancer.
The document discusses cervical cancer and ovarian cancer. For cervical cancer, it is the second leading cause of death among women aged 15-45 years old with an incidence rate of 25-45 per 100,000 women per year. Most cases are detected at an advanced stage. Screening methods like Pap smear, ThinPrep, Hybrid Capture, and genotyping can detect cervical cancer early with sensitivities ranging from 67.3-90.3% and specificities from 70.9-76.9%. Prevention involves risk factor identification, vaccination, and early detection through screening. For ovarian cancer, ultrasound, CA-125 level, and risk indices like RMI can help evaluate adnexal masses and predict malignancy in ovarian
This document summarizes key information about ovarian cancer, including epidemiology, risk factors, screening, staging, treatment with surgery and chemotherapy. It notes that ovarian cancer incidence is stable worldwide, with most women diagnosed at advanced stage. Screening with CA125 and ultrasound has not proven mortality benefit. Surgical staging and optimal debulking improves outcomes, while platinum-based chemotherapy is standard first-line treatment and improves survival. Ongoing research focuses on maintenance therapies and intraperitoneal chemotherapy administration.
This document summarizes key information about ovarian cancer, including epidemiology, risk factors, screening, staging, treatment with surgery and chemotherapy. It notes that ovarian cancer incidence is stable worldwide, with most women diagnosed at advanced stage. Screening with CA125 and ultrasound has not proven mortality benefit. Surgical staging and optimal debulking improves outcomes, while platinum-based chemotherapy is standard first-line treatment and improves survival. Ongoing research evaluates incorporating targeted therapies and intraperitoneal chemotherapy administration.
Cervical cancer is the 13th most common cancer in Saudi women ages 15-44. The incidence rate in Saudi Arabia is low at 1.9 cases per 100,000 women. It is estimated that every year 152 women are diagnosed with cervical cancer and 55 die from the disease in Saudi Arabia. Human papillomavirus (HPV) infection causes nearly all cases of cervical cancer; HPV integrates into host cells and expresses oncogenes that can lead to cancer over time if left untreated. Screening using the Pap test has significantly reduced cervical cancer rates in areas with organized screening programs by detecting pre-cancerous lesions early.
This document provides updates to guidelines for several types of cancer screening, including breast, colorectal, cervical, prostate, lung, and ovarian cancer. For each cancer, it discusses what screening tests are recommended, for which populations and age groups, and how frequently screening should occur. It also notes some controversial issues and new recommendations from groups like the US Preventive Services Task Force.
This document discusses guidelines for cancer screening and the National Cancer Control Programme in India. It provides screening guidelines for several common cancers, including breast, cervical, colorectal, lung and prostate cancer. Screening aims to detect cancer before symptoms appear using tests such as blood tests, medical imaging or stool tests. Early detection can improve health outcomes. The National Cancer Control Programme also aims to increase awareness and improve access to screening and treatment services across India.
Demystifying Gynecologic Cancer ScreeningsPennMedicine
This document summarizes gynecologic cancer screening recommendations presented by Dr. Ashley Haggerty. It discusses screening guidelines for cervical cancer using Pap tests and HPV testing, noting a shift to less frequent screening. It also covers HPV vaccination and notes its effectiveness in preventing cervical cancer. For ovarian cancer, the document indicates screening is not currently recommended due to lack of evidence showing reduced mortality. It concludes by discussing debates around annual pelvic exams.
Giloy in Ayurveda - Classical Categorization and SynonymsPlanet Ayurveda
Giloy, also known as Guduchi or Amrita in classical Ayurvedic texts, is a revered herb renowned for its myriad health benefits. It is categorized as a Rasayana, meaning it has rejuvenating properties that enhance vitality and longevity. Giloy is celebrated for its ability to boost the immune system, detoxify the body, and promote overall wellness. Its anti-inflammatory, antipyretic, and antioxidant properties make it a staple in managing conditions like fever, diabetes, and stress. The versatility and efficacy of Giloy in supporting health naturally highlight its importance in Ayurveda. At Planet Ayurveda, we provide a comprehensive range of health services and 100% herbal supplements that harness the power of natural ingredients like Giloy. Our products are globally available and affordable, ensuring that everyone can benefit from the ancient wisdom of Ayurveda. If you or your loved ones are dealing with health issues, contact Planet Ayurveda at 01725214040 to book an online video consultation with our professional doctors. Let us help you achieve optimal health and wellness naturally.
More Related Content
Similar to Cervical Cancer Screenings Case Discussions Barb Apgar.ppt
The Papanicolaou test (also called Pap smear, Pap test, cervical smear, or smear test) is a screening test used in gynecology to detect premalignant and malignant (cancerous) processes in the ectocervix. http://docturs.com/dd/pg/groups/2392/cervical-smear-test-pap-test/
Women should see a gynecologist annually starting at age 13-15 even if a Pap test is not needed, to discuss health and lifestyle. The Pap test schedule depends on age and risk factors - it is recommended every 3 years from ages 21-30 and to begin co-testing with HPV at age 30. After age 65, Pap tests may not be needed if the last 3 tests were normal. Regular mammograms are essential to screen for breast cancer, even with clinical breast exams, as exams alone have not been shown to reduce breast cancer mortality.
This document provides guidelines for cervical cancer screening and management of abnormal findings according to the 2007 ASCCP guidelines. Key points include: initiating screening at age 21 or 3 years after first sexual intercourse; transitioning to every 3 year screening after age 30 with 3 normal annual pap smears; diagnostic excisional procedure is recommended for CIN II or III in adults but observation is preferred for adolescents; and endometrial biopsy is recommended for women over 35 with atypical glandular cells to evaluate for endometrial cancer.
The document summarizes the 2013 guidelines for cervical cancer screening in average-risk women. It recommends that screening should begin at age 21 with conventional or liquid-based cytology every 3 years. From ages 30-65, it is acceptable to continue cytology alone every 3 years, but preferred is co-testing with cytology and HPV testing every 5 years. Screening should stop at age 65 for women with adequate negative prior screening or after total hysterectomy with no history of precancerous lesions. The guidelines do not recommend annual screening or primary HPV testing alone for screening.
Cervical cancer prevention involves screening programs, proper sampling and reporting techniques, and management of abnormal Pap smear results. Effective screening programs screen women starting at age 30-35 and every 3-5 years until age 65, depending on country. Screening aims to detect precancerous lesions through Pap smears so they can be treated before developing into invasive cancer. Management of abnormal results involves tests like colposcopy and treatment such as cryotherapy or LEEP for higher grade lesions to prevent cancer progression. Regular screening can reduce lifetime cervical cancer risk by over 90% and is critical for prevention.
This document discusses various types of cancer screening. It begins by explaining the purpose and benefits of screening, as well as some limitations. It then outlines recommendations for breast, cervical, colorectal, genetic, lung, and prostate cancer screening. For each type of cancer, it provides details on screening modalities, intervals, and considerations for increased risk populations. The goal of screening is to detect cancer early before symptoms appear, but it must be weighed against potential harms.
This document discusses cancer screening guidelines for several common cancers. It recommends screening for breast cancer with annual mammograms and clinical exams starting at age 40, and beginning earlier or including MRI for those at high risk. Cervical cancer screening should begin at age 21 with Pap tests every 3 years or co-testing with HPV every 5 years. Colorectal cancer screening options include colonoscopy every 10 years, sigmoidoscopy every 5 years, or annual fecal tests. Genetic screening is recommended for those with a family history suggesting inherited cancer risk. Lung cancer screening with low-dose CT is advised for high-risk smokers aged 55-74. Prostate cancer screening involves PSA testing and DRE for men aged 50-69
This document provides guidelines for managing abnormal Pap smears, cervical dysplasia, and cervical cancer. It discusses evaluating Pap test results using the Bethesda system and determining appropriate follow up. It also outlines treatment options for cervical dysplasia like cryotherapy, LEEP, and cone biopsy. For invasive cervical cancer, it describes staging and evaluating and treating the disease in consultation with a gynecologic oncologist.
screening programme in breast and colorectal carcinomaYAJNADATTASARANGI1
- Screening is the presumptive identification of unrecognized disease in asymptomatic populations through tests or procedures.
- The document discusses screening guidelines for breast and colorectal cancer. Guidelines are based on risk factors like family history, personal medical history, genetic factors, and age.
- Screening tests for breast cancer include clinical breast exams, mammograms, MRI in high risk groups. Guidelines vary based on risk level. Colorectal cancer screening includes colonoscopy, stool tests, and is recommended starting at age 50 for average risk individuals.
The document provides updated guidelines from the American Society for Colposcopy and Cervical Pathology (ASCCP) for managing abnormal cervical cancer screening tests and cervical precancer. Key changes include new screening guidelines, management of HPV-positive women under 30, and updated recommendations for evaluating cytological abnormalities, cervical precancer, and histopathological diagnoses. The guidelines are based on evidence from over 1 million women and aim to help clinicians better manage cervical cancer screening and precancer treatment.
This document discusses screening for various gynecological cancers. It provides details about:
1. Screening for cervical cancer, noting the success of the Pap smear in reducing cervical cancer rates. It recommends screening with HPV testing, cytology, or VIA starting at age 30.
2. Screening for ovarian cancer, stating there is currently no role for organized screening but screening high risk women with CA-125 and ultrasound can be considered.
3. Screening for endometrial cancer is not routinely recommended due to a lack of evidence supporting its effectiveness in asymptomatic women.
The COLONPREV trial compared fecal immunochemical testing every 2 years to a one-time colonoscopy for colorectal cancer screening in asymptomatic adults ages 50-69. An interim analysis found that FIT was non-inferior to colonoscopy for detecting colon cancer, though colonoscopy identified more adenomas. The main criticism is that the study is not yet completed, with mortality data to be collected through 2021. A limitation of FIT is that it cannot identify adenomas like colonoscopy can.
Cervical cancer prevention involves screening programs using cervical cytology to detect precancerous lesions and early cancers. Screening guidelines recommend starting screening at age 25-30 and screening every 3-5 years until age 65-70 depending on screening test and risk factors. Abnormal Pap smears are managed based on the degree of abnormality from mild dysplasia to severe dysplasia and cancer as classified by reporting systems like Bethesda. Prevention aims to detect and treat precancerous lesions to prevent progression to invasive cancer.
The document discusses cervical cancer and ovarian cancer. For cervical cancer, it is the second leading cause of death among women aged 15-45 years old with an incidence rate of 25-45 per 100,000 women per year. Most cases are detected at an advanced stage. Screening methods like Pap smear, ThinPrep, Hybrid Capture, and genotyping can detect cervical cancer early with sensitivities ranging from 67.3-90.3% and specificities from 70.9-76.9%. Prevention involves risk factor identification, vaccination, and early detection through screening. For ovarian cancer, ultrasound, CA-125 level, and risk indices like RMI can help evaluate adnexal masses and predict malignancy in ovarian
This document summarizes key information about ovarian cancer, including epidemiology, risk factors, screening, staging, treatment with surgery and chemotherapy. It notes that ovarian cancer incidence is stable worldwide, with most women diagnosed at advanced stage. Screening with CA125 and ultrasound has not proven mortality benefit. Surgical staging and optimal debulking improves outcomes, while platinum-based chemotherapy is standard first-line treatment and improves survival. Ongoing research focuses on maintenance therapies and intraperitoneal chemotherapy administration.
This document summarizes key information about ovarian cancer, including epidemiology, risk factors, screening, staging, treatment with surgery and chemotherapy. It notes that ovarian cancer incidence is stable worldwide, with most women diagnosed at advanced stage. Screening with CA125 and ultrasound has not proven mortality benefit. Surgical staging and optimal debulking improves outcomes, while platinum-based chemotherapy is standard first-line treatment and improves survival. Ongoing research evaluates incorporating targeted therapies and intraperitoneal chemotherapy administration.
Cervical cancer is the 13th most common cancer in Saudi women ages 15-44. The incidence rate in Saudi Arabia is low at 1.9 cases per 100,000 women. It is estimated that every year 152 women are diagnosed with cervical cancer and 55 die from the disease in Saudi Arabia. Human papillomavirus (HPV) infection causes nearly all cases of cervical cancer; HPV integrates into host cells and expresses oncogenes that can lead to cancer over time if left untreated. Screening using the Pap test has significantly reduced cervical cancer rates in areas with organized screening programs by detecting pre-cancerous lesions early.
This document provides updates to guidelines for several types of cancer screening, including breast, colorectal, cervical, prostate, lung, and ovarian cancer. For each cancer, it discusses what screening tests are recommended, for which populations and age groups, and how frequently screening should occur. It also notes some controversial issues and new recommendations from groups like the US Preventive Services Task Force.
This document discusses guidelines for cancer screening and the National Cancer Control Programme in India. It provides screening guidelines for several common cancers, including breast, cervical, colorectal, lung and prostate cancer. Screening aims to detect cancer before symptoms appear using tests such as blood tests, medical imaging or stool tests. Early detection can improve health outcomes. The National Cancer Control Programme also aims to increase awareness and improve access to screening and treatment services across India.
Demystifying Gynecologic Cancer ScreeningsPennMedicine
This document summarizes gynecologic cancer screening recommendations presented by Dr. Ashley Haggerty. It discusses screening guidelines for cervical cancer using Pap tests and HPV testing, noting a shift to less frequent screening. It also covers HPV vaccination and notes its effectiveness in preventing cervical cancer. For ovarian cancer, the document indicates screening is not currently recommended due to lack of evidence showing reduced mortality. It concludes by discussing debates around annual pelvic exams.
Similar to Cervical Cancer Screenings Case Discussions Barb Apgar.ppt (20)
Giloy in Ayurveda - Classical Categorization and SynonymsPlanet Ayurveda
Giloy, also known as Guduchi or Amrita in classical Ayurvedic texts, is a revered herb renowned for its myriad health benefits. It is categorized as a Rasayana, meaning it has rejuvenating properties that enhance vitality and longevity. Giloy is celebrated for its ability to boost the immune system, detoxify the body, and promote overall wellness. Its anti-inflammatory, antipyretic, and antioxidant properties make it a staple in managing conditions like fever, diabetes, and stress. The versatility and efficacy of Giloy in supporting health naturally highlight its importance in Ayurveda. At Planet Ayurveda, we provide a comprehensive range of health services and 100% herbal supplements that harness the power of natural ingredients like Giloy. Our products are globally available and affordable, ensuring that everyone can benefit from the ancient wisdom of Ayurveda. If you or your loved ones are dealing with health issues, contact Planet Ayurveda at 01725214040 to book an online video consultation with our professional doctors. Let us help you achieve optimal health and wellness naturally.
Spontaneous Bacterial Peritonitis - Pathogenesis , Clinical Features & Manage...Jim Jacob Roy
In this presentation , SBP ( spontaneous bacterial peritonitis ) , which is a common complication in patients with cirrhosis and ascites is described in detail.
The reference for this presentation is Sleisenger and Fordtran's Gastrointestinal and Liver Disease Textbook ( 11th edition ).
Storyboard on Skin- Innovative Learning (M-pharm) 2nd sem. (Cosmetics)MuskanShingari
Skin is the largest organ of the human body, serving crucial functions that include protection, sensation, regulation, and synthesis. Structurally, it consists of three main layers: the epidermis, dermis, and hypodermis (subcutaneous layer).
1. **Epidermis**: The outermost layer primarily composed of epithelial cells called keratinocytes. It provides a protective barrier against environmental factors, pathogens, and UV radiation.
2. **Dermis**: Located beneath the epidermis, the dermis contains connective tissue, blood vessels, hair follicles, and sweat glands. It plays a vital role in supporting and nourishing the epidermis, regulating body temperature, and housing sensory receptors for touch, pressure, temperature, and pain.
3. **Hypodermis**: Also known as the subcutaneous layer, it consists of fat and connective tissue that anchors the skin to underlying structures like muscles and bones. It provides insulation, cushioning, and energy storage.
Skin performs essential functions such as regulating body temperature through sweat production and blood flow control, synthesizing vitamin D when exposed to sunlight, and serving as a sensory interface with the external environment.
Maintaining skin health is crucial for overall well-being, involving proper hygiene, hydration, protection from sun exposure, and avoiding harmful substances. Skin conditions and diseases range from minor irritations to chronic disorders, emphasizing the importance of regular care and medical attention when needed.
TEST BANK For Brunner and Suddarth's Textbook of Medical-Surgical Nursing, 14...Donc Test
TEST BANK For Brunner and Suddarth's Textbook of Medical-Surgical Nursing, 14th Edition (Hinkle, 2017) Verified Chapter's 1 - 73 Complete.pdf
TEST BANK For Brunner and Suddarth's Textbook of Medical-Surgical Nursing, 14th Edition (Hinkle, 2017) Verified Chapter's 1 - 73 Complete.pdf
TEST BANK For Brunner and Suddarth's Textbook of Medical-Surgical Nursing, 14th Edition (Hinkle, 2017) Verified Chapter's 1 - 73 Complete.pdf
Breast cancer: Post menopausal endocrine therapyDr. Sumit KUMAR
Breast cancer in postmenopausal women with hormone receptor-positive (HR+) status is a common and complex condition that necessitates a multifaceted approach to management. HR+ breast cancer means that the cancer cells grow in response to hormones such as estrogen and progesterone. This subtype is prevalent among postmenopausal women and typically exhibits a more indolent course compared to other forms of breast cancer, which allows for a variety of treatment options.
Diagnosis and Staging
The diagnosis of HR+ breast cancer begins with clinical evaluation, imaging, and biopsy. Imaging modalities such as mammography, ultrasound, and MRI help in assessing the extent of the disease. Histopathological examination and immunohistochemical staining of the biopsy sample confirm the diagnosis and hormone receptor status by identifying the presence of estrogen receptors (ER) and progesterone receptors (PR) on the tumor cells.
Staging involves determining the size of the tumor (T), the involvement of regional lymph nodes (N), and the presence of distant metastasis (M). The American Joint Committee on Cancer (AJCC) staging system is commonly used. Accurate staging is critical as it guides treatment decisions.
Treatment Options
Endocrine Therapy
Endocrine therapy is the cornerstone of treatment for HR+ breast cancer in postmenopausal women. The primary goal is to reduce the levels of estrogen or block its effects on cancer cells. Commonly used agents include:
Selective Estrogen Receptor Modulators (SERMs): Tamoxifen is a SERM that binds to estrogen receptors, blocking estrogen from stimulating breast cancer cells. It is effective but may have side effects such as increased risk of endometrial cancer and thromboembolic events.
Aromatase Inhibitors (AIs): These drugs, including anastrozole, letrozole, and exemestane, lower estrogen levels by inhibiting the aromatase enzyme, which converts androgens to estrogen in peripheral tissues. AIs are generally preferred in postmenopausal women due to their efficacy and safety profile compared to tamoxifen.
Selective Estrogen Receptor Downregulators (SERDs): Fulvestrant is a SERD that degrades estrogen receptors and is used in cases where resistance to other endocrine therapies develops.
Combination Therapies
Combining endocrine therapy with other treatments enhances efficacy. Examples include:
Endocrine Therapy with CDK4/6 Inhibitors: Palbociclib, ribociclib, and abemaciclib are CDK4/6 inhibitors that, when combined with endocrine therapy, significantly improve progression-free survival in advanced HR+ breast cancer.
Endocrine Therapy with mTOR Inhibitors: Everolimus, an mTOR inhibitor, can be added to endocrine therapy for patients who have developed resistance to aromatase inhibitors.
Chemotherapy
Chemotherapy is generally reserved for patients with high-risk features, such as large tumor size, high-grade histology, or extensive lymph node involvement. Regimens often include anthracyclines and taxanes.
BBB and BCF
control the entry of compounds into the brain and
regulate brain homeostasis.
restricts access to brain cells of blood–borne compounds and
facilitates nutrients essential for normal metabolism to reach brain cells
STUDIES IN SUPPORT OF SPECIAL POPULATIONS: GERIATRICS E7shruti jagirdar
Unit 4: MRA 103T Regulatory affairs
This guideline is directed principally toward new Molecular Entities that are
likely to have significant use in the elderly, either because the disease intended
to be treated is characteristically a disease of aging ( e.g., Alzheimer's disease) or
because the population to be treated is known to include substantial numbers of
geriatric patients (e.g., hypertension).
Pictorial and detailed description of patellar instability with sign and symptoms and how to diagnose , what investigations you should go with and how to approach with treatment options . I have presented this slide in my 2nd year junior residency in orthopedics at LLRM medical college Meerut and got good reviews for it
After getting it read you will definitely understand the topic.
Congestive Heart failure is caused by low cardiac output and high sympathetic discharge. Diuretics reduce preload, ACE inhibitors lower afterload, beta blockers reduce sympathetic activity, and digitalis has inotropic effects. Newer medications target vasodilation and myosin activation to improve heart efficiency while lowering energy requirements. Combination therapy, following an assessment of cardiac function and volume status, is the most effective strategy to heart failure care.
Computer in pharmaceutical research and development-Mpharm(Pharmaceutics)MuskanShingari
Statistics- Statistics is the science of collecting, organizing, presenting, analyzing and interpreting numerical data to assist in making more effective decisions.
A statistics is a measure which is used to estimate the population parameter
Parameters-It is used to describe the properties of an entire population.
Examples-Measures of central tendency Dispersion, Variance, Standard Deviation (SD), Absolute Error, Mean Absolute Error (MAE), Eigen Value
As the world population is aging, Health tourism has become vitally important and will be increased day by day. Because
of the availability of quality health services and more favorable prices as well as to shorten the waiting list for medical
services regionally and internationally. There are some aspects of managing and doing marketing activities in order for
medical tourism to be feasible, in a region called as clustering in a region with main stakeholders groups includes Health
providers, Tourism cluster, etc. There are some related and affecting factors to be considered for the feasibility of medical
tourism within this study such as competitiveness, clustering, Entrepreneurship, SMEs. One of the growth phenomenon
is Health tourism in the city of Izmir and Turkey. The model of five competitive forces of Porter and The Diamond model
that is an economical model that shows the four main factors that affect the competitiveness of a nation and its industries
in this study. The short literature of medical tourism and regional clustering have been mentioned.
2. Disclosures
1. Apgar B, Brotzman G, Spitzer M. Integrated Text and Atlas
of Colposcopy. Elsevier Publishers, 2004, 2008.
2. Brotzman G, Spitzer M, Apgar B. Colposcopic Image
Library on CD. SABK, Inc 2004.
3. ASCCP Board of Directors. 2007-current.
4. A 20 year old G1P1 presents for contraception. She
has had annual Pap's (all normal) since her pregnancy
at age 16. She has had 7 partners since age 15 and a
new partner for 3 months. What would you advise her
about cervical cancer screening?
1. No Pap test now but at age 21.
2. Pap test now and annually because of multiple
partners.
3. HPV testing now.
4. Pap test and HPV testing at age 21.
5. The mother of a 17 year old comes in with her daughter
because she found her OCPs. The daughter told her
she had been sexually active for 2 years with multiple
partners. Mother wants her tested for all STI’s and
wants her to have a Pap test. She has not received the
HPV vaccine series. What do you do?
1. Query the daughter without the mother.
2. STI test her now, no Pap.
3. Pap and STI test her now.
4. Pap and HPV at age 21.
5. STI testing and Pap at age 21.
6. Women younger than 21 Years: No screening.
2012 Consensus Guidelines
When to begin screening
1. Saslow et al. ACS/ASCCP/ASCP. CA Cancer J Clin 2012; 62:
147-72 and AJCP 2012; 137: 516 – 542.
2. Moyer VA, et al. USPSTF. Ann Int Med 2012; 156: 880-91
3. ACOG Practice Bulletin #131, November 2012
4. NCCN Cervical Cancer Screening Guideline v. 2-2012.
www.NCCN.org
7. A 21 year old comes in for her first cervical
cancer screening. She is sexually active.
Assuming Pap is negative, when is her next
screening?
1. 1 year, Pap only.
2. 2 years, Pap only.
3. 3 years, Pap only
4. 3 years, Pap and HPV testing.
8. Age 21-29. Testing with cytology (Pap) alone every 3 years.
Co-testing should NOT be performed for women under age 30.
Reflex HPV testing for ASCUS only.
2012 Consensus Guidelines:
Screening Frequency
1. Saslow et al. ACS/ASCCP/ASCP. CA Cancer J Clin 2012; 62:
147-72 and AJCP 2012; 137: 516 – 542.
2. Moyer VA, et al. USPSTF. Ann Int Med 2012; 156: 880-91
3. ACOG Practice Bulletin #131, November 2012
4. NCCN Cervical Cancer Screening Guideline v. 2-2012.
www.NCCN.org
9. Risk in young women, not exactly
adolescents
The risk of cervical cancer is 10-fold higher than risk
in adolescents (1.4/100,000).
High enough to justify screening.
~ 55,000 Pap's must be obtained for every
cervical cancer diagnosed.
Low enough to allow observation for minor
cytologic abnormalities.
10. A 21 year old had a negative Pap 2 years
ago while pregnant. What screening should
be done now?
1. Pap now.
2. Pap and HPV testing now.
3. No Pap needs to be done now.
11. 21 year old G2P0 on Depo. She presents for
her first cervical cancer screening. Multiple
partners for 3 years. Pap shows ASC-US, reflex
HPV type 16 +
What is the next step?
1. Immediate colposcopy.
2. Pap in one year.
3. Pap and HPV in one year.
4. Routine screening (Pap in 3 years).
12. ASCUS or LSIL in young women – very common
cytologic diagnosis in this age group
2 years
Not for LSIL
13. She returns in one year. Her Pap is
still ASCUS. What is the next step?
1. Immediate colposcopy.
2. Pap in one year.
3. Pap and HPV in one year.
4. Routine screening.
15. A 31 year old has not had a Pap test in 3 years.
What is her “preferred” cervical cancer
screening?
1. Co-testing (Pap and HPV) now.
2. Pap only now.
3. No screening now.
16. Age 30-65. Testing with cytology alone every 3 years or co-testing with
cytology and testing for high-risk HPV types every 5 years.
Co-testing “preferred” and cytology “acceptable” by all but USPSTF.
USPSTF says either acceptable.
2012 Consensus Guidelines:
Screening Frequency
1. Saslow et al. ACS/ASCCP/ASCP. CA Cancer J Clin 2012; 62:
147-72 and AJCP 2012; 137: 516 – 542.
2. Moyer VA, et al. USPSTF. Ann Int Med 2012; 156: 880-91
3. ACOG Practice Bulletin #131, November 2012
4. NCCN Cervical Cancer Screening Guideline v. 2-2012.
www.NCCN.org
17. 45 year old G2P2 presents as a new patient. No history
of abnormal Paps. Last Pap 3 years ago. New sexual
partner for 6 mos. Monogamous prior.
What is the preferred cervical cancer screening ?
1. Pap now and then annually since she has a new
partner.
2. Pap test/HPV co-testing now and if both negative,
repeat every 5 years.
3. Pap test now and if normal, every 3 years.
4. No cervical cancer screening is needed today.
18. A 51 year old postmenopausal woman had a LEEP 2
years ago for CIN 3. 2 negative Pap's since then. She
had a TAH for fibroids 6 months ago. What would you
advise her about vaginal cancer screening?
1. She does not need further Pap tests.
2. She should have Pap tests until age 65 and
then discontinue.
3. Routine age based screening for 20 years.
20. You are considering stopping cervical cancer screening
in a 65 year old woman who has never had an abnormal
Pap. She has not had co-testing but had 2 Pap's in the
past 10 years with the most recent one 6 years ago.
Is her screening “adequate” enough to stop screening?
1. Yes
2. No
21. Adequate screening: ACOG, ASCCP, ACS*
Adequate negative prior screening is defined
as:
3 consecutive negative cytology results
OR
2 consecutive negative co-tests
done within the 10 years before stopping
screening with the most recent test within 5 years.
*USPSTF does not define adequate screening
22. A 71 year old widow is dating several
widowed men. She has always had
negative Pap's. Does she need screening?
1. No
1. Yes
1. Depends if any of the men had a wife
with cervical cancer.
23. A 69 year old woman’s husband died 5 years
ago. She has no hx abnormal Pap's and her last
Pap was at age 66. New sexual partner.
What would you advise her about cervical cancer
screening?
1. Pap test only now.
2. Pap and HPV testing now.
3. Pap test 3 years after resuming sexual
activity.
4. No further Pap test is necessary.
24. Women older than 65 Years: After adequate negative prior
screening results.
Women with a history of CIN2, CIN3, or AIS should continue
routine age-based screening for at least 20 years.
Screening should not be resumed for any reason, even if a
woman reports having a new sexual partner.
2012 Consensus Guidelines:
When to stop screening
1. Saslow et al. ACS/ASCCP/ASCP. CA Cancer J Clin 2012; 62:
147-72 and AJCP 2012; 137: 516 – 542.
2. Moyer VA, et al. USPSTF. Ann Int Med 2012; 156: 880-91
3. ACOG Practice Bulletin #131, November 2012
4. NCCN Cervical Cancer Screening Guideline v. 2-2012.
www.NCCN.org
25. A 55 year old had a hysterectomy for fibroids 3 years
ago. She has had 3 normal Pap's since then. She had
normal Pap's prior to the TAH. What would you advise
her about vaginal cancer screening?
Continue age-based “routine” screening with Pap's.
Continue age-based “routine” screening with co-
testing.
Stop Pap's now.
Stop Pap's now but start again if she has a new
sexual partner.
26. No screening is necessary. Applies to women without a cervix
and without a history of CIN2, CIN3, AIS, or cancer in the past 20
years.
Evidence of adequate negative prior screening is not required (
USPSTF requires).
Screening should not be resumed for any reason, including if a woman
reports having a new sexual partner.
2012 Consensus Guidelines:
Women with prior hysterectomy
1. Saslow et al. ACS/ASCCP/ASCP. CA Cancer J Clin 2012; 62: 147-72 and
AJCP 2012; 137: 516 – 542.
2. Moyer VA, et al. USPSTF. Ann Int Med 2012; 156: 880-91
3. ACOG Practice Bulletin #131, November 2012
4. NCCN Cervical Cancer Screening Guideline v. 2-2012. www.NCCN.org
27. Percentage of women who had a Pap test within 3
years by hysterectomy status and age group
MMWR 2013;61(51):1043-1047
28. A 35 year old G1P1 presents after routine co-testing showing
a negative Pap test and positive HPV testing. She was
previously screened with cytology only but has not had
screening in 5 years. She’s had multiple sexual partners in the
past year but before was monogamous for 15 years What is
the next step??
1. Routine screening in 5 years.
2. Immediate colposcopy.
3. Repeat HPV testing in one year.
4. Repeat both cytology and HPV testing
(cotesting) in one year.
29. 2013 ASCCP consensus guidelines
Women > age 30, Pap -, HPV +
Wright TC, et al. J Lower Genital Tract Disease, 2007; 11: 201-222 and 223-239
30. She returns in one year. Cotesting results
show Pap – HPV –
What is the next step?
1. Repeat cotesting in one year.
2. Repeat cotesting in 3 years.
3. Repeat cotesting in 5 years.
4. Pap only in 3 years.
31. 2013 ASCCP consensus guidelines
Women > age 30, Pap -, HPV +
Wright TC, et al. J Lower Genital Tract Disease, 2007; 11: 201-222 and 223-239
32. 42 year old woman is Pap – HPV +
Your lab uses genotyping and she is HPV 16 and
18 negative.
What is the next step?
1. Repeat cotesting in one year.
2. Repeat cotesting in 3 years.
3. Repeat cotesting in 5 years.
4. Colposcopy.
33.
34. Her cotesting in one year is
Pap – HPV 16 +. What do you do
now?
1. Immediate colposcopy.
2. Repeat cotesting in 1 year.
3. Repeat cotesting in 3 years.
4. Return to routine screening.
35. 2013 ASCCP consensus guidelines
Women > age 30, Pap -, HPV +
Wright TC, et al. J Lower Genital Tract Disease, 2007; 11: 201-222 and 223-239
Go back to
Initial
algorithm
36. Unsatisfactory Pap
Unsat Pap's are unreliable for detecting cervical
abnormalities.
Conventional Pap: “obscuring factors”
rendered Pap unsatisfactory.
ThinPrep: can control for obscuring factors.
Unsat Pap's arise largely from insufficient
squamous cells.
Caution: a negative HPV test cannot be relied on
as it may be falsely negative because of an
insufficient sample.
37. Life cycle of the SCJ
Adolescents and
young women
Reproductive years
Postmenopause
39. 31 year old presents for her “annual” Pap. Her last Pap was 4
years ago at a prenatal visit. No hx abnormal Pap's. She had sex
last night and used a lot of lubrication. Because she has a hx of
no-shows, you do her Pap today. It is unsatisfactory due to low
numbers of squames. HPV is negative. What is the next step?
1. Bring her in immediately for a repeat Pap.
2. Pap and HPV in one year because she has
no hx of abnormal Pap's.
3. Ask the lab to repeat the HPV test.
4. Repeat the Pap in 2-4 months.
41. 35 year old had a negative Pap 3 years ago.
You decide to cotest her. Her Pap is
unsatisfactory but her HPV is +
What is the next step?
1. Repeat cotesting now.
2. Repeat cotesting in one year.
3. Repeat Pap in 2-4 months.
4. Immediate colposcopy.
44. 29 year old with negative Pap but no
endocervical cells.
What is the next step?
1. Routine screening.
1. Ask the lab to do HPV testing.
2. Repeat the Pap in 4-6 months.
45.
46. A 35 year old had a Pap 3 years ago. You
decide to repeat the Pap instead of doing
cotesting. Results show her Pap is negative but
lacks endocervical cells. What is the next step?
1. Request HPV testing now.
2. Repeat her Pap in one year.
3. Cotesting in one year.
4. Routine screening (Pap in 3 years).
49. Are women with no endocervical
cells at higher risk over time?
No higher risk for CIN 3+ over time than
women with a compete endocervical
component.
Would be expected however if true precancers
had been missed.
Lower rate of expected Pap abnormalities
over time because most women with no
endocervical cells are “older”.
Older women have lower CIN 3+ risk.
50. 65 year old postmenopausal woman
Stratified squamous
epithelium
Apgar, Brotzman, Spitzer