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At least 19 recordsLinked to original sources
PubMed1990

Biotin and phosphorus-isotopic labelled DNA/RNA probes for the detection of human papilloma virus sequences.

In this study, the diagnostic accuracy and practicability of different hybridization techniques for the detection of human papilloma virus (HPV) DNA were tested. Cervical cell scrapes (n = 67) were analysed for HPV-DNAs 6/11 and 16, in order to compare a commercially available in situ DNA hybridization-assay with the conventional Southern-blot analysis. The in situ DNA hybridization-assay gave a sensitivity of 81.5%, a specificity of 97.5% and a diagnostic efficiency of 91.0% for HPV-DNAs 6/11. Using the same assay, we observed a sensitivity of 100%, a specificity of 96.3% and a diagnostic efficiency of 97.0% for HPV-DNA 16. The practicability of dot-blot DNA hybridization technique was tested on 176 cervical cell scrapes, in order to determine the prevalence rate of HPV-genotypes 6/11, 16/18 and 31/33/35. In the random control group (n = 106), 1.9% of the cases were HPV-DNA positive. In the cancer prevention group (n = 70), patients with reactive and reparative cell changes showed a HPV-DNA positivity of 55.0%, with mild (slight) dysplasia/CIN 1 of 73.7%, and with moderate to severe dysplasia/CIN 2 to CIN 3, including the carcinoma in situ/CIN 3 of 80.0%. Patients with squamous cell carcinoma of the cervix uteri gave HPV-DNA positive results in 96.2% of the cases. The suitability of in situ DNA hybridization for morphological studies was tested on tissue biopsies (n = 68). The HPV-DNAs 6/11 were found predominantly to 72.7% of the examined condylomas. The HPV-DNA positive cervices increased with the severity of the cytological dysplasia.(ABSTRACT TRUNCATED AT 250 WORDS)

Biotin↗
PubMed1988

Cervical cancer screening in Tuscany: a survey of the actual state of cervical cancer prevention in the Local Sanitary Units of the Tuscan region.

Every Local Sanitary Unit (USL) of the Tuscan Region was contacted to define screening variables, such as adequacy of the staff involved in prevention, smear technique, data collection and evaluation, laboratory quality control, and modalities of invitations to screening. The reported data show that 21 of 40 USL, but only 9 of 28 USL outside the Florence province (where a common screening program is performed), are performing active invitations to screening. The most serious staff inadequacies concern data evaluation and personnel performing the test. Sixteen of 28 USL outside Florence suggest an annual rescreening, which causes overcrowding of services and a poor availability for the unscreened population. Moreover, the poor quality of data collection makes it impossible to evaluate the benefit offered by the screening programs in the 28 USL outside Florence. Cytologic quality control is often lacking, and the smear technique is inadequate in 10 of 28 USL outside Florence. The lack in the USL of epidemiologic competence and of cost/benefit considerations and the need for political decisions about cancer prevention programs are stressed.

Cost-Benefit Analysis↗
PubMedDate not supplied

Developing cancer control capacity in state and local public health agencies.

In 1986, the National Cancer Institute began a major grant program to enhance the technical capabilities of public health departments in cancer prevention and control. This effort, commonly referred to as "capacity building" for cancer control, provided funding to support eight State and one local health department. The program focused on developing the knowledge and skills of health department personnel to implement intervention programs in such areas as smoking cessation, diet modification, and breast and cervical cancer screening. The grants ranged from 2 to 5 years in length, with funding of $125,000 to $1.6 million per grant. The total for the program was $7.4 million. While the priorities set for these grants were nominally similar, their capacity building activities in cancer prevention and control evolved into unique interventions reflecting the individual needs and priorities of each State or locality. Their experiences illustrate that technical development for planning, implementing, and evaluating cancer prevention and control programs is a complex process that must occur at multiple levels, regardless of overall approach. Factors found to contribute to successful implementation of technical development programs include* commitment of the organization's leadership to provide adequate support for staff and activities and to keep cancer prevention and control on the organizational agenda,* the existence of appropriate data to monitor and evaluate programs,* appropriately trained staff,* building linkages with State and community agencies and coalitions to guide community action,* an established plan or process for achieving cancer control objectives,* access to the advice of and participation of individual cancer and health experts,* an informed State legislature,* diffusion of cancer prevention and control efforts,and* the ability to obtain funds needed for future activities.

Community Participation↗
PubMed1992

Reversible contraception for the woman over 35 years of age.

Methods of reversible contraception, oral contraceptives, intrauterine devices, and Norplant (systemic progestin-only contraceptive; Wyeth-Ayerst, Radnor, PA), can be used for women over 35 years of age. Oral contraceptive formulations are safe and effective for healthy women up to the age of menopause. Oral contraceptives in women who do not smoke cigarettes do not result in a significant increased risk for cardiovascular disease. The incidence of breast cancer is not increased in women who have used oral contraceptives. A slight increase was found in younger women who had been on oral contraceptives based on a reanalysis of the contraceptive and steroid hormone study of the Centers for Disease Control. A reduction in the incidence of ovarian epithelial neoplasia by 40% was found in three European case-control studies. Two intrauterine devices are currently available on the US market: Paragard (GynoPharma, Somerville, NJ) and Progestasert (Alza Corp., Palo Alto, CA). Both of these provide highly effective contraception. A World Health Organization prospective randomized study found that there was an increase in pelvic inflammatory disease rates in the first 20 days after intrauterine device insertion. The intrauterine device itself did not increase the pelvic inflammatory disease incidence rates. The Norplant system exerts its contraceptive action through ovulation inhibition and alteration of cervical mucus. The major consumer complaint is irregular or prolonged uterine bleeding, which can be controlled by oral estrogen.

Adult↗
PubMed1991

["Papanicolaou." Outmoded, isn't it?].

The quality of cytopathology services in the United States has recently come under public scrutiny. While numerous studies have demonstrated remarkable success of the PAPANICOLAOU test in the reduction of cervical cancer, problems that include inadequacies in obtaining the sample, processing the sample screening and interpretation based on the PAPANICOLAOU Classification have been questioned. The recommendations of expert consultants attending a workshop sponsored by the Division of Cancer Prevention and Control, National Institutes regarding utilization of the Pap Smear have been made and published as the Bethesda System. In general terms, the recommendations are: 1. The cytopathology report is a medical consultation 2. The PAPANICOLAOU classification for reporting consultations is not acceptable in the modern practice of diagnostic cytopathology. 3. The recommendations made by participant and here published, should serve as a guideline for reports. 4. All reports should include: a. A statement regarding adequacy b. A designation of normal or otherwise. c. A descriptive diagnosis.

Carcinoma↗
PubMed1973

The evaluation of cancer control measures.

The assessment of a screening procedure falls into two parts. The first is the development of a test and the establishment of criteria of specificity and sensitivity. The second stage is that of the application of the test to the general population, demanding attention to the natural history of the disease and to the usefulness and simplicity of the test itself. The decision to organize a screening programme has usually to be taken on the basis of incomplete information and in the setting of a population subjected to constant change. It is the hope of the Committee on Cancer Prevention and Detection of the UICC that the conclusions from the Symposium will prove helpful to all who face such decisions.

Breast Neoplasms↗
PubMed1989

Interpretation of cancer prevention trials.

Principles and methods to guide interpretation require a different emphasis for cancer trials. Assumptions used to design a trial must be validated and modified during the trial to avoid limitations. To maximize information from such trials, recruitment strategies for commonly free-living subjects, measurements of safety and compliance, and ascertainment with pathologic review of endpoints must be obtained. Consideration of multiple endpoints may provide a better interpretation of cancer prevention for skin, colon, and transient occurrences illustrated by cervical dysplasia or biochemical precursors. A careful definition of the limitations of preventive trials is required. These include the actual size of the intervention groups, completeness and duration of follow-up, and comparison between trial participants and a defined source population. To obtain a valid interpretation with adequate precision of intervention effectiveness, time to endpoints should be evaluated using statistical multivariate methods such as Cox proportional hazard or relative risk models. These permit adjustment for important confounding and risk modifiers such as compliance, dietary intake, and drift in control group. The magnitude of the intervention efficacy and the generalizability of results of the trial will be negatively impacted if the intervention has a delayed (latent) effect. Such delay in intervention effect requires added considerations with possible extension of trial duration. Use of confidence limits for intervention effectiveness provides added insight and improved interpretation of prevention trials. The final component of a cancer prevention trial, as with any study, is to interpret and report its results. Providing a valid interpretation with adequate precision to hypotheses of a cancer prevention trial requires added emphasis on the accuracy of the assumptions made to design the trial and the duration of the trial. Design assumptions regarding compliance to the prescribed interventions, time until the experimental intervention achieves full effect, and the frequency of endpoints directly impact on the number of endpoints observed. Terminating a cancer prevention trial before adequate information is obtained, thus severely flawing its interpretation, requires ongoing awareness. Interpretation of a cancer prevention trial should include several added steps: first, investigators to critically review the actual manner in which the trial was conducted; second, carry out an appropriate analysis of the data; and third, review the results and note exceptions or limitations in the data. The results of the trial should be contrasted with previous studies. Implications of the results to future trials should be considered. Finally, these interpretations should be documented in a written report and made available to the scientific community.

Clinical Trials as Topic↗
PubMed1990

[The potential of cancer prevention].

Cancer prevention is an important cancer control strategy. It consists of primary and secondary cancer preventions. The former aims to prevent cancers by removing risk factors and supplementing protective factors. The latter aims to prevent cancer deaths by early detection-early treatment through periodic screening. The potential of cancer prevention in Japan was estimated statistically based on available data and assumptions. The main results obtained from the present estimation were as follows: 1) about 9-10% of cancers could be prevented if prevalence of adults smoker decreased to a half of the present level; 2) about 8-10% of cancer could be prevented by the improvement of dietary habits; reduction of salt intake and avoidance of excess intake of fats; 3) another 1-5% could be prevented by prevention of hepatitis B virus infection and improvements of work environment and air pollution; 4) a total of about 18-25% could be prevented if primary prevention is promoted extensively; 5) about 10-13% of cancer deaths could be prevented if periodic screenings for stomach cancer, cervical cancer, breast cancer, lung cancer and large intestinal cancer are widely conducted and the coverage rate of these cancer screenings reach to 30%; 6) a total of about 30-40% of cancer incidence/deaths could be prevented if both of primary and secondary preventions are promoted extensively in Japan. It is considered necessary to improve these estimates after considering time factors in primary cancer prevention and biases inherent to cancer screening in secondary cancer prevention.

Diet, Sodium-Restricted↗
PubMed1987

'Avoidable mortality' from cervical cancer: exploring the concept.

The National Cancer Institute of the United States is encouraging research aimed at reducing 'avoidable mortality' from cancer. This article explores the meaning of the concept from a cancer-control perspective. Using cervical cancer as the focus of discussion, the author examines reference standards and social constraints that can help define the boundaries of avoidable mortality. The article considers the implications of voluntary participation in screening programs, the negative association between risk status and screening frequency, errors in collecting and interpreting Pap smears, improper and incomplete followup, and selected intervals for screening tests. To reach underscreened populations who are at high risk of cervical cancer, prevention strategists must create opportunities for intervention through innovative 'outreach' and 'inreach' programs. Inreach strategies exploit opportunities for cancer screening within the existing health-care process. Possibilities for reducing mortality from cervical cancer depend on more than the state of science. The likelihood of change is also a function of social priorities, social commitments, and the allocation of resources to social technologies that can effect change.

Adult↗
PubMed1991

Analysis of the role of cancer prevention and control measures in reducing cancer mortality.

One goal of the war against cancer is to create declines in cancer mortality rates. A decrease in these rates can only occur in two ways: 1) a decrease in incidence rates and 2) a real increase in overall survival rates. Reductions in incidence rates can be envisioned to occur through three mechanisms (in order of the time course of cancer): 1) reduction or amelioration of environmental or lifestyle risk factors, 2) use of agents that prevent the occurrence of cancer by blocking the progression to cancer, and 3) early detection at a preneoplastic state combined with treatment that prevents or delays progression to invasive cancer. "True" increases in overall survival can occur by two mechanisms (in order of the time course of cancer): 1) early detection of cancer by screening tests and subsequent effective treatment and 2) advancements in treatment. Unique patterns or "fingerprints" of stage-specific incidence and overall incidence and of survival rates characterize the various cancer prevention and control mechanisms that can decrease mortality rates. The rates are presented for five organ sites that have shown reduced cancer mortality. The patterns of rates for breast cancer for women under the age of 65 years were most consistent with early detection. The testicular cancer fingerprints were most consistent with advances in treatment, whereas cervical cancer rates were most consistent with the detection of preneoplastic lesions. The stomach cancer fingerprints were indicative of reductions in lifestyle or environmental risks, and colorectal cancer rates were indicative of a combination of treatment advances and early detection. These fingerprint patterns can be extended to other situations in which mortality trends are changing in order to suggest possible causes of observed changes. Limitations of this model are also discussed.

Female↗
PubMedDate not supplied

Cancer prevention counseling on telephone helplines.

Since 1983, the National Cancer Institute (NCI) has collected data by means of its Cancer Information Service (CIS), a toll-free telephone helpline for health care professionals and members of the public who have questions about cancer treatment, diagnosis, and prevention. These data reveal information about the characteristics of callers and their questions and about how inquiries reflect mass media promotions and secular trends. A request for a publication is the most common type of inquiry, followed by information about specific cancer sites, smoking prevention and cessation, other types of prevention, cancer treatment, cancer symptoms, referrals to physicians, NCI clinical trials, hospital and clinic-based screening programs, and general counseling or coping. Breast cancer is the most common cancer of interest, followed by respiratory system cancers, colon and prostate cancers, leukemia, melanoma, nonHodgkin's lymphoma, cervical cancer, general or unspecified skin cancer, and ovarian cancer. Responding to these other caller inquiries, CIS counselors may proactively guide callers to a desirable goal, such as screening mammography. Protocols have been developed to assist counselors' proactive efforts, and preliminary results are beginning to support this approach. The findings gathered in this study underscore the health education potential of telephone helplines and point to the need for controlled evaluation research on the effectiveness of proactive counselor advice.

Adult↗
PubMed1990

Screening for cervical cancer in emergency centers and sexually transmitted disease clinics.

Low-income women are at increased risk of developing cervical cancer compared with middle- and upper-income women. How can poor women be reached for screening and early diagnosis of cervical cancer and its precursor stages? One answer to this question is based on the observation that a high percentage of the unscreened population has received some form of medical care within the previous 5 years. Emergency centers and sexually transmitted disease (STD) clinics often provide such care to patients who lack a regular source of health care. Thus, they represent potential resources for cervical cancer screening. However, in a survey of 19 hospitals whose patient populations include a high proportion of low-income patients, only five reported a protocol for cervical cancer screening in their emergency centers. Similarly, all 11 STD clinics included in this survey reported that fewer than 5% of their female patients had a Papanicolaou smear taken even though virtually all of them received a pelvic examination. Based on these findings, it appears that health care administrators and policymakers could intensify their cancer prevention programs by mobilizing these resources for cancer control.

Community Health Centers↗
PubMed1990

[Hospital epidemiology--a comparative case control study of breast and cervical cancers].

To promote the comprehensive measure of cancer prevention for future, a hospital-based epidemiological study on a large scale has started at the Aichi Cancer Center Hospital. As the first step of this study by using a common questionnaire, a simultaneous case-control study on the two cancers involving 175 cases with breast cancer, 56 cases with cervical cancer and 231 controls was conducted in 1988. Body weight was positively related to breast cancer only in older (50-69) patients. Young age at first birth (less than or equal to 23) increased the risk of cervical cancer (OR = 4.1). Active and passive smoking increased the risk of cervical cancer (OR = 2.6, 2.3) but only passive smoking increased the risk of older breast cancer (OR = 2.0). Frequent intakes of green vegetables and carrot decreased the risk of younger (30-49) breast cancer (OR = 0.5, 0.5) and cervical cancer (OR = 0.3, 0.5). Some other factors with positive and negative effects on these two cancers were identified in this case-control analysis.

Breast Neoplasms↗
PubMed1990

Primary prevention of cancer: priorities for practical implementation and research.

In CMEA countries among all malignant neoplasms lung cancer ranks as a first both in incidence and mortality followed by stomach, breast and cervical cancer, lung and breast cancer being on increase, while stomach and cervical cancer have been decreasing. To the most important causes of cancer belong smoking, excessive alcohol consumption, certain occupational exposures, ambient-air pollution. Therefore, the priorities in cancer prevention and control in the CMEA countries should be directed towards complete removal or reduction in the exposure to these risk factors. Modification of diet, most probably, would reduce the frequency of some of the aforgoing cancers and first of all cancer of the stomach.

Air Pollution↗
PubMedDate not supplied

Development of a community cancer education program: the Forsyth County, NC cervical cancer prevention project.

The authors outline the development and implementation of a public health education program for cervical cancer screening among black women in Forsyth County, NC. The educational program includes distributing electronic and printed information media messages, a program of direct education for women, and providing information on current issues in cervical screening to primary-care physicians. Program development was based on social marketing principles, the PRECEDE model, and the communication-behavior change (CBC) model. Since a true experimental design was not feasible, program evaluation is based on several complementary quasi-experimental designs. Analysis of baseline data indicate that the county where the intervention is taking place, and the control county, are similar with respect to both demographic characteristics and the current level of screening activity. Preliminary results indicate that the program has been successful in raising women's level of awareness of cervical cancer and cervical screening.

Adult↗
PubMed1988

Screening: potential for cancer prevention.

Cancer screening is the application of a test in large numbers of asymptomatic persons for the early detection of cancer. The objective is to reduce deaths among the population screened. Prerequisites for implementation of cancer screening are sufficient knowledge of the biology of the cancer, an appropriate screening test, an effective intervention, either by removal or with curative treatment, and the decision that the costs are worth the benefits. At this time, screening asymptomatic women for early detection of cancers of the cervix using the Pap test and breast using mammography has the greatest potential for the control of these common cancers.

Breast Neoplasms↗