There have been many advancements in the prevention, diagnosis, and management of uterine cervical neoplasms. Larger studies are needed to determine whether surgery alone is an acceptable alternative strategy in localized disease.
In this pilot study we demonstrated that women enrolled into the cervical health program had significant improvements in their health status compared to the control group, and the scores on many of the scales were higher than those reported in the literature. Further research is needed to confirm our findings before implementing an intervention targeting low socio-economic groups in our setting.
Results from a recent clinical trial shows that women who have a biopsy of an endometrial lesion at an earlier age (40-49 years old) are more likely to have a high-grade endometrial carcinoma than women who were older (50-59 years old). A pilot study showed that these histologic criteria could be used to identify patients who might benefit from adjuvant therapy.
The cost of cervical screening programs should not be driven by economic considerations alone; instead, equity and social justice needs must be considered. The negative socio-economic consequences of cervical screening programs would need to be balanced against the positive benefits of screened participants being able to receive both early and regular care when needed (without waiting until they were sick enough to require treatment); and, if they are treated appropriately, have better outcomes.
Results from a recent paper of this study have shown no significant difference in the prevalence of a number of risk factors (age, nulliparity, BMI, smoking, alcohol, and sexual activity) between patients with and without pathology, and therefore, we conclude that uterine cervical neoplasm is not caused primarily by environmental factors.
A pelvic examination and endometrial biopsy should be performed in every woman with abnormal vaginal bleeding, regardless of age. In women without abnormal vaginal bleeding, examination of the cervix is recommended after completion of menopause.
Patients with uterine cervical neoplasms are at increased risk for distant metastases after initial diagnosis. Unlike other cancers where large-volume disease is associated with more distant metastases, in patients with uterine cervical neoplasms small-volume disease seems to be associated with an increased likelihood of systemic spread.
The 5-year survival rate for women diagnosed with stage I-III uterine cervical carcinoma was 80% (95% confidence interval, 69 to 87%) and 92% (95% confidence interval, 84 to 97%) for women diagnosed with stage IIIA1 and IIIA1 primary tumors, respectively. On the basis of this study, it appears that stage I, grade 1 carcinomas are more likely than stage III, grade 2 carcinomas to develop into myometrial invasion at time of diagnosis, whereas grade 3 carcinomas may be more likely to be associated with parametrial involvement.
The presence of endometrial polyps and adenomyosis in women with uterine cervical neoplasms increases the risk of developing dysplasia. Dysplastic lesions were found on the cervix in 28% of women with histologically proven cervical neoplasms. Women with adenomyosis showed an increased likelihood of dysplastic lesions (25%). Patients with endometrial polyps had a higher prevalence of dysplastic lesions than those without endometrial polyps (43% vs. 23%, p = 0.02). Patients with endometrial polyps tended to develop more severe dysplastic lesions than those with adenomyosis (67% vs. 56%, p = 0.51).
Based on the results of our study, we conclude that uterine cervical neoplasms are genetically heterogeneous. Further studies on large number of patients are needed to define the genetic background of uterine cervical neoplasms.
The HAHP was effective in improving HRQOL among women with UCA, particularly in terms of reduction in symptoms associated with cancer or treatment. Therefore, the HAHP should be considered an integral component of the multidisciplinary care of women with UCA.