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Chapter 54 - Screening for Gynaecological Cancers

from Section 11 - Public Health Issues in Gynaecology

Published online by Cambridge University Press:  24 November 2021

Tahir Mahmood
Affiliation:
Victoria Hospital, Kirkcaldy
Charles Savona-Ventura
Affiliation:
University of Malta, Malta
Ioannis Messinis
Affiliation:
University of Thessaly, Greece
Sambit Mukhopadhyay
Affiliation:
Norfolk & Norwich University Hospital, UK
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Summary

The aim of gynaecological cancer screening is to prevent the development of cancer by identifying and treating pre-cancerous disease or achieve early diagnosis, which is likely to improve patient outcomes, including survival. For ovarian cancer, screening approaches have broadly focused on validated morphological scores and/or detecting increased CA-125 levels or trends. Population-based screening has been ineffective, but new approaches for early diagnosis and prevention that leverage molecular genomics are in development. For cervical cancer screening, European countries will continue with centralized national screening programmes, which will increasingly adopt HPV screening alone or in the form of co-testing and implement triage protocols and evidence based referral pathways. The individual population cervical cancer risk and the cost and patient inconvenience and attitude towards screening and potential unnecessary treatment is considered. Unlike cervical cancer, systematic testing for endometrial carcinoma is not recommended as there is no standard or routine screening test.

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Publisher: Cambridge University Press
Print publication year: 2021

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