Publications by authors named "Maggie Cruickshank"
Article Synopsis
- The study examines why general practitioners (GPs) often skip pelvic examinations (PEs) for women, which can delay diagnosing gynaecological cancers.
- It uses qualitative interviews and the COM-B behaviour change model to explore GPs' perceptions about PEs, highlighting obstacles and motivations influencing their practices.
- The findings suggest that GPs' decisions around PEs are complex and influenced by their training, clinical environment, and differing definitions of high-quality care, indicating a need for tailored interventions to encourage more frequent use of PEs.
The European Society of Gynaecological Oncology (ESGO), the International Society for the Study of Vulvovaginal Disease (ISSVD), the European College for the Study of Vulval Disease (ECSVD), and the European Federation for Colposcopy (EFC) consensus statement on the management of vaginal intraepithelial neoplasia.
Int J Gynecol Cancer
April 2023
Article Synopsis
- The European Society of Gynaecological Oncology and other organizations created consensus statements to enhance care for patients with vaginal intraepithelial neoplasia (VaIN).
- Treatment for VaIN depends on the lesion's grade, with follow-ups for low-grade VaIN (VaIN 1) and treatment required for high-grade (VaIN 2-3), highlighting that management should be personalized.
- Surgical excision is the primary treatment; alternatives like CO laser and topical agents exist, with imiquimod showing the best outcomes, while brachytherapy is suited for specific cases, and consistent follow-up is essential due to the recurring nature of VaIN.
The European Society of Gynaecological Oncology (ESGO), the International Society for the Study of Vulvovaginal Disease (ISSVD), the European College for the Study of Vulval Disease (ECSVD), and the European Federation for Colposcopy (EFC) Consensus Statement on the Management of Vaginal Intraepithelial Neoplasia.
J Low Genit Tract Dis
April 2023
Article Synopsis
- The consensus statements developed by ESGO, ISSVD, ECSVD, and EFC aim to enhance care for patients with vaginal intraepithelial neoplasia (VaIN), outlining management strategies based on lesion grade.
- For low-grade VaIN (VaIN 1), follow-up is usually sufficient, while high-grade VaIN (VaIN 2-3) requires treatment, with surgical excision being the primary method if invasion is suspected.
- Treatments like CO2 laser and topical agents, especially Imiquimod, are effective, but surgical options are often necessary for cases post-hysterectomy, and patients should be closely monitored due to the risk of recurrence.
Several scoring systems have been developed to evaluate disease severity in mucosal lichen planus, but only a few have been validated to ensure reproducible and accurate assessment of disease severity. The current systematic review was undertaken to identify clinical severity scoring systems in mucosal lichen planus that have undergone validity or reliability testing and to describe their operating characteristics. We performed a bibliographic search in five databases from their inception to October 2022 for severity scoring systems in mucosal lichen planus that have undergone validity or reliability tests.
View Article and Find Full Text PDFObjective: The aim of the study was to estimate the impact of COVID-19 pandemic on the practice of cervical cancer screening in European countries.
Materials And Methods: A 3 rounds e-survey was conducted among the 31 European Federation for Colposcopy member countries during 2020. Each representative was asked to answer to each questionnaire for their own country.
Objectives: The management of women with cervical squamous intraepithelial lesions (SIL) is fundamental to prevention of cervical cancer in an organized cervical screening programme. Clinical guidance should improve quality of care and clinical effectiveness if developed and implemented appropriately. This survey provides an update on the current situation of national guidelines for management of cervical SIL amongst member countries of European Federation for Colposcopy (EFC).
View Article and Find Full Text PDFThe age-standardised incidence of cervical cancer in Europe varies widely by country (between 3 and 25/100000 women-years) in 2018. Human papillomavirus (HPV) vaccine coverage is low in countries with the highest incidence and screening performance is heterogeneous among European countries. A broad group of delegates of scientific professional societies and cancer organisations endorse the principles of the WHO call to eliminate cervical cancer as a public health problem, also in Europe.
View Article and Find Full Text PDFBackground: Urgent suspected cancer referral guidelines recommend that women with gynaecological cancer symptoms should have a pelvic examination (PE) prior to referral. We do not know to what extent GPs comply, their competency at PE, or if PE shortens the diagnostic interval.
Objectives: We conducted a systematic review of the use, quality and effectiveness of PE in primary care for women with suspected gynaecological cancer.
Background: Cervical cancer is the fourth most common cancer in women, and we recently reported human leukocyte antigen (HLA) alleles showing strong associations with cervical neoplasia risk and protection. HLA ligands are recognized by killer immunoglobulin-like receptors (KIRs) expressed on a range of immune cell subsets, governing their proinflammatory activity. We hypothesized that the inheritance of particular HLA-KIR combinations would increase cervical neoplasia risk.
View Article and Find Full Text PDFA small percentage of women with cervical HPV infection progress to cervical neoplasia, and the risk factors determining progression are incompletely understood. We sought to define the genetic loci involved in cervical neoplasia and to assess its heritability using unbiased unrelated case/control statistical approaches. We demonstrated strong association of cervical neoplasia with risk and protective HLA haplotypes that are determined by the amino-acids carried at positions 13 and 71 in pocket 4 of HLA-DRB1 and position 156 in HLA-B.
View Article and Find Full Text PDFBackground: Although it is recognised that some women experience pain or bleeding during a cervical cytology test, few studies have quantified physical after-effects of these tests.
Aim: To investigate the frequency, severity, and duration of after-effects in women undergoing follow-up cervical cytology tests, and to identify subgroups with higher frequencies in Grampian, Tayside, and Nottingham.
Design: Cohort study nested with a multi-centre individually randomised controlled trial.
Objective: Few studies have investigated physical after-effects of colposcopy. We compared post-colposcopy self-reported pain, bleeding, discharge and menstrual changes in women who underwent: colposcopic examination only; cervical punch biopsies; and large loop excision of the transformation zone (LLETZ).
Design: Observational study nested within a randomised controlled trial.
Objective: It has been suggested that women over 50 with a satisfactory negative smear history are at low risk for dyskaryosis and might be suitable for withdrawal from the cervical screening programme. The objectives of this study are to document the pattern of dyskaryosis in the cervical smears of women over 50 and to relate the risk of dyskaryosis in these women to the prior smear history.
Design: Available computerised smear data were analysed.