F GUIDOZZI DEPARTMENT OF OBSTETRICS AND GYNAECOLOGY FACULTY OF HEALTH SCIENCES UNIVERSITY OF WITWATERSRAND
|
|
- Dortha Hampton
- 5 years ago
- Views:
Transcription
1 F GUIDOZZI DEPARTMENT OF OBSTETRICS AND GYNAECOLOGY FACULTY OF HEALTH SCIENCES UNIVERSITY OF WITWATERSRAND
2 INTRODUCTION The onset of the menopause is often a time when women take stock of their health and express concerns about the chance of becoming ill. Such concerns can encourage healthy modifications of lifestyle which will maintain or improve general health. Cancer prevention : To understand their potential risks for cancer To encourage proactive preventative strategies To support early consultation when abnormal symptoms present To utilize health resources especially to be screened Screening policies and management vary from one country to another depending on resources and health-care policy.
3 Cancer incidence increasing because of longer life expectancy globally Cancer is an important cause of death, not primary cause of mortality. CVS disease represents 35-40% of deaths in most developed countries whilst 20-25% of women will die from cancer Preventative strategies include PRIMARY (patient driven) SECONDARY (screening, others) TERTIARY (surgical) Awareness programs
4 Breast, lung and cervical cancers are the most common in women, followed by colorectal cancer, stomach, ovarian, endometrial Mortality from breast cancer represent 13.7% of the mortality from cancer in women globally Lung cancer 13% Colorectal cancer 9% Cervical cancer 8.2% Mortality from ovarian cancer (4.2%) and endometrial cancer (2.2%) is much less.
5 BREAST CANCER Breast cancer is as common in developed countries (49%) as in developing countries (51%) Predominantly in postmenopausal women (67%), although it occurs more frequently in postmenopausal women in developed countries (39%) than in developing countries (28%). In 2010, over 1.5 million new cases of breast cancer were reported and there were over deaths globally Incidence is changing due to screening and life style modifications, but has increased globally
6 BREAST CANCER 10% are associated with strong genetic susceptibility (1) BRCA1and BRCA2 gene mutations where there is about 60% lifetime risk for breast cancer by 70 years of age (2) Lynch Syndrome (3) Family history Multifactorial associated with increasing sociocultural and education levels
7 CERVICAL CANCER Cervical cancer is more frequent in developing countries, where 80% of cervical cancer cases occur In 2012, more than half a million new cases of cancer of the cervix were reported together with 280, 000 deaths due to the disease. Third most common cancer globally, although it is the most common in black South African females, second most common in coloured women brought about by lack of screening and diagnostic facilities IN SA majority of cases present with late stage disease when diagnosed and burden of avoidable suffering is considerable
8 LUNG CANCER 520,000 new cases annually in women Mortality rate is still very high, 428,000 deaths annually World-wide incidence decreasing because of decrease in smoking Smoking main risk, pollution is issue in some countries Increase in female non-smokers due to passive smoking Low incidence in SA having cultural and economic and social determinants, only 4% of female smokers are Black, c/w 40% among Colored, 27% among White and 13% among Indian/Asiatic
9 COLORECTAL CANCER Colorectal represents 10 % of all incident cancers in women globally The lifetime risk of colorectal cancer is about 5% and is significantly affected by lifestyle factors Fourth or fifth most common cancer in Africa 5-10% originate from families with genetic predispositions. Hereditary non-polyposis colorectal cancer, LYNCH Syndrome Autosomal dominant expression, characterized by early onset colorectal cancer and microsatellite instability Additional 40-60% lifetime risk of endometrial cancer and 10-12% lifetime risk of ovarian cancer
10 ENDOMETRIAL CANCER Less frequent than breast, lung and colorectal cancers although commonest in western world Eighth to tenth most common in Africa Attributable global death rates in 2010 was 59,000 In Africa incidence increases with age peaking 70 years Risk factors include obesity, diabetes, nulliparity, ET, PCOS Not screenable and every PMB episode must be investigated
11 OVARIAN CANCER Disease of aging women and highest incidence is in those countries with higher life expectancy, with lowest global incidence in Africa Global deaths in 2010 was about 161,000 Incidence has not changed significantly in the last 30 years Usual late presentation BRCA1 & 2 carriers have 40% and 12% lifetime risk c/w 1.4% Lynch syndrome OCP, BSO, salpingectomy at hysterectomy, hysterectomy, tubal ligation all will decrease risk for cancer to varying degrees
12 MODIFIABLE LIFE STYLE RISK FACTORS Deaths attributable to risk factors in 2010 world-wide Number of 95% intervals Risk factor deaths of uncertainty Smoking Second-hand smoke Alcohol High body mass index Dietary factors and physical inactivity
13 ROLE OF OBESITY Obesity and BMI have increased globally and in developing countries. Obesity is risk factor breast, colon, endometrial and ovarian cancers.. BREAST CANCER Positive correlation in post-menopausal women, inverse correlation in premenopausal women. Obesity is also a risk factor for having a more aggressive breast cancer and worse survival.
14 COLON CANCER OBESITY Overweight and obesity, low physical activity and type 2 diabetes are linked to insulin resistance and increased risk for colon cancers in all kinds of populations ENDOMETRIAL CANCER Endometrial cancer and sarcomas increased in obese women Obesity negatively affects mortality whereas physical activity improves OVARIAN CANCER Diet high in cholesterol is significant in etiology of ovarian cancer
15 ROLE OF NUTRITION AND ALCOHOL Breast cancer Increasing consumption of alcohol is associated with an increase in the risk of hormone-dependent breast cancer. Colorectal cancers Intake of alcohol and red and processed meat associated with an increased risk, stronger for colon than rectal cancer Lung cancer Increased risk with cured meat, deep-fried cooking and chili
16 EPIC study Red meat < 500g/week Processed meat < 3g/day Alcohol <10g/day Fruits and vegetables >400 g/day Dietary fiber >25 g/day Physical activity 2 h/week vigor act, or 30 min/day cycl/sport Normal body mass index BMI kg/m² Overall, 12.6% (95% CI %) of all cancers could have been prevented in the whole study population Estimated diet, nutrition, physical activity, normalization of BMI may lead to a reduction of all cancer by 26% (6-42%) in the UK, 24% (7-40) in the USA, 19% (3-31%) in Brazil and 20% (5-37%) in China.
17 FRENCH STUDY life style aspects and cancer risk Smoking, physical activity, fruit and vegetable consumption, alcohol consumption, BMI 65,000 women aged years Significant decrease in postmenopausal breast cancer and lung cancer 7% decrease in all-site cancer risk 7% decrease in breast cancer 47% decrease in lung cancer
18 HRT AS A RISK FACTOR BREAST CANCER WHI EPT was initially associated with a 26% increase in risk Further analysis using centrally adjudicated data and adjusted 95% CI showed that risk was not significantly increased (RR=1.24) Absolute increase in risks equates to 4 extra cases per 1000 users of EPT for 5 years and only seen in previous users E only did not increase breast cancer risk at 6.8 years follow up (RR=0.77), whilst at 11.8 years in fully compliant users there was significant risk reduction (RR=0.67) which persists after stopping use for up to 5.9 years later
19 HRT AS A RISK FACTER BREAST CANCER Exercise decreases breast cancer even in HRT users. HRT risk primarily seen in lean patients ENDOMETRIAL CANCER Estrogens alone increase endometrial cancer risk. Addition of progestogens decreases risk of endometrial cancer. E and P preparations significantly decrease risk
20 HRT AS A RISK FACTOR LUNG CANCER Non-significant increase in risk of non-small cell lung cancer Significant increase in risk of death from lung cancer in women receiving HRT but not in the women in the estrogen-only trial. COLORECTAL CANCER 44% decrease in risk in E and P users which persists for 5 years after stopping therapy. No impact by E only therapy OTHERS Null-effect on melanoma, non-melanoma, oesophageal cancer, a decrease in stomach cancer and an increase in gall bladder cancer.
21 SECONDARY PREVENTATIVE STRATEGIES SCREENING Breast cancer Breast cancer screening is mostly performed using mammograms, every 2 years from 50 to 74 years of age. In lower middle-resource countries, CBE from ages 40 to 60 years could reduce breast cancer mortality at substantially lower cost. BSE and CBE with mammogram remain gold standard for breast cancer screening. Should ideally be digital and not film mammography Breast density very important. Sensitivity decreases from 88% to 62% to 67% in women with extremely or moderately dense breast tissue respectively
22 CANADIAN TASK FORCE GUIDELINES 2011 Reduction in mortality is relatively small in women aged years Greater reduction in mortality in women years than year Harms of over diagnosis and unnecessary biopsy may be greater for younger than older women Frequency of 2-3 years is appropriate
23 INDICATIONS FOR MRI SCREENING OF BREAST BRCA1 and 2 gene mutation carriers First degree relatives with breast cancer especially if diagnosed < 40 If life-time risk is greater than 20-25% Extremely dense breast History of lobular ca in situ or biopsy with atypical hyperplasia Any other high risk patient with uncertainty on screening modalities Previous thoracic radiotherapy
24 Prevalence of Cervical Neoplasia (%) SCREENING FOR CERVICAL CANCER PREVALENCE OF SIL AND CERVICAL CANCER BY AGE 6.0% 5.0% 4.0% LSIL HSIL Cancer 3.0% 2.0% 1.0% 0.0% < Age (Years) *Study conducted in rural Costa Rica (N=9175) 1. Herrero R, Hildesheim A, Bratti C, et al. Population-based study of human papillomavirus infection and cervical neoplasia in rural Costa Rica. J Natl Cancer Inst. 2000;92: Adapted with permission from Oxford University Press.
25 PREVENTION OF CERVICAL CANCER Cervical smear, HPV screening, Co-testing or VIA National policy of 1 screen per 10 years from 30 years onwards For women who have never been screened and who are >50 years old then one smear is to be offered Three yearly in HIV positive women Will decrease cervical cancer in SA by about 65% From a South African perspective, cervical cytology every 3 years, HPV testing every 5 years ( best as co-testing) from 50 years and continue to years
26 AMERICAN COLLEGE OF GASTROENTEROLOGY GUIDELINES FOR COLORECTAL CANCER SCREENING 2008 (a)colonoscopy every 10 years from 50 years of age. (b)alternatives Flexible sigmoidoscopy every 5-10 years CT colonoscopy every 5 years Fecal immunochemical test for blood annually
27
28 WOMEN AT HIGH RISK FOR ENDOMETRIAL CANCER Known HNPCC genetic mutation carrier status Substantial likelihood of being a mutation carrier (known in family) Absence of genetic testing results in families with a suspected autosomal dominant predisposition to colonic cancer Long term unopposed E only therapy Postmenopausal bleeding Thickened endometrium especially if typical profile
29 SECONDARY INTERVENTION CHEMO-PREVENTION TAMOXIFEN.Breast cancer Vitamin D...Colorectal cancer Bisphosphonates Breast cancer Metformin..Endometrial/breast cancer Aspirin Colorectal cancer COX2 inhibitors..colorectal cancer Retinoids..Head and neck tumours
30 TERTIARY INTERVENTIONS LLETZ BRCA 1 and BRCA2 gene mutation carriers Role of routine salpingo-oophorectomy and total abdominal hysterectomy, with or without bilateral mastectomy to decrease risk of ovarian cancer, fallopian tube cancer and breast cancer Breast cancers invariably E, P, and Her2 receptor negative and therefore Tamoxifen is not effective LYNCH syndrome Every woman with endometrial cancer must have colonoscopy and every woman treated for colorectal cancer should have endometrial surveillance. Endometrial biopsy.
31 WHEN SHOULD WOMEN CONSULT FOR SYMPTOMS? Abnormal vaginal bleeding, abdominal or pelvic pain, distension, abnormal vaginal discharge, hematuria, or rectal bleeding. Breast nipple discharge or palpation of a lump, induration of a localized zone of the breast, a skin abnormality on the area of the breasts or nipple retraction, peau d orange. Unusual cough, dyspnea, hemoptysis or thoracic pain Occurrence of venous thrombosis in women without a family history can reveal a cancer.
32 CONCLUSION Cancer incidence is increasing as a consequence of longer life expectancy in developed and developing countries. Breast, colorectal, lung, cervical, endometrial and ovarian cancer are where the gynaecologist is most likely to make a difference Prevention must incorporate primary, secondary and tertiary interventions Primary strategies mandate patient life styles modification Secondary interventions mandate that screening strategies after which individual management of premalignant lesions is available Triaging women according risk factors can minimize risk by instituting appropriate surgical or chemo-preventative strategies Education and awareness programs are crucial
33 PREVENTING CANCER IN POSTMENOPAUSAL WOMEN THANK YOU FOR YOUR ATTENTION
34
35
36
37
38
39
40
41 Franco EL et al. Vaccine :
42 HPV VACCINATION Very effective primary preventative strategy Target group ideally should be before HPV infection Offer full protection against types 16 and 18, although through cross protection offer protection against other high risk types Coverage again is important Vaccinating young girls and screening women over 30 years at 70% coverage for both will provide up to 70% reduction of cervical cancer Can vaccinate middle aged women, upto 45 years for the Quadrivalent and 55 for the Bivalent
43 BARRIERS TO SCREENING IN DEVELOPING COUNTRIES 1) Competing health needs 2) Limited human and financial resources 3) Poorly developed healthcare services 4) Women are uninformed and disempowered 5) War and civil strife 6) Widespread poverty 7) Type of screening test
44 VIA VISUAL INSPECTION AFTER ACETIC ACID APPLICATION Naked eye inspection, after 1 2 minutes of 3 5% AA Well-defined acetowhite areas NEGATIVE Absence of acetowhite lesions, faint ill defined translucent lesions, nabothian cysts or acetowhite dots VILI VISUAL INSPECTION WITH LUGOL S IODINE Naked eye inspection, immediately after application. Mustard yellow areas. Health mature squamous epithelium = BLACK or DARK BROWN Abnormal squamous epithelium = MUSTARD YELLOW In developing country option may include VIA or VILI and see-and-treat strategy with cryotherapy Denny et al. JAMA. 2005; 294: , Gaffkin et al. Lancet 2003; 361:
45 SCREENING OPTIONS Cytology based screening HPV DNA testing Visual inspection methods VIA VILI Colposcopy
46 PREVENTING CANCER IN POSTMENOPAUSAL WOMEN In any single country, differences in genetics, health care, and socioeconomic disparities can lead to differences in the mortality rate for a given cancer. USA where African-American women have 7% lower incidence rate of cancers compared to White women while their overall cancer-related death rate is 17% higher. In South Africa significant disparity exists with view to cervical cancer.
47 PRIMARY PREVENTATIVE STRATEGIES Stop smoking Control weight Exercise (vigorous exercise for at least 2-3 h/week) <15g/day alcohol intake Diet rich in vegetables, fibers and fruits (five fruit and vegetables/day but only two fruits, maximum three), low intake of animal fat, and a low proportion of carbohydrates.
48 PREVENTION OF CANCER IN POSTMENOPAUSAL WOMEN Mortality to incidence ratio is higher in developing countries compared to high-income regions especially Sub Saharan Africa Must decrease social inequities and improve access to health care for low-income groups. Implementation of better screening, diagnostic and management modalities of premalignant disease and incorporate our knowledge with view to hereditary influence in etiology of cancer Awareness programs alert women of their risk factors, life style modifications, provide information with view to screening tests will reduce the burden of disease and improve the prognosis for tumors detected at an earlier stage.
49 CONTROVERSIES SURROUNDING ROUTINE MAMMOGRAPHY OF LOW/MEDIUM RISK WOMEN Does not decrease mortality significantly, 1-3/1000 women screened l Improved survival was not through mammography but to improved treatment strategies Leads to about 1-20% of over diagnosis of breast cancer. Cancer that would never become clinically apparent : lead to diagnosis and unnecessary treatment of breast cancer Leads to repeated mammography, invasive biopsy procedures and surgical interventions because of high rate of false positive assessments High cost/benefit ratio, increases anxiety
50 SCREENING FOR CERVICAL CANCER ASCP, ASC, ASCCP Women aged >65 years with evidence of adequate negative prior screening and no history of CIN2+ within the last 20 years should not be screened with any modality Adequate negative prior screening defined as 3 consecutive negative cytology results or 2 consecutive negative co-tests within 10 years with most recent test within last 5 years Once screening discontinued it should not be resumed for any reason, even if woman reports having a new sexual partner South African perspective, cervical smear frequency from 50 years every 3 years, HPV testing every 5 years ( co-testing best option)
51 ENDOMETRIAL CANCER 1 and 2 or more risk factors increase cancer risk by 8- and 18-fold respectively Assuming a 2.6% lifetime risk, abovementioned risk factors confer a lifetime risk of about 18% and 32% respectively Small % are hormone independent and are poorly differentiated Not screenable and every postmenopausal bleed needs investigation Component of Lynch type syndrome
52 ENDOMETRIAL AND OVARIAN CANCER SCREENING There are no reliable screening tools for Ovarian cancer Endometrial cancer Lung cancer
53 PERFORMANCE AND CHARACTERISTICS OF DIFFERENT SCREENING TESTS
Menopause and Cancer risk; What to do overcome the risks? Fatih DURMUŞOĞLU,M.D
Menopause and Cancer risk; What to do overcome the risks? Fatih DURMUŞOĞLU,M.D Menopause and Cancer How does menopause affect a woman s cancer risk? Ø Menopause does not cause cancer.but risk of developing
More informationNicolaus Copernicus University in Torun Medical College in Bydgoszcz Family Doctor Department CANCER PREVENTION IN GENERAL PRACTICE
Nicolaus Copernicus University in Torun Medical College in Bydgoszcz Family Doctor Department CANCER PREVENTION IN GENERAL PRACTICE A key mission for family medicine is preserving health and maximizing
More informationCancer Facts for Women
Cancer Facts for Women Some of the cancers that most often affect women are breast, colorectal, endometrial, lung, cervical, skin, and ovarian cancers. Knowing about these cancers and what you can do to
More informationGuidelines for Breast, Cervical and Colorectal Cancer Screening
Guidelines for Breast, Cervical and Colorectal Cancer Screening Your recommendation counts. Talk to your patients about screening for cancer. CancerCare Manitoba provides organized, population-based screening
More informationSarah Burton. Lead Gynae Oncology Nurse Specialist Cancer Care Cymru
Sarah Burton Lead Gynae Oncology Nurse Specialist Cancer Care Cymru Gynaecological Cancers Cervical Cancers Risk factors Presentation Early sexual activity Multiple sexual partners Smoking Human Papiloma
More information6 Week Course Agenda. Today s Agenda. Ovarian Cancer: Risk Factors. Winning the War 11/30/2016 on Women s Cancer Gynecologic Cancer Prevention
6 Week Course Agenda Winning the War 11/30/2016 on Women s Cancer Gynecologic Cancer Prevention Lee-may Chen, MD Director, Division of Gynecologic Oncology Professor Department of Obstetrics, Gynecology
More informationBreast Cancer Risk Assessment and Prevention
Breast Cancer Risk Assessment and Prevention Katherine B. Lee, MD, FACP October 4, 2017 STATISTICS More than 252,000 cases of breast cancer will be diagnosed this year alone. About 40,000 women will die
More informationGynecologic Cancers are many diseases. Speaker Disclosure: Gynecologic Cancer Care in the Age of Precision Medicine. Controversies in Women s Health
Gynecologic Cancer Care in the Age of Precision Medicine Gynecologic Cancers in the Age of Precision Medicine Controversies in Women s Health Lee-may Chen, MD Department of Obstetrics, Gynecology & Reproductive
More informationUpdates In Cancer Screening: Navigating a Changing Landscape
Updates In Cancer Screening: Navigating a Changing Landscape Niharika Dixit, MD I have no conflict of interest. 1 Why Should You Care Trends in Cancer Incidence by Site United States. Siegal Et al: CA
More informationGynecologic Cancers are many diseases. Gynecologic Cancers in the Age of Precision Medicine Advances in Internal Medicine. Speaker Disclosure:
Gynecologic Cancer Care in the Age of Precision Medicine Gynecologic Cancers in the Age of Precision Medicine Advances in Internal Medicine Lee-may Chen, MD Department of Obstetrics, Gynecology & Reproductive
More informationCamelia Davtyan, MD, FACP Clinical Professor of Medicine Director of Women s Health UCLA Comprehensive Health Program
Camelia Davtyan, MD, FACP Clinical Professor of Medicine Director of Women s Health UCLA Comprehensive Health Program A B C D USPSTF recommends the service. There is high certainty that Offer or provide
More informationCancer in Women. Lung cancer. Breast cancer
Cancer in Women You can get cancer at any age, but it is more likely as you get older. The types of cancer people get and the risk of dying from cancer are not the same for all ethnic groups. Here are
More informationCytology Update M Laing QEUH
Cytology Update M Laing QEUH Age change to 25 to 65 Age 25 to 50 Three yearly smear invitation Age 50 to 65 Five yearly smear invitation Women on non routine screening will be invited up to age 70 OUTCOME
More informationCANCER SCREENING. Er Chaozer Department of General Medicine, Tan Tock Seng Hospital
CANCER SCREENING Er Chaozer Department of General Medicine, Tan Tock Seng Hospital Introduction Screening average risk patients Benefits and harms from screening Early cancer detection early treatment
More informationMaking Sense of Cervical Cancer Screening
Making Sense of Cervical Cancer Screening New Guidelines published November 2012 Tammie Koehler DO, FACOG The incidence of cervical cancer in the US has decreased more than 50% in the past 30 years because
More informationWhat is the Impact of Cancer on African Americans in Indiana? Average number of cases per year. Rate per 100,000. Rate per 100,000 people*
What is the Impact of Cancer on African Americans in Indiana? Table 13. Burden of Cancer among African Americans Indiana, 2008 2012 Average number of cases per year Rate per 100,000 people* Number of cases
More informationHEALTH AWARENESS MONTH
HEALTH AWARENESS MONTH W H O THEME FOR 2017 D E P R E S S I O N : L E T S TA L K WHAT IS DEPRESSION? Depression is an illness characterized by persistent sadness, and loss of interest in activities that
More informationWellness Along the Cancer Journey: Healthy Habits and Cancer Screening Revised October 2015 Chapter 7: Cancer Screening and Early Detection of Cancer
Wellness Along the Cancer Journey: Healthy Habits and Cancer Screening Revised October 2015 Chapter 7: Cancer Screening and Early Detection of Cancer Healthy Habits and Cancer Screening Rev 10.20.15 Page
More informationPassport to Health Preventing and Recognizing Gynecologic Cancers
Passport to Health Preventing and Recognizing Gynecologic Cancers Presented by: Obstetrician/Gynecologist Leigh Bauer, M.D. They can sneak up on you. 2 Gynecologic cancers, that is. Knowing the facts can
More informationScreening and Detection in Cancer Survivors. Jose W. Avitia, MD Oncology/Hematology
Screening and Detection in Cancer Survivors Jose W. Avitia, MD Oncology/Hematology Breast Cancer Summary of 2012 ASCO guideline recommendations for surveillance after breast cancer treatment History/physical
More informationCancer Facts & Figures for African Americans
Cancer Facts & Figures for African Americans What is the Impact of Cancer on African Americans in Indiana? Table 12. Burden of Cancer among African Americans Indiana, 2004 2008 Average number of cases
More informationProtect & Detect: What Women should Know about cancer. The American College of Obstetricians and Gynecologists
Protect & Detect: What Women should Know about cancer The American College of Obstetricians and Gynecologists A Message From ACOG President Kenneth L. Noller, MD Dr. Noller is the Louis E. Phaneuf professor
More informationScreening Mammograms: Questions and Answers
CANCER FACTS N a t i o n a l C a n c e r I n s t i t u t e N a t i o n a l I n s t i t u t e s o f H e a l t h D e p a r t m e n t o f H e a l t h a n d H u m a n S e r v i c e s Screening Mammograms:
More informationA patient s guide to understanding. Cancer. Screening
A patient s guide to understanding Cancer Screening Contents 04 06 10 12 Cancer Screening Who Should Go For Cancer Screening 05 Nasopharyngeal Carcinoma Colorectal Cancer 08 Lung Cancer Liver Cancer Breast
More informationPrimary Care Approach to Genetic Cancer Syndromes
Primary Care Approach to Genetic Cancer Syndromes Jason M. Goldman, MD, FACP FAU School of Medicine Syndromes Hereditary Breast and Ovarian Cancer (HBOC) Hereditary Nonpolyposis Colorectal Cancer (HNPCC)
More informationChange your Lifestyle to prevent Epidemic of Non Communicable Diseases Principles of Nutrition and Physical Activity in Cancer Control
Change for the better Dr. Arun Kurkure Change your Lifestyle to prevent Epidemic of Non Communicable Diseases Principles of Nutrition and Physical Activity in Cancer Control Scientific evidence suggests
More information10/25/2011 OBJECTIVES Cancer Screening in the United States, 2011 A Review of Current American Cancer Society Guidelines and Issues in Cancer Screenin
OBJECTIVES Cancer Screening in the United States, 2011 A Review of Current American Cancer Society Guidelines and Issues in Cancer Screening Kathy Gray, DNP, CRNP, FNP-BC Cancer Screenings and Guidelines
More informationCancer Screening I have no conflicts of interest. Principles of screening. Cancer in the World Page 1. Letting Evidence Be Our Guide
Cancer Screening 2012 Letting Evidence Be Our Guide Jeffrey A. Tice, MD Division of General Internal Medicine University of California, San Francisco I have no conflicts of interest Principles of screening
More informationIf you do not have time for the entire presentation refer to the following table of contents. To navigate through the slides, right click on your
Welcome This is an online version of a lecture given by Dr Keith Merritt on gyn cancers. Its purpose is to help women become more aware of early symptoms, risk factors, screening strategies and the importance
More informationMANAGEMENT OF HIGH RISK BREAST PATIENTS DR PAMELA THOMPSON BREAST PHYSICIAN, FSH
MANAGEMENT OF HIGH RISK BREAST PATIENTS DR PAMELA THOMPSON BREAST PHYSICIAN, FSH HIGH RISK MANAGEMENT OBJECTIVES Be alert to FHx Breast and/or Ovarian cancer Know how to perform a risk assessment Be aware
More informationOne of the commonest gynecological cancers,especially in white Americans.
Gynaecology Dr. Rozhan Lecture 6 CARCINOMA OF THE ENDOMETRIUM One of the commonest gynecological cancers,especially in white Americans. It is a disease of postmenopausal women with a peak incidence in
More informationAppropriate Use of Cytology and HPV Testing in the New Cervical Cancer Screening Guidelines
Appropriate Use of Cytology and HPV Testing in the New Cervical Cancer Screening Guidelines Tim Kremer, MD Ralph Anderson, MD 1 Objectives Describe the natural history of HPV particularly as it relates
More informationScreening for Cervical Cancer: Demystifying the Guidelines DR. NEERJA SHARMA
Screening for Cervical Cancer: Demystifying the Guidelines DR. NEERJA SHARMA Cancer Care Ontario Cervical Cancer Screening Goals Increase patient participation in cervical screening Increase primary care
More informationPrevention, Diagnosis and Treatment of Gynecologic Cancers
Prevention, Diagnosis and Treatment of Gynecologic Cancers Jubilee Brown MD and Pamela T. Soliman MD, MPH Department of Gynecologic Oncology and Reproductive Medicine University of Texas MD Anderson Cancer
More informationNorth American Menopause Society (NAMS)
North American Menopause Society (NAMS) 2012 Hormone Therapy Position Statement Cynthia B. Evans, MD Assistant Professor-Clinical Department of Obstetrics and Gynecology The Ohio State University College
More informationI have no financial interests in any product I will discuss today.
Cervical Cancer Prevention: 2012 and Beyond George F. Sawaya, MD Professor Department of Obstetrics, Gynecology and Reproductive Sciences Department of Epidemiology and Biostatistics University of California,
More informationRVP Medical Director Anthem Blue Cross. Provider Clinical Liaison, Oncology Solutions
David Pryor MD, MPH RVP Medical Director Anthem Blue Cross Leora Fogel Provider Clinical Liaison, Oncology Solutions Remember these key facts: There are things you can do to lower your risk. Progress is
More informationProactive Health Management for Women in High Stress Careers April 4, Eirwen M. Miller, MD Division of Gynecologic Oncology
Proactive Health Management for Women in High Stress Careers April 4, 2018 Eirwen M. Miller, MD Division of Gynecologic Oncology 1 Annual Well-Woman Care Blood pressure Weight Physical exam (including
More informationOncology in midlife and beyond
Oncology in midlife and beyond A. Gompel*, R. J. Baber, T. J. de Villiers, K-E. Huang**, R. J. Santen, D. Shah, P. Villaseca*** and S. Shapiro *Unité de Gynécologie Endocrinienne, Université Paris Descartes,
More informationI have no financial interests in any product I will discuss today.
Cervical Cancer Screening Update and Implications for Annual Exams George F. Sawaya, MD Professor Department of Obstetrics, Gynecology and Reproductive Sciences Department of Epidemiology and Biostatistics
More informationGuidelines for the Early Detection of Cancer
Guidelines for the Early Detection of Cancer The American Cancer Society recommends these cancer screening guidelines for most adults. Screening tests are used to find cancer before a person has any symptoms.
More informationTissue Breast Density
Tissue Breast Density Reporting breast density within the letter to the patient is now mandated by VA law. Therefore, this website has been established by Peninsula Radiological Associates (PRA), the radiologists
More informationOvarian Cancer Causes, Risk Factors, and Prevention
Ovarian Cancer Causes, Risk Factors, and Prevention Risk Factors A risk factor is anything that affects your chance of getting a disease such as cancer. Learn more about the risk factors for ovarian cancer.
More informationProgram Guidelines Clinical Guidelines Patient Enrollment Resource Documents Eligibility Guidelines... 2
BREAST AND CERVICAL CANCER TABLE OF CONTENTS Program Guidelines... 1 Clinical Guidelines... 1 Patient Enrollment... 1 Resource Documents... 1 Eligibility Guidelines... 2 Breast Screening Guidelines and
More informationBSO, HRT, and ERT. No relevant financial disclosures
BSO, HRT, and ERT Jubilee Brown, MD Professor & Associate Director, Gynecologic Oncology Levine Cancer Institute at the Carolinas HealthCare System Charlotte, North Carolina No relevant financial disclosures
More informationCancer 376 Causes of cancer 376 Cancer can be cured if found and treated early 376
374 Cancer and Growths Chapter 24 In this chapter: Cancer 376 Causes of cancer 376 Cancer can be cured if found and treated early 376 Problems of the Cervix (the Opening of the Womb) 377 Common problems
More informationRAISING THE AWARENESS OF GYNAECOLOGICAL CANCER. Penny Bognuda CNS Gynaecologic Oncology ADHB. June 2015.
RAISING THE AWARENESS OF GYNAECOLOGICAL CANCER Penny Bognuda CNS Gynaecologic Oncology ADHB. June 2015. AIMS AND OBJECTIVES OF THE NEXT ½ HOUR. Brief overview of the different types of gynaecological cancers
More informationOvaries: In Sickness and Health. Mr N Pisal Consultant Gynaecologist The Portland Hospital
Ovaries: In Sickness and Health Mr N Pisal Consultant Gynaecologist The Portland Hospital Topics for discussion How to assess ovarian function? AMH PCOS Ovarian pain Ovarian cysts Ovarian screening Menopause
More informationPage 1. Selected Controversies. Cancer Screening! Selected Controversies. Breast Cancer Screening. ! Using Best Evidence to Guide Practice!
Cancer Screening!! Using Best Evidence to Guide Practice! Judith M.E. Walsh, MD, MPH! Division of General Internal Medicine! Womenʼs Health Center of Excellence University of California, San Francisco!
More informationFaculty Pap Smear Guidelines: Family Planning Update 2008 Part Two
Faculty Pap Smear Guidelines: Family Planning Update 2008 Part Two Seshu P. Sarma, MD, FAAP Emory University Regional Training Center Atlanta, Georgia Produced by the Alabama Department of Public Health
More informationAlabama Cancer Facts & Figures ACS
Alabama Cancer Facts & Figures 2007 1.800.ACS.2345 www.cancer.org Alabama Cancer Facts & Figures 2007 1 Dear Friends and Colleagues, In partnership with the Alabama Department of Public Health and the
More informationOhio Northern University HealthWise. Authors: Alexis Dolin, Andrew Duska, Hannah Lamb, Eric Miller, Pharm D Candidates 2018 May 2018
Women s Health Authors: Alexis Dolin, Andrew Duska, Hannah Lamb, Eric Miller, Pharm D Candidates 2018 May 2018 Let Your Body Empower You! National Women s Health Week Polycystic Ovary Syndrome Page 2 Breast
More informationTHE MODERN GYNECOLOGIC EXAMINATION & SCREENING FOR GYNECOLOGIC MALIGNANCIES
THE MODERN GYNECOLOGIC EXAMINATION & SCREENING FOR GYNECOLOGIC MALIGNANCIES Denise Uyar, MD Associate Professor OB/GYN Chief Gynecologic Oncology Medical College of Wisconsin April 12, 2019 NO DISCLOSURES
More informationBreast Cancer. American Cancer Society
Breast Cancer American Cancer Society Reviewed February 2017 What we ll be talking about How common is breast cancer? What is breast cancer? What causes it? What are the risk factors? Can breast cancer
More informationCervical Cancer Prevention Month. January 2011 Morehouse College
Cervical Cancer Prevention Month January 2011 Morehouse College What is Cervical Cancer? Cervical Cancer begins in the cervix (lower part of the womb, called the uterus). Cervical Cancer, at one point,
More informationProstate cancer was the most commonly diagnosed type of cancer among Peel and Ontario male seniors in 2002.
Cancer HIGHLIGHTS Prostate, colorectal, and lung cancers accounted for almost half of all newly diagnosed cancers among Peel seniors in 22. The incidence rates of lung cancer in Ontario and Peel have decreased
More informationCERVICAL CANCER FACTSHEET. What is cervical cancer?
CERVICAL CANCER FACTSHEET What is cervical cancer? ENGAGe is releasing a series of factsheets to raise awareness of gynaecological cancers and to support its network to work at a grassroots level. Take-up
More informationPage 1. Controversies in Cancer Prevention and Screening. Disclosures. Screening. Principles of Screening. I have no conflicts of interest
Controversies in Cancer Prevention and Screening Disclosures Using the Best Evidence in 2015 I have no conflicts of interest Judith M.E. Walsh, MD, MPH Division of General Internal Medicine Women s Health
More informationBreast Cancer Update Michael B. Peyser MS MD FACS Fellow Society of Surgical Oncology Windsong Breast Care
Breast Cancer Update 2017 Michael B. Peyser MS MD FACS Fellow Society of Surgical Oncology Windsong Breast Care Used with permission by Anna Chen MD, Windsong Radiology Group Statistics as of 2013 230,815
More informationSurgery to Reduce the Risk of Ovarian Cancer. Information for Women at Increased Risk
Surgery to Reduce the Risk of Ovarian Cancer Information for Women at Increased Risk Centre for Genetics Education NSW Health 2017 The Centre for Genetics Education NSW Health Level 5 2C Herbert St St
More informationCancer Awareness Talk ICPAK 2014
Cancer Awareness Talk ICPAK 2014 F. Chite Asirwa, MB ChB. MD. MSc. Internist. Medical Oncologist & Hematologist Asst. Professor of Medicine Division of Hematology/Oncology Indiana University Email: fasirwa@iu.edu
More informationDysplasia: layer of the cervical CIN. Intraepithelial Neoplasia. p16 immunostaining. 1, Cervical. Higher-risk, requires CIN.
CLINICAL PRACTICE GUIDELINE Guideline Number: DHMP_DHMC_PG1015 Guideline Subject: Routine Cervical Cancer Screening Effective Date: 9/2018 Revision Date: 9/2019 Pages: 2 of 2 Quality Management Committee
More informationTumori eredofamiliari: sorveglianza di donne ad alto rischio
Tumori eredofamiliari: sorveglianza di donne ad alto rischio 14/01/2018 Dott Matteo Generali AUSL Modena Carpi U.O. Ostetricia e Ginecologia Screening for gynaecologic cancer in genetically predisposed
More informationHereditary Breast and Ovarian Cancer (HBOC) Information for individuals and families
Hereditary Breast and Ovarian Cancer (HBOC) Information for individuals and families What is Hereditary Breast and Ovarian Cancer (HBOC)? Hereditary Breast and Ovarian Cancer is a genetic condition which
More informationAdult Female Preventive Health Guidelines
2016-2017 Adult Female Preventive Health Guidelines Important Note Health Net s Preventive Health Guidelines provide Health Net members and practitioners with recommendations for preventive care services
More informationUpdate on Cervical Cancer Screening. Rahmouna Farez M.D. Assistant Professor, Medical College of Wisconsin 5/2/2014
Update on Cervical Cancer Screening Rahmouna Farez M.D. Assistant Professor, Medical College of Wisconsin 5/2/2014 Objectives Review the natural history of HPV as it relates to cervical cancer screening
More informationUpdate on Cervical Cancer Screening
Update on Cervical Cancer Screening Rahmouna Farez M.D. Assistant Professor, Medical College of Wisconsin 5/2/2014 Objectives Review the natural history of HPV as it relates to cervical cancer screening
More informationHealth Promotion, Screening, & Early Detection
OCN Test Content Outline 2018 Health Promotion, Screening, & Early Detection Kelley Blake MSN, RN, AOCNS, OCN UW Medicine/Valley Medical Center I. Care Continuum 19% A. Health promotion & disease prevention
More informationAlabama Cancer Facts & Figures 2009
Alabama Cancer Facts & Figures 2009 1.800.227.2345 cancer.org Have questions about cancer? Cancer information specialists are available 24 hours a day, 7 days a week. Call the American Cancer Society at
More informationA senior s guide for preventative healthcare services Ynolde F. Smith D.O.
A senior s guide for preventative healthcare services Ynolde F. Smith D.O. What can we do to prevent disease? Exercise Eating Well Keep a healthy weight Injury prevention Mental Health Social issues (care
More informationCancer Screenings and Early Diagnostics
Cancer Screenings and Early Diagnostics Ankur R. Parikh, D.O. Medical Director, Center for Advanced Individual Medicine Hematologist/Medical Oncologist Atlantic Regional Osteopathic Convention April 6
More information8/26/17. Smoking Cessation and Cancer Prevention Jussuf T. Kaifi, MD, PhD, FACS Chief, Section for Thoracic Surgery. Cancer in the United States
Smoking Cessation and Cancer Prevention Jussuf T. Kaifi, MD, PhD, FACS Chief, Section for Thoracic Surgery Cancer in the United States CDC and ASCO: Cancer leading cause of death in 22 states In 2033:
More informationFAQ-Protocol 3. BRCA mutation carrier guidelines Frequently asked questions
ULast updated: 09/02/2015 Protocol 3 BRCA mutation carrier guidelines Frequently asked questions UQ: How accurate are the remaining lifetime and 5 year breast cancer risks in the table? These figures are
More informationObjectives. I have no financial interests in any product I will discuss today. Cervical Cancer Screening Guidelines: Updates and Controversies
Cervical Cancer Screening Guidelines: Updates and Controversies I have no financial interests in any product I will discuss today. Jody Steinauer, MD, MAS University of California, San Francisco Objectives
More informationCervical Cancer Screening Update. Melissa Hartman, DO Women s Health
Cervical Cancer Screening Update Melissa Hartman, DO Women s Health Previous Cervical Cancer Screening Organization Recommendation ACS (2011) ACP (2008) NCI (2003) Age 21 or 3 years after first intercourse
More informationI have no financial interests in any product I will discuss today.
Cervical Cancer Screening Update and Implications for Annual Exams George F. Sawaya, MD Professor Department of Obstetrics, Gynecology and Reproductive Sciences Department of Epidemiology and Biostatistics
More informationCANCER SCREENING USPSTF AND BEYOND. DeAnn Cummings, MD March 3, 2018
CANCER SCREENING USPSTF AND BEYOND DeAnn Cummings, MD March 3, 2018 OBJECTIVES Review and discuss cancer screening guidelines for: Colorectal CA Prostate CA Breast CA Ovarian CA Secondary prevention, NOT
More informationMammography and Other Screening Tests. for Breast Problems
301.681.3400 OBGYNCWC.COM Mammography and Other Screening Tests What is a screening test? for Breast Problems A screening test is used to find diseases, such as cancer, in people who do not have signs
More informationpatient education Fact Sheet
patient education Fact Sheet PFS007: BRCA1 and BRCA2 Mutations OCTOBER 2017 BRCA1 and BRCA2 Mutations Cancer is caused by several different factors. A few types of cancer run in families. These types are
More informationCANCER SCREENING USPSTF AND BEYOND. DeAnn Cummings, MD March 9, 2019
CANCER SCREENING USPSTF AND BEYOND DeAnn Cummings, MD March 9, 2019 OBJECTIVES Review and discuss cancer screening guidelines for: Colorectal CA Prostate CA Breast CA Ovarian CA Secondary prevention, NOT
More informationCervical Skills. Dr Margaret Laing Queen Elizabeth University Hospital
Cervical Skills Dr Margaret Laing Queen Elizabeth University Hospital What is screening? Screening is a test offered to an apparently well person with the possibility of detecting a serious disease before
More informationPreventive Health Guidelines
Preventive Health Guidelines Guide to Clinical Preventive Services Adult LifeWise has adopted the United States Preventive Services Task Force (USPSTF) Guide to Clinical Preventive Services. The guideline
More informationMolly A. Brewer DVM, MD, MS Chair and Professor Department of Obstetrics and Gynecology University of Connecticut School of Medicine
Molly A. Brewer DVM, MD, MS Chair and Professor Department of Obstetrics and Gynecology University of Connecticut School of Medicine Review causes of abnormal uterine bleeding: Adolescent Reproductive
More informationBRCA genes and inherited breast and ovarian cancer. Information for patients
BRCA genes and inherited breast and ovarian cancer Information for patients This booklet has been written for people who have a personal or family history of breast and/or ovarian cancer that could be
More informationGynecologic Malignancies. Kristen D Starbuck 4/20/18
Gynecologic Malignancies Kristen D Starbuck 4/20/18 Outline Female Cancer Statistics Uterine Cancer Adnexal Cancer Cervical Cancer Vulvar Cancer Uterine Cancer Endometrial Cancer Uterine Sarcoma Endometrial
More informationThe exact cause of breast cancer remains unknown, yet certain factors are linked to the chance of getting the disease. They are as below:
Published on: 9 Feb 2013 Breast Cancer What Is Cancer? The body is made up of cells that grow and die in a controlled way. Sometimes, cells keep dividing and growing without normal controls, causing an
More informationIncreased Risk of Breast Cancer: Screening and Prevention. Elizabeth Pritchard, MD 4/5/2017
Increased Risk of Breast Cancer: Screening and Prevention Elizabeth Pritchard, MD 4/5/2017 No disclosures Defining Risk Risk Factors Modifiable Lifestyle obesity physical activity alcohol consumption breast
More informationInformation leaflet for women with an increased lifetime risk of breast and ovarian cancer. Hereditary Breast and Ovarian Cancer (HBOC)
Information leaflet for women with an increased lifetime risk of breast and ovarian cancer Hereditary Breast and Ovarian Cancer (HBOC) What is Hereditary Breast and Ovarian Cancer (HBOC)? Hereditary Breast
More informationCervical Cancer 4/27/2016
Guidelines for Cervical Cancer Screening and Prevention Management of Abnormal Results Kathy A. King, MD Assistant Professor of OB/GYN Medical College of Wisconsin May 6, 2016 Cervical Cancer In US about
More informationCancer in the LGBTQ Community. Katie Imborek, MD Clinical Assistant Professor University of Iowa Department of Family Medicine
+ Cancer in the LGBTQ Community Katie Imborek, MD Clinical Assistant Professor University of Iowa Department of Family Medicine + Objectives Discuss the possible reasons that LGBTQ people have a disproportionate
More informationCVIM s Cancer Screening Practices
12-13-17 Professional Practice Minutes CVIM s Cancer Screening Practices At CVIM, preventative health care is very important! In these minutes you will find a review of our recommendations for cancer screening
More informationCancer Control - the role of Surveillance. Anthony B. Miller Department of Public Health Sciences University of Toronto, Canada
Cancer Control - the role of Surveillance Anthony B. Miller Department of Public Health Sciences University of Toronto, Canada Overview of presentation Define Cancer Control Discuss what we need for surveillance
More informationGynecological Cancers
Gynecological Cancers Outline Ovarian Cancer Uterine (Endometrial) Cancer Cervical Cancer Vulvar Cancer Vaginal Cancer Overian Cancer Ovarian cancer is cancer that forms in the tissue of the ovary and
More information650, Our Failure to Deliver
650, Our Failure to Deliver, Director UAB Comprehensive Cancer Center Professor of Gynecologic Oncology Evalina B. Spencer Chair in Oncology President, American Cancer Society All Sites Mortality Rates
More informationClinical guideline Published: 25 June 2013 nice.org.uk/guidance/cg164
Familial breast cancer: classification, care and managing breast cancer and related risks in people with a family history of breast cancer Clinical guideline Published: 25 June 2013 nice.org.uk/guidance/cg164
More informationAlabama Breast and Cervical Cancer Early Detection Program (ABCCEDP) County Health Department Protocol
Alabama Breast and Cervical Cancer Early Detection Program (ABCCEDP) County Health Department Protocol BREAST AND CERVICAL CANCER TABLE OF CONTENTS ABCCEDP Overview and Purpose... 1 Clinical Guidelines...
More informationCurrent Strategies in the Detection of Breast Cancer. Karla Kerlikowske, M.D. Professor of Medicine & Epidemiology and Biostatistics, UCSF
Current Strategies in the Detection of Breast Cancer Karla Kerlikowske, M.D. Professor of Medicine & Epidemiology and Biostatistics, UCSF Outline ν Screening Film Mammography ν Film ν Digital ν Screening
More informationBREAST CANCER d an BREAST SELF EXAM
BREAST CANCER and BREAST SELF EXAM American Cancer Society Statistics: 2009 Invasive breast cancer will be diagnosed in over 192,370 women Carcinoma in situ will be diagnosed in 62,280 women More than
More informationBreast Cancer Screening: Changing Philosophies in Educating Women and Teens
Breast Cancer Screening: Changing Philosophies in Educating Women and Teens Courtney Benedict CNM MSN Disclosures Merck Nexplanon trainer Session Objectives Explain the rationale for initiation and frequency
More informationCervical Dysplasia and HPV
Cervical Dysplasia and HPV J. Anthony Rakowski D.O., F.A.C.O.O.G. MSU SCS Board Review Coarse HPV Double stranded DNA virus The HPV infect epithelial cells of the skin and mucous membranes Highest risk
More information