Cervical Cancer Screening (PDQ®): Screening - Patient Information [NCI] - Hydatidiform Mole (HM) Management
Treatment of HM is within the purview of the obstetrician/gynecologist and will not be discussed separately here. However, following the diagnosis and treatment of HM, patients should be monitored to rule out the possibility of metastatic gestational trophoblastic neoplasia. In almost all cases, this can be performed with routine monitoring of serum beta human chorionic gonadotropin (beta-hCG) to document its return to normal. An effective form of contraception is important during the follow-up period to avoid the confusion that can occur with a rising beta-hCG as a result of pregnancy. Chemotherapy is necessary when there is the following: A rising beta-hCG titer for 2 weeks (3 titers).A tissue diagnosis of choriocarcinoma.A plateau of the beta-hCG for 3 weeks.Persistence of detectable beta-hCG 6 months after mole evacuation.Metastatic disease.An elevation in beta-hCG after a normal value.Postevacuation hemorrhage not caused by retained tissues.Chemotherapy is ultimately required for
Cervical Cancer Screening (PDQ®): Screening - Patient Information [NCI] - Evidence of Harm
Annually in the United States, an estimated 65 million women undergo cervical cancer screening; about 3.9 million (6%) will be referred for further evaluation. About 11,000 cases of invasive cervical cancer were diagnosed in 2008. Thus, Papanicolaou (Pap) test screening results in a large number of colposcopies for benign conditions.The major potential harm of screening for cervical cancer lies in the screening detection of many cytologic abnormalities such as atypical squamous cells of undetermined significance (ASCUS) and low-grade squamous intraepithelial lesions (LSIL), the majority of which would never progress to cervical cancer. Women with human papillomavirus (HPV)-positive ASCUS or LSIL on Pap testing are usually referred for colposcopy. Histological CIN 2+ is treated with cryotherapy or loop electrosurgical excision procedure. These procedures permanently alter the cervix and have consequences on fertility and pregnancy. Younger women are more likely to acquire HPV
Cervical Cancer Screening (PDQ®): Screening - Patient Information [NCI] - Treatment Options for Recurrent Endometrial Cancer
Treatment of recurrent endometrial cancer may include the following:Radiation therapy as palliative therapy to relieve symptoms and improve the patient's quality of life.Hormone therapy.Clinical trials of chemotherapy.Check for U.S. clinical trials from NCI's list of cancer clinical trials that are now accepting patients with recurrent endometrial carcinoma. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. General information about clinical trials is available from the NCI Web site.
Cervical Cancer Screening (PDQ®): Screening - Patient Information [NCI] - What is screening?
Screening is looking for cancer before a person has any symptoms. This can help find cancer at an early stage. When abnormal tissue or cancer is found early,it may be easier to treat. By the time symptoms appear,cancer may have begun to spread. Scientists are trying to better understand which people are more likely to get certain types of cancer. They also study the things we do and the ...
Cervical Cancer Screening (PDQ®): Screening - Patient Information [NCI] - High-Risk Gestational Trophoblastic Neoplasia (FIGO Score ≥7) Treatment
Multiagent chemotherapy is standard for the initial management of high-risk gestational trophoblastic neoplasia (GTN). A systematic literature review revealed only one randomized controlled trial (and no high-quality trials)—conducted in the 1980s—comparing multiagent chemotherapy regimens for high-risk GTN. In the trial, only 42 women were randomly assigned to either a CHAMOMA regimen (i.e., methotrexate, folinic acid, hydroxyurea, dactinomycin, vincristine, melphalan, and doxorubicin) or MAC (i.e., methotrexate, dactinomycin, and chlorambucil). There was substantially more life-threatening toxicity in the CHAMOMA arm and no evidence of higher efficacy. However, there were serious methodologic problems with this trial. It was reportedly designed as an equivalency trial, but owing to the small sample size, the trial was inadequately powered to assess equivalence. In addition, the characteristics of the patients randomly assigned to the two study arms were not
Cervical Cancer Screening (PDQ®): Screening - Patient Information [NCI] - Risks of Cervical Cancer Screening
Screening tests have risks.Decisions about screening tests can be difficult. Not all screening tests are helpful and most have risks. Before having any screening test, you may want to discuss the test with your doctor. It is important to know the risks of the test and whether it has been proven to reduce the risk of dying from cancer.The risks of cervical cancer screening include the following: False-negative test results can occur.Screening test results may appear to be normal even though cervical cancer is present. A woman who receives a false-negative test result (one that shows there is no cancer when there really is) may delay seeking medical care even if she has symptoms.False-positive test results can occur.Screening test results may appear to be abnormal even though no cancer is present. Also, some abnormal cells in the cervix never become cancer. A false-positive test result (one that shows there is cancer when there really isn't) can cause anxiety and is usually followed by
Cervical Cancer Screening (PDQ®): Screening - Patient Information [NCI] - Stage Information for Cervical Cancer
Cervical carcinoma has its origins at the squamous-columnar junction whether in the endocervical canal or on the portion of the cervix. The precursor lesion is dysplasia or carcinoma in situ (cervical intraepithelial neoplasia [CIN]), which can subsequently become invasive cancer. This process can be quite slow. Longitudinal studies have shown that in untreated patients with in situ cervical cancer, 30% to 70% will develop invasive carcinoma over a period of 10 to 12 years. However, in about 10% of patients, lesions can progress from in situ to invasive in a period of less than 1 year. As it becomes invasive, the tumor breaks through the basement membrane and invades the cervical stroma. Extension of the tumor in the cervix may ultimately manifest as ulceration, exophytic tumor, or extensive infiltration of underlying tissue including bladder or rectum. In addition to local invasion, carcinoma of the cervix can spread via the regional lymphatics or bloodstream.
Cervical Cancer Screening (PDQ®): Screening - Patient Information [NCI] - nci_ncicdr0000062699-nci-header
This information is produced and provided by the National Cancer Institute (NCI). The information in this topic may have changed since it was written. For the most current information, contact the National Cancer Institute via the Internet web site at http://cancer.gov or call 1-800-4-CANCER.Gestational Trophoblastic Disease Treatment
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Cervical Cancer Screening (PDQ®): Screening - Patient Information [NCI] - Description of the Evidence
BackgroundNatural history, incidence, and mortalityIn the United States in 2013, it is estimated that 12,340 cases of invasive cervical cancer will be diagnosed and that 4,030 women will die of the disease. These rates had been improving steadily. However, from 2005 to 2009, rates were stable in women younger than 50 years and decreased by 3.0% per year in women aged 50 years and older. From 2005 to 2009, mortality rates were stable among women of all ages. This improvement has been attributed largely to screening with the Papanicolaou (Pap) test.Invasive squamous carcinoma of the cervix results from the progression of preinvasive precursor lesions called cervical intraepithelial neoplasia (CIN), or dysplasia. CIN is histologically graded into mild dysplasia (CIN 1), moderate dysplasia (CIN 2), or severe dysplasia (CIN 3). Not all of these lesions progress to invasive cancer; many mild and moderate lesions regress. A further