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Neoplasia cervical utero

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https://www.readbyqxmd.com/read/26915529/a-common-clinical-dilemma-management-of-abnormal-vaginal-cytology-and-human-papillomavirus-test-results
#1
REVIEW
Michelle J Khan, L Stewart Massad, Walter Kinney, Michael A Gold, E J Mayeaux, Teresa M Darragh, Philip E Castle, David Chelmow, Herschel W Lawson, Warner K Huh
OBJECTIVE: Vaginal cancer is an uncommon cancer of the lower genital tract, and standardized screening is not recommended. Risk factors for vaginal cancer include a history of other lower genital tract neoplasia or cancer, smoking, immunosuppression, and exposure to diethylstilbestrol in utero. Although cervical cancer screening after total hysterectomy for benign disease is not recommended, many women inappropriately undergo vaginal cytology and/or human papillomavirus (hrHPV) tests, and clinicians are faced with managing their abnormal results...
May 2016: Gynecologic Oncology
https://www.readbyqxmd.com/read/26901279/a-common-clinical-dilemma-management-of-abnormal-vaginal-cytology-and-human-papillomavirus-test-results
#2
Michelle J Khan, L Stewart Massad, Walter Kinney, Michael A Gold, E J Mayeaux, Teresa M Darragh, Philip E Castle, David Chelmow, Herschel W Lawson, Warner K Huh
OBJECTIVE: Vaginal cancer is an uncommon cancer of the lower genital tract, and standardized screening is not recommended. Risk factors for vaginal cancer include a history of other lower genital tract neoplasia or cancer, smoking, immunosuppression, and exposure to diethylstilbestrol in utero. Although cervical cancer screening after total hysterectomy for benign disease is not recommended, many women inappropriately undergo vaginal cytology and/or human papillomavirus (HPV) tests, and clinicians are faced with managing their abnormal results...
April 2016: Journal of Lower Genital Tract Disease
https://www.readbyqxmd.com/read/26528108/unexpected-premalignant-gynecological-lesions-in-women-undergoing-vaginal-hysterectomy-for-utero-vaginal-prolapse
#3
Assem A M Elbiaa, Ibrahim A Abdelazim, Mohamed M Farghali, M Hussain, A E Omu
AIM OF THE STUDY: Aim of the study was to estimate the incidence of unexpected premalignant gynecological lesions in women undergoing vaginal hysterectomy for utero-vaginal prolapse. MATERIAL AND METHODS: Eighty women with asymptomatic utero-vaginal prolapse were included in this prospective study for vaginal hysterectomy after preoperative preparation and after written informed consent. Women included in this study were screened preoperatively by high vaginal swab, Pap smear, endometrial biopsy and trans-vaginal ultrasound...
September 2015: Przeglad Menopauzalny, Menopause Review
https://www.readbyqxmd.com/read/22711081/screening-for-cervical-cancer-u-s-preventive-services-task-force-recommendation-statement
#4
Virginia A Moyer
DESCRIPTION: Update of the 2003 U.S. Preventive Services Task Force (USPSTF) recommendation statement on screening for cervical cancer. METHODS: The USPSTF reviewed new evidence on the comparative test performance of liquid-based cytology and the benefits and harms of human papillomavirus (HPV) testing as a stand-alone test or in combination with cytology. In addition to the systematic evidence review, the USPSTF commissioned a decision analysis to help clarify the age at which to begin and end screening, the optimal interval for screening, and the relative benefits and harms of different strategies for screening (such as cytology and co-testing)...
June 19, 2012: Annals of Internal Medicine
https://www.readbyqxmd.com/read/22422943/screening-for-cervical-cancer-u-s-preventive-services-task-force-recommendation-statement
#5
Virginia A Moyer et al.
Description: Update of the 2003 U.S. Preventive Services Task Force (USPSTF) recommendation statement on screening for cervical cancer. Methods: The USPSTF reviewed new evidence on the comparative test performance of liquid-based cytology and the benefits and harms of human papillomavirus (HPV) testing as a stand-alone test or in combination with cytology. In addition to the systematic evidence review, the USPSTF commissioned a decision analysis to help clarify the age at which to begin and end screening, the optimal interval for screening, and the relative benefits and harms of different strategies for screening (such as cytology and co-testing)...
March 14, 2012: Annals of Internal Medicine
https://www.readbyqxmd.com/read/21991952/adverse-health-outcomes-in-women-exposed-in-utero-to-diethylstilbestrol
#6
Robert N Hoover, Marianne Hyer, Ruth M Pfeiffer, Ervin Adam, Brian Bond, Andrea L Cheville, Theodore Colton, Patricia Hartge, Elizabeth E Hatch, Arthur L Herbst, Beth Y Karlan, Raymond Kaufman, Kenneth L Noller, Julie R Palmer, Stanley J Robboy, Robert C Saal, William Strohsnitter, Linda Titus-Ernstoff, Rebecca Troisi
BACKGROUND: Before 1971, several million women were exposed in utero to diethylstilbestrol (DES) given to their mothers to prevent pregnancy complications. Several adverse outcomes have been linked to such exposure, but their cumulative effects are not well understood. METHODS: We combined data from three studies initiated in the 1970s with continued long-term follow-up of 4653 women exposed in utero to DES and 1927 unexposed controls. We assessed the risks of 12 adverse outcomes linked to DES exposure, including cumulative risks to 45 years of age for reproductive outcomes and to 55 years of age for other outcomes, and their relationships to the baseline presence or absence of vaginal epithelial changes, which are correlated with a higher dose of, and earlier exposure to, DES in utero...
October 6, 2011: New England Journal of Medicine
https://www.readbyqxmd.com/read/20189438/-how-did-i-contract-human-papillomavirus-hpv
#7
REVIEW
N Gavillon, H Vervaet, E Derniaux, P Terrosi, O Graesslin, C Quereux
More than 120 genotypes have been identified among the Papillomavirus (HPV) family. These viruses are ubiquitary with skin or mucous membrane tropism and cause various pathologies from wart to neoplasia. HPV family is classified according to their tropism. Genital HPV infection is considered as the most frequent sexually transmitted disease in the world. Seventy-five percent of women will be in contact with HPV at least one time in their life. HPV is usually transmitted through direct skin-to-skin contact, more often during penetrative genital contact...
March 2010: Gynécologie, Obstétrique & Fertilité
https://www.readbyqxmd.com/read/19681363/-vaginal-adenosis-and-vaginal-intraepithelial-neoplasia-a-review-of-the-literature-and-a-case-report
#8
REVIEW
Alejandro González Gleason, Drusso Vera Gaspar, Carlos López Castañares
Vaginal adenosis is an uncommon pathology, characterized by the presence of cylindrical epithelium in the vagina. This pathology is considered rare if not found in women exposed in utero to diethylstilbestrol (dietilestilbestrol). Vaginal intraepithelial neoplasia (VAIN) is another uncommon condition in women who have not been hysterectomized to treat cervical intraepithelial neoplasia (CIN), with an incidence of 0.3 per 100,000 women. On the other hand 0.9% of the patients who have been poshysterectomized to treat CIN develop VAIN...
July 2009: Ginecología y Obstetricia de México
https://www.readbyqxmd.com/read/18369304/cervical-screening-and-general-physical-examination-behaviors-of-women-exposed-in-utero-to-diethylstilbestrol
#9
MULTICENTER STUDY
Elizabeth A Camp, Ann L Coker, Rebecca Troisi, Stanley J Robboy, Kenneth L Noller, Karen J Goodman, Linda T Titus-Ernstoff, Elizabeth E Hatch, Arthur L Herbst, Raymond H Kaufman, Ervin Adam
OBJECTIVE: To estimate whether women exposed in utero to diethylstilbestrol (DES) report receiving more cervical and general physical examinations compared to unexposed women. MATERIALS AND METHODS: 1994 Diethylstilbestrol Adenosis cohort data are used to assess the degree of recommended compliance of cervical screenings found in 3,140 DES-exposed and 826 unexposed women. Participants were enrolled at 4 sites: Houston, Boston, Rochester, and Los Angeles. Logistic regression modeling was used to analyze mailed questionnaire data, which included reported frequency over the preceding 5 years (1990-1994) of Papanicolaou smears and general physical examinations...
April 2008: Journal of Lower Genital Tract Disease
https://www.readbyqxmd.com/read/16891989/the-occurrence-of-genital-types-of-human-papillomavirus-in-normal-pregnancy-and-in-pregnant-renal-transplant-recipients
#10
Malgorzata Gajewska, Miroslaw Wielgos, Pawel Kamiński, Piotr Marianowski, Magdalena Malejczyk, Slawomir Majewski, Longin Marianowski
OBJECTIVE: The aim of this study was to evaluate: 1) The prevalence of human papillomavirus (types 6 and 11 carrying a low risk of neoplasia, and type 16 implicated as cause of cervical neoplasia and cancer) in normal pregnant women and pregnant renal transplant recipients. 2) The correlation between maternal HPV infection and HPV presence in the cord blood and the oral cavity of the neonate. Evaluation of a likely, additional route of HPV transmission to the fetus, apart from the infected birth canal during vaginal delivery...
August 2006: Neuro Endocrinology Letters
https://www.readbyqxmd.com/read/16452187/urogenital-carcinogenesis-in-female-cd1-mice-induced-by-in-utero-arsenic-exposure-is-exacerbated-by-postnatal-diethylstilbestrol-treatment
#11
Michael P Waalkes, Jie Liu, Jerrold M Ward, Douglas A Powell, Bhalchandra A Diwan
Transplacental inorganic arsenic carcinogenicity, together with postnatal exposure to diethylstilbestrol or tamoxifen, was studied. Pregnant CD1 mice received 85 ppm arsenic in the drinking water from gestation days 8 to 18 and were allowed to give birth. Groups (n = 35) of female offspring were injected s.c. on postpartum days 1 through 5 with diethylstilbestrol (2 microg/pup/d) or tamoxifen (10 microg/pup/d) and observed for 90 weeks. Arsenic alone induced some urogenital system tumors, including mostly benign tumors of the ovary and uterus, and adrenal adenoma...
February 1, 2006: Cancer Research
https://www.readbyqxmd.com/read/16445652/detection-of-chromosomal-aberrations-by-fluorescence-in-situ-hybridization-in-cervicovaginal-biopsies-from-women-exposed-to-diethylstilbestrol-in-utero
#12
COMPARATIVE STUDY
R A Hajek, D W King, M A Hernández-Valero, R H Kaufman, J C Liang, J A Chilton, C L Edwards, J T Wharton, L A Jones
Epidemiologic studies have associated estrogens with human neoplasms such as those in the endometrium, cervix, vagina, breast, and liver. Perinatal exposure to natural (17beta-estradiol [17beta-E(2)]) and synthetic (diethylstilbestrol [DES]) estrogens induces neoplastic changes in humans and rodents. Previous studies demonstrated that neonatal 17beta-E(2) treatment of mice results in increased nuclear DNA content of cervicovaginal epithelium that precedes histologically evident neoplasia. In order to determine whether this effect was associated with chromosomal changes in humans, the frequencies of trisomy of chromosomes 1, 7, 11, and 17 were evaluated by the fluorescence in situ hybridization (FISH) technique in cervicovaginal tissue from 19 DES-exposed and 19 control women...
January 2006: International Journal of Gynecological Cancer
https://www.readbyqxmd.com/read/15886059/cervical-neoplasia-during-pregnancy-diagnosis-management-and-prognosis
#13
REVIEW
K Van Calsteren, I Vergote, F Amant
Pregnancy represents an exceptional opportunity for the early diagnosis of cervical cancer since visual inspection, cytological examination and bimanual palpation are considered to be part of routine antenatal care. An abnormal cervical smear should generally be managed as in the non-pregnant state. However, colposcopy and biopsies are mainly intended to exclude invasive disease because a conservative approach is preferred in cases of pre-invasive disease. The only absolute indication for conization in pregnancy is to rule out (micro-)invasive disease or make the diagnosis of invasive carcinoma when such a diagnosis will alter the timing or mode of delivery...
August 2005: Best Practice & Research. Clinical Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/15870516/six-cases-of-women-with-diethylstilbestrol-in-utero-demonstrating-long-term-manifestations-and-current-evaluation-guidelines
#14
Candice A Tedeschi, Mary Rubin, Burton A Krumholz
Diethylstilbestrol (DES), a nonsteroidal estrogen, was widely used in the United States from 1940 through 1971 to prevent pregnancy loss. In the late 1960s, an association was made with an increased incidence of clear cell adenocarcinoma in young women exposed in utero to DES. Additional study of these women over the next 35 years has shown an increased risk of other health problems including intraepithelial neoplasia, ectopic pregnancy, first trimester spontaneous abortion and second trimester pregnancy loss...
January 2005: Journal of Lower Genital Tract Disease
https://www.readbyqxmd.com/read/15512425/not-just-a-cervical-ectropion-three-case-reports-of-diethylstilbestrol-des-exposed-women-presenting-with-vaginal-discharge-and-cervical-ectropion
#15
M Wingfield
Typical changes in the cervix are described in three women following in utero exposure to diethylstilbestrol. It is important that these changes are recognised on colposcopy and appropriate follow-up colposcopy arranged. In the absence or cervical intraepithelial neoplasia, local destructive therapy is not indicated as this may be associated with cervical stenosis.
November 1999: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/11714112/incidence-of-squamous-neoplasia-of-the-cervix-and-vagina-in-women-exposed-prenatally-to-diethylstilbestrol-united-states
#16
E E Hatch, A L Herbst, R N Hoover, K L Noller, E Adam, R H Kaufman, J R Palmer, L Titus-Ernstoff, M Hyer, P Hartge, S J Robboy
OBJECTIVES: Women exposed prenatally to diethylstibestrol (DES) have an excess risk of clear-cell adenocarcinoma of the vagina and cervix, but the effect on the incidence of squamous neoplasia is uncertain. The purpose of the current study was to evaluate the long-term risk of developing high-grade squamous neoplasia of the genital tract among women exposed prenatally to DES. METHODS: A cohort comprising 3,899 DES-exposed and 1,374 unexposed daughters was followed for 13 years (1982 1995) for pathology-confirmed diagnoses of high-grade squamous intraepithelial neoplasia (HSIL) of the genital tract...
November 2001: Cancer Causes & Control: CCC
https://www.readbyqxmd.com/read/7608876/vaginal-columnar-cell-metaplasia-an-acquired-adenosis-associated-with-topical-5-fluorouracil-therapy
#17
C F Dungar, E J Wilkinson
Vaginal adenosis, with columnar epithelium of endocervical or endometrial type forming glands within the vagina, has been observed as a congenitally acquired process, associated with in utero exposure to diethylstilbestrol; approximately 20% of those women exposed in utero have adenosis. It has been observed that vaginal adenosis may occur in nonexposed women; the origin is thought to be acquired following puberty. This study analyzed eight patients who, following topical vaginal therapy with 5-fluorouracil for vaginal intraepithelial neoplasia, had unresolving, reddened areas in the upper one-third of the vagina...
May 1995: Journal of Reproductive Medicine
https://www.readbyqxmd.com/read/7470424/a-case-of-clear-cell-adenocarcinoma-of-the-vagina-in-pregnancy
#18
J A Davis, V Wadehra, A S McIntosh, J M Monaghan
The case is described of a 20 year old pregnant woman with clear cell adenocarcinoma of the vagina who had been exposed to diethyl stilboestrol in utero. This is the second of three cases known to have occurred in Britain. The importance of radical treatment is discussed. Neither cervical nor vaginal intra-epithelial neoplasia were seen histologically, although squamous metaplasia was widespread, and in some areas was immature and showed atypical features which could be misinterpreted as intra-epithelial neoplasia...
March 1981: British Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/7312237/risks-of-cervical-intraepithelial-neoplasia-among-des-exposed-women
#19
W C Fowler, G Schmidt, D A Edelman, D G Kaufman, C M Fenoglio
The increased occurrence of cervical intraepithelial neoplasia (CIN) in women with in utero exposure to diethylstilbestrol (DES) is described. Among 335 self-referred women exposed to DES, 14.9% (50) had a least 1 cytologic smear interpreted as CIN, and 16.2% (54) had at least 1 biopsy interpreted as CIN. Excluding those with grade 1 CIN, 8.7% (29) had at least grade 2 CIN on biopsy and 4.2% (14) had biopsies interpreted as grade 3 CIN. No invasive lesions were detected. Because the problem of differentiating true intraepithelial neoplasia from morphologically indistinguishable but benign lesions in DES-exposed women remains unresolved, the authors believe a conservative approach to treatment is still indicated...
December 1981: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/7195532/cervical-intraepithelial-neoplasia-associated-with-exposure-to-diethylstilbestrol-in-utero-a-clinical-and-pathologic-study
#20
J W Orr, H M Shingleton, H Gore, J M Austin, K D Hatch, S J Soong
The anatomic, colposcopic, cytologic, and histologic findings of the cervix in 300 women exposed to diethylstilbestrol (DES) in utero are reported. Structural cervical abnormalities were found in 51.7% of these patients and an abnormal colposcopic examination was present in 50.6%. The initial interpretation of the pathologic specimens revealed that 26.6% of patients had cytologic or histologic evidence of cervical dysplasia. A uniform pathologic review demonstrated that 10.8% of the cytologic specimens and 37...
July 1981: Obstetrics and Gynecology
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