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Overview of Traditional Methods of Diagnosis and Treatment for Women-Associated Cancers
Published in Shazia Rashid, Ankur Saxena, Sabia Rashid, Latest Advances in Diagnosis and Treatment of Women-Associated Cancers, 2022
Malika Ranjan, Namyaa Kumar, Safiya Arfi, Shazia Rashid
Cervical cancer is cancer arising from the cervix, a part of the uterus in female reproductive organ. The persistent infection of the human papillomavirus (high-risk subtypes of HPV, HPV-16 and HPV-18) is the principal cause of almost all cervical cancers whereas risk factors such as early marriage, promiscuity, bad genital hygiene and so forth are other well-known causes [15]. Cervical cancer, though highly prevalent cancer, can be prevented primarily by avoiding HPV infection through HPV vaccination and undergoing screening programs. The commonly used bivalent (Cervarix), quadrivalent (Gardasil) and 9-valent HPV vaccine (Gardasil-9) have shown greater (90%) efficacy in protecting against infection of HPV-16 and HPV-18, which are associated with high-grade cervical dysplasia. The implementation of formal screening programs in developed countries has helped reduce incidents and mortality of cervical cancer to nearly half in the past 30 years [15].
Cervical Cancer Screening And Management In Pregnancy
Published in Vincenzo Berghella, Obstetric Evidence Based Guidelines, 2022
Vaidehi Mujumdar, Scott D. Richard
The Pap smear is used to screen for cellular abnormalities that are associated with an increased risk for the development of cervical cancer. It selects those women who should have further evaluation, such as HPV DNA testing, colposcopy, and/or biopsy, which then is used for treatment decisions. The National Comprehensive Cancer Network (NCCN) panel has adopted recommendations set forth by the American Cancer Society on initiation and frequency of Pap smear [17]. Of note, ACS has new 2020 recommendations that include that people with a cervix ages 25–65 get a primary HPV test every 5 years as the preferred screening method. They do not recommend cervical cancer screening in patients less than 25 years of age [3]. The primary HPV test, the cobas test, is manufactured by Roche and can be used alone for screening. This test detects 14 “high-risk” HPV types, while also specifically identifying HPV 16 and 18. The rationale remains that invasive cancer is rare in women under 21. Annual surveillance is recommended for patients with known immunosuppression from HIV or organ transplantation; individuals exposed to diethylstilbestrol in utero; or those who have been previously treated for CIN 2, CIN 3, or cervical cancer [3]. Pap smears are often obtained at the first prenatal visit by many providers, but the guidelines for nonpregnant patients (HPV test every 5 years for patients ≥25 years old) can be followed in pregnant patients [10].
Cancer
Published in Vincenzo Berghella, Maternal-Fetal Evidence Based Guidelines, 2022
Elyce Cardonick, Charlotte Maggen, Puja Patel
Treatment for invasive cervical cancer involves either surgery, radiation or both, depending on the stage at diagnosis (Figure 44.2). Neoadjuvant chemotherapy for invasive cervical disease may be given during the second and third trimesters of pregnancy for patients with positive nodes [109, 110]. See also Chapter 34 in Obstetrics Evidence Based Guidelines.
Anesthesia management and outcomes of gynecologic oncology surgery
Published in Postgraduate Medicine, 2023
Hicret Yeniay, Bahar Kuvaki, Sule Ozbilgin, Hasan Bahadır Saatli, Hikmet Tunç Timur
A total of 37 (8.8%) patients underwent surgery for cervical cancer, including 29 surviving and 8 deceased patients, resulting in a mortality rate of 21.60%. The distribution of cancer stages among patients with cervical cancer was as follows: stage I, 73.0% (n = 27); stage II, 13.5% (n = 5); and stage III, 13.5% (n = 5). The five-year survival rates for the different stages of cervical cancer were as follows: stage I, 88.9% (n = 24); stage II, 80.0% (n = 4); and stage III, 20.0% (n = 1). There was not any patients with stage IV cervical cancer in this cohort. The amount of colloid administration for patients with cervical cancer was 554.05 ± 349.28 mL. The difference between the administered amount to the surviving and deceased patients was not statistically significant (p = 0.628).
Advancing cervical cancer diagnosis and screening with spectroscopy and machine learning
Published in Expert Review of Molecular Diagnostics, 2023
Carlos A. Meza Ramirez, Michael Greenop, Yasser A. Almoshawah, Pierre L. Martin Hirsch, Ihtesham U. Rehman
Persistent human papillomavirus (HPV), especially the high-risk HPV-16 and HPV-18, is known to be essential for cervical cancer to occur [10]. Risk factors for HPV include smoking, HIV, low socioeconomic level, multiple sexual partners, and because HPV is a sexually transmitted infection, sexual intercourse before the age of 16 [10]. The current approach to cervical cancer screening is a Pap smear test, an invasive procedure causing lowered participation [8]. Further diagnosis can be carried out by white light colposcopy with a sensitivity of ~ 96% but a specificity of ~ 48% [11]. A biopsy is the gold standard for diagnosis but is further invasive and can be impractical for patients with several suspicious lesions [11]. Developing new approaches could provide improvements in the overall accuracy of cervical cancer diagnosis, as well as a more accessible sample collection.
Combinational therapies for the treatment of advanced cervical cancer
Published in Expert Opinion on Pharmacotherapy, 2023
From a therapeutic standpoint, invasive cervical cancer can be categorized as early, locally advanced, and advanced stages. In the past, early and locally advanced stages were treated with surgery, radiation, or both combined. However, since 1990, chemotherapy has been added concomitantly with radiation for locally advanced stages as definitive therapy and adjuvant therapy for early-stage patients with high-risk factors for recurrence [2,3]. The advanced stage comprises the International Federation of Gynecology and Obstetrics (FIGO) stage IVB patients (with metastatic disease) and patients who have progressed or have recurrence to primary treatment. As only a minority of advanced patients are amenable to curative surgery or radiation [4,5], chemotherapy is the primary therapeutical modality for most of these patients Table 1.