The AHCPR released its evidence-based report, "Evaluation of Cervical Cytology" in early 1999. This report represents the most comprehensive analysis available to date of Pap smears and new technologies designed to improve cervical cancer screening. Both the ACOG and the AHCPR have released simplified summaries of the results of the evidence report that may lead to misunderstandings of the potential clinical impact of these new technologies. This report reviews the 4 major statements in these summaries and discusses how they are either incorrect based on the full AHCPR report or may be misinterpreted because their ramifications are not fully discussed. New screening technology has the potential to finally bring the sensitivity of a new Pap test to an acceptable level. The increased sensitivity afforded by these new technologies can reduce negative outcomes at reasonable cost-effectiveness ratios and at an equivalent or superior specificity compared to the conventional Pap smear.
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http://dx.doi.org/10.1046/j.1526-0976.2001.005002073.x | DOI Listing |
Am J Surg Pathol
January 2025
Department of Pathology.
Despite being designated as "noncarcinogenic" human papillomavirus (HPV) types, mono-infection with HPV6 or HPV11 has been found in squamous cell carcinomas (SCCs) at specific sites, including the larynx, penis, anus, and rarely, the lower female genital tract. The association between clinicopathologic features, viral status, and the carcinogenic mechanisms related to these low-risk HPVs remains unclear. The current study characterizes a series of low-risk HPV6 and HPV11-associated SCCs of the uterine cervix (6 cases) and vulva (2 cases).
View Article and Find Full Text PDFCureus
December 2024
Department of Obstetrics and Gynecology, Osaka Metropolitan University Graduate School of Medicine, Osaka, JPN.
Immune checkpoint inhibitors (ICIs), such as pembrolizumab, have revolutionized cancer therapy but can lead to severe immune-related adverse events (irAEs). We present a case of fulminant type 1 diabetes mellitus (T1DM) with diabetic ketoacidosis (DKA) and mesenteric ischemia in a 78-year-old woman with recurrent stage IIIC1 cervical cancer treated with pembrolizumab. Thirty-four days after initiating a pembrolizumab-containing regimen, she presented with vomiting, severe hyperglycemia, metabolic acidosis, and strongly positive urine ketones.
View Article and Find Full Text PDFBMJ Oncol
February 2024
Institute of Social and Preventative Medicine, University of Bern, Bern, Switzerland.
Objective: This study aimed to provide evidence to improve cervical screening for women living with HIV (WLHIV). We assessed the accuracy of screening tests that can be used in low-resource settings and give results at the same visit.
Methods And Analysis: We conducted a paired, prospective study among consecutive eligible WLHIV, aged 18-65 years, receiving cervical cancer screening at one hospital in Lusaka, Zambia.
BMJ Oncol
February 2024
Obstetrics & Gynaecology, University of Cape Town, Cape Town, Western Cape, South Africa.
AJPM Focus
February 2025
Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, California.
Introduction: The authors determined whether certain subgroups of patients with cancer on Ohio Medicaid benefited from the program's expansion to a greater/lesser extent. Study outcomes included stage at diagnosis for screening-amenable cancers (breast [=1,707 and 2,976], cervical [=309 and 655], and colorectal [=927 and 2,009] cancer, before and after expansion, respectively) and time to treatment initiation.
Methods: Using linked data from the 2011-2017 Ohio cancer registry and Medicaid, the authors conducted a robust Poisson regression analysis for stage at diagnosis and Cox regression analysis for time to treatment initiation to obtain the adjusted risk for earlier stage at diagnosis before to after expansion or hazard of shorter time to treatment initiation for each demographic or clinical subgroup after compared with before pre-Medicaid expansion.
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