Cervical Cancer In Young Women Research Articles

A retrospective study of 290 cases of cervical cancer in young women at Kobe City General Hospital

A retrospective study of 290 cases of cervical cancer in young women at Kobe City General Hospital

Cervical screening in 20–24-year olds

In 2003 the NHS Cervical Screening Programme in England changed the age at which women are first invited for cervical screening from 20 to 25 years. The aim of this review was to assess the evidence for benefit and harm of undertaking cervical screening in Wales for women aged 20-24 years. A literature review looking for evidence of the effectiveness and potential harmful effects of cervical screening was undertaken. Welsh data for the number of cases of high-grade cervical intraepithelial neoplasia (CIN3) were examined and rates of invasive cervical cancer (1981-2003) for young women calculated. The medical notes of women less than 25 years old diagnosed with cervical cancer were reviewed and a cost analysis was performed. The literature review failed to identify any randomized controlled studies of the effectiveness of cervical screening in young women, but demonstrated that organized screening programmes result in a decrease in the incidence of cervical carcinoma. Following the introduction of the Welsh organized call/recall cervical screening programme in 1988, cervical cancer has been reduced by 58% in women aged 20-24 years and 45% in women aged 25-29 years (mean age-specific rate per 100,000 women aged 20-24 years: 4.2 in 1981-88 compared with 2.2 in 1989-2003). If these changes can be attributed to the screening of women aged 20-24, then the costs of at least pound sterling 82,500 are estimated to prevent one cervical cancer in this age group. The incidence of cervical cancer in young women has halved since the introduction of the Welsh-organized call-recall cervical screening programme. In Wales we recommend that women continue to be invited for cervical screening from 20 years of age. This will provide the information required to compare the incidence and stage at diagnosis of cervical cancer in young women invited for first time cervical screening at different ages across the UK.

553 POSTER Increasing incidence trends of cervical cancer in young women in Tianjin, China 1981–2000

553 POSTER Increasing incidence trends of cervical cancer in young women in Tianjin, China 1981–2000

Abdominal wall metastasis of a cervical adenocarcinoma at the laparoscopic trocar insertion site after ovarian transposition: case report and review of the literature

Background Laparoscopic ovarian transposition is currently used in the preirradiation management of cervical cancer in young women. This surgical technique helps avoid the short- and long-term complications of early menopause. Because there remains a risk of metastasis at the site where the laparoscopic trocar is inserted, more precise indications for this surgery are required. Case We report the case of a patient with an abdominal wall metastasis that followed laparoscopic ovarian transposition performed before radiation therapy and surgical treatment for a stage IIb cervical adenocarcinoma. Observations during the laparotomy nonetheless led us to resect the transposed ovary during the laparotomy. The pathology examination of the ovary found a microscopic metastasis. Several months later, a left abdominal parietal nodule, corresponding to a metastasis of the adenocarcinoma, was found on the site through which the trocar had been inserted during the laparoscopy and was probably associated with the ovarian transposition. Conclusion This is the only published case to describe an abdominal wall metastasis due to laparoscopic trocar insertion during ovarian transposition. The decision to perform a laparoscopic ovarian transposition in cervical cancer must take into account the frequency of trocar site metastases, which seems to be higher with advanced-stage cervical cancers, in cases of lymph node involvement and especially in adenocarcinomas.

ADOLESCENT BEHAVIOR AND SEXUALLY TRANSMITTED DISEASES: THE DILEMMA OF HUMAN PAPILLOMAVIRUS

Adolescence is a period of physical, cognitive, psychosocial, and moral development that often results in risk-taking behavior. As a consequence, adolescents are at high risk for sexually transmitted disease (STD). Two of the most common STDs in the United States, chlamydia and human papillomavirus (HPV), affect millions of adolescent women. HPV, contrasted with chlamydia, poses a unique challenge to health care providers. In addition to causing genital warts, HPV has been shown to be the causative agent in the development of cervical cancer. Interventions that are effective in decreasing the transmission of chlamydia, such as increasing condom use, are less effective in prevention of HPV. Efforts to increase adolescent awareness of HPV, to increase age of first coitus, and to decrease numbers of sexual partners are more effective for HPV prevention. Early screening for HPV, smoking cessation, and health promotion may be effective in decreasing the incidence of cervical cancer in young women. Nurse practitioners and other primary health care providers need a more holistic approach to the prevention of HPV in adolescent women.

Chien-Tien Hsu Memorial Lecture. Fertility and gynaecologic malignancies.

Fertility and gynaecological malignancies have an important relationship. A clear inverse relationship exists between family size and the incidence of ovarian and endometrial cancer. Current methods of fertility control have an influence on subsequent development of various gynaecological malignancies. A slightly increased risk of breast cancer has been reported in current users and those who had used hormonal contraceptives (OCs) within 10 years; this risk declined with time and disappeared after 10 years. Women who started OC before age 20 had a higher relative risk; the disease did not spread beyond the breast in the majority. Most studies found OC to reduce the risk of ovarian and endometrial cancer. The relative risks of squamous cell carcinoma and adenomatous carcinoma of the cervix have been reported to be 1.3 and 1.5, respectively in ever-users of OCs; however, the aetiology of cervical cancer is multifactoral. Several reports suggest the beneficial effect of tubal ligation and breast feeding in reducing the risk of ovarian cancer. Therapy of gynaecological malignancies may have an influence on subsequent fertility. Amenorrhoea developing after treatment of hydatidiform mole may be due to choriocarcinoma, recurrent mole or a normal pregnancy. Choriocarcinoma can also develop after a partial mole. The risk of fetal teratogenicity from chemotherapy is present only if conception occurs during or immediately following the treatment cycles. Fertility is not impaired following chemotherapy. Successful pregnancies have occurred in women who have had widespread GTD including cerebral metastases. In the young patient with gynaecological malignancy preservation of fertility is possible. Fertility-sparing surgery may be safe in early ovarian epithelial cancers and even in advanced germ cell tumours. Recently, the fertility-sparing surgery of radical trachelectomy and pelvic lymphadenectomy has been carried out for early invasive cervical cancer in young women. Gynaecological cancer occurring in pregnancy is uncommon; it presents the clinician with a difficult situation to manage. In most instances the cancer is treated as though the patient is not pregnant; the timing and mode of delivery needs individualization. The overall prognosis for breast cancer complicating pregnancy is poor. Survival in cervical cancers diagnosed antepartum is similar to the non-pregnant patient. Ovarian cancer in pregnancy has a good prognosis because of the early stage at diagnosis.

Cervical cancer in older women: A molecular analysis of human papillomavirus types, HLA types, and p53 mutations

OBJECTIVE: The purpose of this study was to evaluate cervical cancers in older women to determine whether they differed from tumors in younger women with respect to human papillomavirus types, frequencies of p53 mutations, and presence of a proposed high-risk HLA-DR2 haplotype. STUDY DESIGN: Cervical tissue was obtained from women undergoing surgical treatment of in situ or invasive carcinoma of the cervix. Viral and genomic deoxyribonucleic acid was extracted. The presence of human papillomavirus deoxyribonucleic acid was detected by polymerase chain reaction amplification. Viral subtypes were assigned by means of a combination of type-specific amplification and automated sequencing of the L1 region. The presence of p53 mutations was evaluated by direct sequencing of exons 5 through 9. The HLA-DR locus was screened for the presence of the high-risk DRB1*1501 allele by means of selective polymerase chain reaction amplification followed by agarose gel electrophoresis of HLA-DR2 types. RESULTS: Tumors from 39 women 62 to 85 years old were analyzed. Tumors from 104 younger women formed a reference group. Human papillomavirus 16 was found in 41% and 54% and human papillomavirus 18 was found in 10% and 12% of the tissue samples from older and younger women, respectively. The overall distributions of human papillomavirus types did not differ statistically between the groups. One of the 25 older patients tested had a p53 mutation. This tumor also had a positive test result for human papillomavirus 18. The DR*1501 allele was present in 33% of the older patients and 28% of the younger patients. The expected frequency of this allele in white Americans is 19.8%. The increased frequency of this allele among both older and younger women with cervical cancer was statistically significant ( P < .05). CONCLUSIONS: We hypothesized that cervical cancer in older women might differ from that in younger women with respect to human papillomavirus types, natural host immunity, or the frequency of nonviral origins of the cancer. The findings show, however, that tumors from older women are extremely similar to those from younger women with respect to the human papillomavirus types present and the infrequent occurrence of p53 mutations. In addition we found that an HLA-DR allele that is associated with a risk of cervical cancer in younger women is also associated with risk in older women. These findings are most consistent with a model similar to that in younger women but with an unusually long latency for the transforming effect of the virus in some hosts. (Am J Obstet Gynecol 1998;179:56-61.)

Cervical Cancer in Young Women in Taiwan: Prognosis Is Independent of Papillomavirus or Tumor Cell Type

The objective of this study was to address the hypotheses that younger patients with cervical cancer have a uniquely worse clinical outcome and/or are more likely to have adverse tumor cell types or specific human papillomaviruses (HPV). Cases of stage Ib–IIa cervical cancer among women 35 years of age or younger (82) and over 35 (54) were analyzed and compared with respect to the following: (1) histologic type (squamous vs nonsquamous), (2) human papillomavirus (HPV) type via polymerase chain reaction, and (3) clinical parameters, including tumor size, nodal metastases, and recurrence/persistence. Patients 35 years of age or younger had a survival similar (71.2% vs 72.4%) to that of older women from the same institution. In the younger group, outcome was not correlated with the presence or absence of HPV or HPV type. Nonsquamous carcinomas, including adenocarcinoma and small cell carcinoma, were strongly associated with HPV18, were more prevalent in the younger group, and had a slightly higher risk of recurrence/persistence; however, these differences were not significant and 71% of the recurrences were squamous cell carcinomas. Thus, in young Taiwanese women with stage Ib–IIa cervical cancer, the majority of deaths cannot be attributed to a specific HPV type or unique tumor morphology.

Cervical cancer in young women: A poorer prognosis?

Objective: The existence of an aggressive form of cervical carcinoma affecting young women is studied by survival analysis of a large patient population. Method: Between 1969 and 1986, 1577 cases of cervical cancer were treated according to well-defined policies at the University Department of Obstetrics and Gynaecology in Debrecen, Hungary. Patients' records were reviewed to obtain data for survival analysis. Kaplan-Meier survival curves were generated for each stage and stratified for age. The log-rank test was used to compare the survival of younger and older patients at each stage. Multivariate analysis was performed to control for stage and treatment type when 5-year survival trends across four different age groups were examined. Results: Comparison of survival of patients under 35 and over 35 years of age, and also those under 40 and over 40 years of age revealed no significant differences. Five-year survival across the < 30, 30–39, 40–49 and ≥ 50 years age groups showed no significant trend. No differences in survival were revealed when the comparison was controlled for stage of disease and treatment type. Conclusion: Results suggest that cervical carcinoma in young women is not more aggressive than in other age groups.

Cervical cancer in young women in Northern Ireland: 1970–1985

From 1970 to 1985, 109 patients under 35 years of age developed invasive cervical cancer in Northern Ireland (NI). Information on incidence, staging, histology, primary treatment and survival was collected retrospectively and results compared with a community-based sample of all age groups from the West Midlands of England. Incidence increased in NI over the study period. Young patients presented with early stage disease, typical histology and had a stage for stage outcome similar to the all age groups. NI results do not demonstrate more aggressive disease in the under 35s.

Changing character of cervical cancer in young women

International Journal of Gynecology & ObstetricsVolume 30, Issue 1 p. 79-79 Citations from the literature oncology Changing character of cervical cancer in young women PM Elliott, PM ElliottSearch for more papers by this authorMHN Tattersall, MHN TattersallSearch for more papers by this authorM Coppleson, M CopplesonSearch for more papers by this authorP Russell, P RussellSearch for more papers by this authorF Wong, F WongSearch for more papers by this authorAS Coates, AS CoatesSearch for more papers by this authorHJ Solomon, HJ SolomonSearch for more papers by this authorPM Bannatyne, PM BannatyneSearch for more papers by this authorKH Atkinson, KH AtkinsonSearch for more papers by this authorJC Murray, JC MurraySearch for more papers by this author PM Elliott, PM ElliottSearch for more papers by this authorMHN Tattersall, MHN TattersallSearch for more papers by this authorM Coppleson, M CopplesonSearch for more papers by this authorP Russell, P RussellSearch for more papers by this authorF Wong, F WongSearch for more papers by this authorAS Coates, AS CoatesSearch for more papers by this authorHJ Solomon, HJ SolomonSearch for more papers by this authorPM Bannatyne, PM BannatyneSearch for more papers by this authorKH Atkinson, KH AtkinsonSearch for more papers by this authorJC Murray, JC MurraySearch for more papers by this author First published: September 1989 https://doi.org/10.1016/0020-7292(89)90230-0AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat No abstract is available for this article. Volume30, Issue1September 1989Pages 79-79 RelatedInformation

Changing character of cervical cancer in young women.

To examine the hypothesis that the pattern of cervical cancer is changing data on women presenting with the disease over 34 years were studied retrospectively. During 1953-86, 2628 women with cervical cancer were referred to a large tertiary referral hospital in Sydney; 418 were aged 35 or less. During the period of review the proportion of young women with the disease increased from under 9% in the 1950s and 1960s to about 25% in the 1970s and 1980s; a similar but less pronounced trend was apparent for the whole of New South Wales in the 1970s and 1980s. The prevalence of less common morphological types of cervical cancer increased throughout the period, particularly in the young. Pelvic lymph node metastases were identified in younger patients with stage Ib and IIa tumours more commonly in the later years of the study, suggesting that the disease was becoming more severe. Overall rates of recurrence improved over time, but an apparent increase in early recurrences was observed in young patients with Ib and IIa tumours and without nodal disease. The results suggest that the clinical and pathological behaviour of cervical cancer changed over the period of review.

Changing character of cervical cancer in young women.

Changing character of cervical cancer in young women.

Changing character of cervical cancer in young women.

To examine the hypothesis that the pattern of cervical cancer is changing data on women presenting with the disease over 34 years were studied retrospectively. During 1953-86, 2628 women with cervical cancer were referred to a large tertiary referral hospital in Sydney; 418 were aged 35 or less. During the period of review the proportion of young women with the disease increased from under 9% in the 1950s and 1960s to about 25% in the 1970s and 1980s; a similar but less pronounced trend was apparent for the whole of New South Wales in the 1970s and 1980s. The prevalence of less common morphological types of cervical cancer increased throughout the period, particularly in the young. Pelvic lymph node metastases were identified in younger patients with stage Ib and IIa tumours more commonly in the later years of the study, suggesting that the disease was becoming more severe. Overall rates of recurrence improved over time, but an apparent increase in early recurrences was observed in young patients with Ib and IIa tumours and without nodal disease. The results suggest that the clinical and pathological behaviour of cervical cancer changed over the period of review.

The increasing problem in Tayside of cervical cancer in younger women.

The incidence of cervical carcinoma in younger women is increasing in Tayside despite a decrease in the overall incidence. However, stage for stage, we did not encounter a poorer survival in younger patients. A number of patients had been sterilised or had a pregnancy when cytological screening was available and not made use of. There were also some false negative smears which were reclassified for retrospective analysis. We would recommend cervical screening every three years and careful inspection of the cervix and a smear taken in cases of abnormal gynaecological symptoms such as post coital bleeding.

Decreasing incidence of invasive cervical cancer in young women

Although the overall incidence of invasive cervical cancer is decreasing, there is concern that the disease might be increasing in younger women. Analysis of data from the Cancer Surveillance System, a population-based cancer registry in western Washington, shows a decreasing incidence of cervical cancer in women of all ages.

Invasive cervical cancer in young women.

Between 1970 and 1979, 103 women below 35 years of age with invasive cervical cancer were treated at the First Obstetrics and Gynaecology Clinic of the University of Milan. Nine patients were pregnant or less than 3 months postpartum. Estimated 10-year disease-free survival, determined by the life-table method, was 100% in stage IA (37 patients), 79% in stage IB (45 patients), 67% in stage II (15 patients), 0% in stages III (5 patients) and IV (1 patient). Prognosis was also strongly associated with lymph-node involvement, 10-year actuarial survival decreasing from 93% in lymph-node-negative to 44% in lymph-node-positive patients (P less than 0.001). The prognostic relevance of the clinical stage decreased after adjustment for lymph-node involvement, but the statistical significance of lymph-node involvement was unaffected when stage was allowed for. In the present series, the estimated 10-year disease-free survival was 80% in patients treated by radical hysterectomy compared with 62% in the group treated by total hysterectomy (stage IB to IV patients only); this difference, however, was not statistically significant when the data were adjusted for clinical stage (P = 0.10). None of the 20 patients with recurrent disease could be managed successfully.

Screening for Cervical Cancer in Young Women

Screening for Cervical Cancer in Young Women

Five-year cure rates of clinically occult and suspected uterine carcinomas; a community cancer detection program.

The effectiveness of a community program for the early detection of uterine cancer is evaluated on the basis of experience with 62,382 cytological examinations and 1,951 biopsies performed on 29,687 patients during a period of nine years. Data on the distribution of cancer according to site, on the frequency of false-positive and false-negative cytological findings, on age-incidence, and on five-year cure rates were obtained. In the case of patients with cervical carcinoma who qualified for five-year follow-up studies, out of 53 suspected lesions 43 were in the late invasive stage, while out of 22 occult lesions only 4 were late invasive. Among the 75 patients with either suspected or occult cervical carcinoma, there were no deaths when the carcinoma was in situ and only three patients with carcinoma of the early invasive type were either dead of cancer or living with evidence of cancer. Repeated routine cytological examinations of vaginal and cervical secretions result in detection of cervical cancer in younger women and at an earlier stage than if the patient permits a neoplasm to progress until symptoms lead to a suspicion of cancer. Early detection and proper treatment greatly improve the prognosis for the patient.