American cancer society guideline for the early detection of cervical neoplasia and cancer.

An update to the American Cancer Society (ACS) guideline regarding screening for the early detection of cervical neoplasia and cancer, based on recommendations from a formal review and recent workshop, is presented. The new screening recommendations address when to begin screening, when screening may be discontinued, whether to screen women who have had a hysterectomy, appropriate screening intervals, and new screening technologies, including liquid-based cytology and HPV DNA testing.

Should punch biopsies be used when high-grade disease is suspected at initial colposcopic assessment? A prospective study.

The reliability and applicability of colposcopically directed cervical punch biopsy was assessed in a sample of 170 paired punch and large loop excision of cervical transformation zone (LLETZ) specimens obtained from previously untreated women who had been selected for treatment on the basis of cytology and/or colposcopic findings and in whom the entire cervical transformation zone was visible. A single punch biopsy was taken immediately before the LLETZ, and all the specimens were reviewed by a single pathologist. Nine (5.

Using the cone biopsy to compare colposcopy clinics in new york and london.

Objective: To assess whether there were significant differences in cytologic and colposcopic assessments associated with conization specimens at a colposcopy clinic in New York compared with a colposcopy clinic in London.

Materials And Methods: A retrospective histopathologic survey of patients evaluated at the Mt. Sinai Hospital Colposcopy Clinic (MSH) in New York City and the Royal Free Hospital Colposcopy Clinic (RFH) in London between January 1, 1997, and December 31, 1998, was reviewed.

Can pre-colposcopy sessions reduce anxiety at the time of colposcopy? A prospective randomised study.

The main objective of this prospective randomised study was to evaluate whether offering pre-colposcopy group sessions reduces anxiety at the time of colposcopy. We also examined whether this strategy improved knowledge about abnormal smears and colposcopy and improved satisfaction with the colposcopy service provided. One hundred and forty-seven women undergoing colposcopy for the first time were randomised into two groups.

Randomized placebo-controlled evaluation of intramuscular interferon beta treatment of recurrent human papillomavirus.

Objective: To evaluate the effectiveness and safety of interferon beta in women with recurrent cervical human papillomavirus (HPV) lesions.

Methods: Women with recurrent HPV of the cervix were assigned randomly to received either 3 million IU of interferon beta daily for 5 days, followed by 2 days of rest for 3 weeks, or placebo on the same schedule (N = 61 in each group). They were evaluated at 6 and 12 months after cytology, colposcopy, and directed punch biopsy.

Diagnostic value of the papanicolaou smear in lower genital tract infections during pregnancy.

Objectives: To evaluate the diagnostic value of the Pap smear in lower genital tract infections during pregnancy.

Materials And Methods: A total of 190 pregnant women were examined in the Lower Genital Tract and Colposcopy clinics of the Obstetrics Division at the University Hospital de Clínicas "José de San Martín" of University of Buenos Aires from April to August 1997. Samples were taken from the vaginal fornix for microbiologic study and from the exocervix for Pap smear.

Effectiveness of 5-Fluorouracil in the treatment of vaginal intraepithelial neoplasia in a mexican population.

Objective: Our purpose was to determine the effectiveness of 5-fluorouracil (5-FU) in the treatment of vaginal intraepithelial neoplasia (VaIN) in a Mexican population.

Materials And Methods: The study was performed in 30 patients with a mean age of 54 years and previous diagnoses from reviewed records and histopathology slides selected from a group of 65 patients with VaIN from 1980 to 1997. Patients received intravaginal treatment with 5-FU, 1.

Economic evaluation of hybrid capture human papillomavirus testing in women with low-grade papanicolaou smear abnormalities.

Objectives: Our aim was to determine the cost-effectiveness of three strategies for detecting cervical intraepithelial neoplasia 2 and 3 after a determination of atypical squamous cells of undetermined significance or low-grade squamous intraepithelial lesion on screening Papanicolaou (Pap) smear.

Methods: Single repeat Pap smear. Hybrid Capture testing for human papillomavirus, and immediate colposcopy were compared.

A multicentre study comparing cervicography and cytology in the detection of cervical intraepithelial neoplasia.

Objective: To evaluate in a multicentre setting the performance of cervicography compared with cytology for the detection of cervical intraepithelial neoplasia.

Design: Prospective comparative multicentre study.

Setting: Three hospitals with outpatient gynaecology clinics and three cancer screening clinics.

Who finds cervical laser therapy painful?

To identify women who find outpatient laser cervical surgery painful we designed a prospective observational study correlating surgical pain with multiple variables. The pain scoring systems were validated by comparing the subjective linear analogue score with an objective scoring method. The pain of surgery was compared with age, parity, acute anxiety scores, psychological state, premenstrual syndrome scores, phase of the menstrual cycle, contraceptive use, menstrual history, nature of the lesion, and intraoperative bleeding.

Cervical intraepithelial neoplasia in patients with breast cancer: a cytological and colposcopic study.

Twenty-six patients with treated breast cancer who had been randomised previously to receive combination chemotherapy including alkylating agents (n = 14) or to undergo oophorectomy (n = 12) following surgery underwent cytological and colposcopic screening of the uterine cervix. Colposcopically directed cervical punch biopsies were taken from all patients in whom a colposcopic abnormality was detected. Breast cancer patients were compared with 79 controls with normal cervical cytology and no known breast malignancy.

The cytological detection of persistent cervical intraepithelial neoplasia after local ablative treatment: a comparison of sampling devices.

Objective: To determine whether the cytological detection of persistent cervical intraepithelial neoplasia (CIN) after local ablative treatment is improved by the use of sampling devices other than the Ayre's spatula.

Design: A randomized controlled study.

Setting: Lothian Area Colposcopy Clinic.

HPV-related genital lesions in men.

Screening of the asymptomatic male partners of women with genital condyloma or intraepithelial neoplasia has shown that about 50% of the individuals examined present genital HPV-associated lesions. Half to two thirds of these lesions are clinically invisible and are detected only after the acetic acid test. Histological studies have shown that 20% of male partners of women with high-grade intraepithelial neoplasia present lesions histologically defined as high-grade intraepithelial neoplasia.

Colposcopic diagnosis of HPV cervical lesions.

The colposcopic criteria for abnormal epithelium are leukoplakia, a white area detected after the application of acetic acid or iodine-negative areas not reacting to the acetic acid test. However, white epithelium and iodine-negative areas are not specific for abnormal tissue, condyloma or intraepithelial neoplasia. The lack of specificity of colposcopic findings has motivated the distinction between minor and major grade abnormalities in the recently proposed new colposcopic terminology.

The efficacy of electrocoagulation diathermy performed under local anaesthesia for the eradication of precancerous lesions of the cervix.

This study demonstrates the feasibility of performing electrocoagulation diathermy with intracervical infiltration of local anaesthetic for precancerous lesions of the cervix. A technique suitable for office procedure without need of any supplementary analgesia is described; 200 patients were treated in this fashion with results indicating the ability to obtain high primary cure rates with low morbidity similar to those previously obtained with general anaesthesia.

Cervical intraepithelial neoplasia in lymphoma patients: a cytological and colposcopic study.

Twenty-seven patients with Hodgkin's (n = 19) and non-Hodgkin's (n = 8) lymphomas underwent cytological and colposcopic screening of the uterine cervix. Colposcopically directed cervical punch biopsies were taken from all patients in whom a colposcopic abnormality was detected. Lymphoma patients were compared with 79 controls with normal cervical cytology and no known haematological abnormality.

Human papillomavirus infection and cervical intraepithelial neoplasia in women with renal allografts.

An increased prevalence of cervical cancer has been observed in immunosuppressed women, but controlled studies are rare. Biopsy specimens from 49 women with renal allografts and 69 non-immunosuppressed controls (with no history of cervical intraepithelial neoplasia, vulval warts, or abnormal results of cervical smear tests) were assessed for colposcopic appearance, cytological and histological diagnosis, and the presence of human papillomavirus types 6/11 and 16/18 DNA sequences. At colposcopy 26 (53%) of the women with allografts had cervical abnormalities compared with 20 (29%) of the controls.