Skip to main content Accessibility help

We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.

Close cookie message
×
Hostname: page-component-586b7cd67f-g8jcs Total loading time: 0 Render date: 2024-11-23T19:58:45.227Z Has data issue: false hasContentIssue false

Chapter 54 - Screening for Gynaecological Cancers

from Section 11 - Public Health Issues in Gynaecology

Published online by Cambridge University Press:  24 November 2021

By
Alexandros Daponte
Edited by
Tahir Mahmood ,
Charles Savona-Ventura ,
Ioannis Messinis  and
Sambit Mukhopadhyay
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
Get access

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.

Keywords

screeningovarian cancerendometrial cancercervical cancer
Type
Chapter
Information
The EBCOG Postgraduate Textbook of Obstetrics & Gynaecology
Gynaecology
 , pp. 467 - 472
Publisher: Cambridge University Press
Print publication year: 2021

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Wilson, JMG, Jungner, G, World Health Organization. Principles and practice of screening for disease. 1968. Available at: https://apps.who.int/iris/handle/10665/37650.Google Scholar
Lheureux, S, Gourley, C, Vergote, I, Oza, AM. Epithelial ovarian cancer. Lancet 2019;393:1240–1253.CrossRefGoogle ScholarPubMed
Sundar, S, Neal, RD, Kehoe, S. Diagnosis of ovarian cancer. BMJ 2015;351:h4443.CrossRefGoogle ScholarPubMed
Kurman, RJ, Shih, IeM. The dualistic model of ovarian carcinogenesis: revisited, revised, and expanded. Am J Pathol 2016;186:733–747.CrossRefGoogle ScholarPubMed
Permuth-Wey, J, Sellers, T. Epidemiology of ovarian cancer: an update. In: Advances in Diagnosis and Management of Ovarian Cancer. New York: Springer, 2014.Google Scholar
Committee on the State of the Science in Ovarian Cancer Research, Board on Health Care Services, Institute of Medicine, National Academies of Sciences, Engineering and Medicine. Ovarian Cancers: Evolving Paradigms in Research and Care. Washington, DC: National Academies Press, 2016.Google Scholar
Henderson, JT, Webber, EM, Sawaya, GF. Preventive Services Task Force Evidence Syntheses, formerly Systematic Evidence Reviews, in screening for ovarian cancer: an updated evidence review for the U.S. Preventive Services Task Force. Report 17-05231-EF-1. 2018.Google Scholar
Jacobs, IJ, Menon, U, Ryan, A, et al. Ovarian cancer screening and mortality in the UK Collaborative Trial of Ovarian Cancer Screening (UKCTOCS): a randomised controlled trial. Lancet 2016;387:945–956.Google Scholar
Rosenthal, AN, Fraser, LSM, Philpott, S, et al. Evidence of stage shift in women diagnosed with ovarian cancer during phase II of the United Kingdom Familial Ovarian Cancer Screening Study. J Clin Oncol 2017;35:1411–1420.Google Scholar
Blyuss, O, Burnell, M, Ryan, A, et al. Comparison of longitudinal CA125 algorithms as a first-line screen for ovarian cancer in the general population. Clin Cancer Res 2018;24:4726–4733.Google Scholar
Simmons, AR, Fourkala, EO, Gentry-Maharaj, A, et al. Complementary longitudinal serum biomarkers to CA125 for early detection of ovarian cancer. Cancer Prev, Res 2019;12:391–400.Google Scholar
Nebgen, DR, Hurteau, J, Holman, LL, et al. Bilateral salpingectomy with delayed oophorectomy for ovarian cancer risk reduction: a pilot study in women with BRCA1/2 mutations. Gynecol Oncol 2018;150:79–84.Google Scholar
Moyer, VA. Risk assessment, genetic counseling, and genetic testing for BRCA-related cancer in women: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med 2014;160:271–281.Google Scholar
Hartmann, LC, Lindor, MN. The role of risk-reducing surgery in hereditary breast and ovarian cancer. N Engl J Med 2016;374:454–468.CrossRefGoogle ScholarPubMed
Jones, MR, Kamara, D, Karlan, BY, Pharoah, PDP, Gayther, SA. Genetic epidemiology of ovarian cancer and prospects for polygenic risk prediction. Gynecol Oncol 2017;147:705–713.Google Scholar
Shi, Z, Yu, H, Wu, Y, et al. Systematic evaluation of cancer-specific genetic risk score for 11 types of cancer in The Cancer Genome Atlas and Electronic Medical Records and Genomics cohorts. Cancer Med 2019;8:3196–3205.CrossRefGoogle ScholarPubMed
American Cancer Society. Cancer Facts & Figures Atlanta, GA: ACS, 2019.Google Scholar
American Cancer Society. Detailed Guide: endometrial cancer: what are the risk factors for endometrial cancer? 2019. Available at: www.cancer.org/cancer/endometrial-cancer.html.Google Scholar
Okuda, T, Sekizawa, A, Purwosunu, Y, et al. Genetics of endometrial cancers. Obstet Gynecol Int 2010;2010:984013.Google Scholar
Colombo, N, Preti, E, Landoni, F, et al. Endometrial cancer: ESMO clinical practice guidelines for diagnosis, treatment and follow-up. Ann Oncol 2013;24;Suppl 6:vi33–vi38.Google Scholar
Jacobs, I, Gentry-Maharaj, A, Burnell, M, et al. Sensitivity of transvaginal ultrasound screening for endometrial cancer in postmenopausal women: a case-control study within the UKCTOCS cohort. Lancet Oncol 2011;12:38–48.CrossRefGoogle ScholarPubMed
Walboomers, JM, Jacobs, MV, Manos, MM, et al. Human papillomavirus is a necessary cause of invasive cervical cancer worldwide. J Pathol 1999;189:12–19.3.0.CO;2-F>CrossRefGoogle ScholarPubMed
Ronco, G, Dillner, J, Elfström, KM, et al. Efficacy of HPV-based screening for prevention of invasive cervical cancer: follow-up of four European randomised controlled trials. Lancet 2014;383:524–532.Google Scholar
Kitchener, HC, Canfell, K, Gilham, C, et al. The clinical effectiveness and cost-effectiveness of primary human papillomavirus cervical screening in England: extended follow-up of the ARTISTIC randomised trial cohort through three screening rounds. Health Technol Assess 2014;18:1–196.Google Scholar
Gilham, C, Sargent, A, Kitchener, HC, Peto, J. HPV testing compared with routine cytology in cervical screening: long-term follow-up of ARTISTIC RCT. Health Technol Assess 2019;23:1–44.Google Scholar
Rositch, AF, Koshiol, J, Hudgens, MG, et al. Patterns of persistent genital human papillomavirus infection among women worldwide: a literature review and meta-analysis. Int J Cancer 2013;133:1271–1285.Google Scholar
Ebisch, RM, de Kuyper-de Ridder, GM, Bosgraaf, RP, et al. The clinical value of HPV genotyping in triage of women with high-risk-HPV-positive self-samples. Int J Cancer 2016;139:691–699.Google Scholar
Khan, MJ, Castle, PE, Lorincz, AT, et al. The elevated 10-year risk of cervical precancer and cancer in women with human papillomavirus (HPV) type 16 or 18 and the possible utility of type-specific HPV testing in clinical practice. J Natl Cancer Inst 2005;97:1072–1079.Google Scholar
Daponte, A, Pournaras, S, Mademtzis, I, et al. Evaluation of high-risk human papillomavirus types PCR detection in paired urine and cervical samples of women with abnormal cytology. J Clin Virol 2006;36:189–193.Google Scholar
Daponte, A, Tsezou, A, Oikonomou, P, et al. Use of real-time PCR to detect human papillomavirus-16 viral loads in vaginal and urine self-sampled specimens. Clin Microbiol Infect 2008;14:619–621.CrossRefGoogle ScholarPubMed
Polman, NJ, Ebisch, RMF, Heideman, DAM, et al. Performance of human papillomavirus testing on self-collected versus clinician-collected samples for the detection of cervical intraepithelial neoplasia of grade 2 or worse: a randomised, paired screen-positive, non-inferiority trial. Lancet Oncol 2019;20:229–238.CrossRefGoogle ScholarPubMed
Arbyn, M, Smith, SB, Temin, S, et al.. Detecting cervical precancer and reaching underscreened women by using HPV testing on self samples: updated meta-analyses. BMJ 2018;363:k4823.CrossRefGoogle ScholarPubMed
Schiffman, M, Kinney, WK, Cheung, LC, et al. Relative performance of HPV and cytology components of cotesting in cervical screening. J Natl Cancer Inst 2018;110:501–508.Google Scholar
Stoler, MH, Wright, TC, Parvu, V, et al. HPV testing with 16, 18, and 45 genotyping stratifies cancer risk for women with normal cytology. Am J Clin Pathol 2019;151:433–444.Google Scholar

Save book to Kindle

To save this book to your Kindle, first ensure [email protected] is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×