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Article ; Online: Commentary on "Cervical cancer screening in England: the past, present, and future": a comparison with Canada.

Duggan, Máire A

2012 Volume 120, Issue 2, Page(s) 97–101

Abstract: For cervical cancer screening to be most effective, all eligible women in the population must be enrolled in an organized program. In this issue, Albrow et al describe how cervical cancer screening in England migrated from "opportunistic" in the 1960s to ...

Abstract	For cervical cancer screening to be most effective, all eligible women in the population must be enrolled in an organized program. In this issue, Albrow et al describe how cervical cancer screening in England migrated from "opportunistic" in the 1960s to "organized" in the 1980s and discuss its continued evolution as new screening approaches and technologies developed. England's current National Health Services Cervical Screening Programme is the poster child for organized screening delivery. A similar model of central coordination and peripheral delivery of screening does not exist in Canada. The provision of health services is under provincial jurisdiction, and consequently each province administers its own version of a cervical cancer screening program. To date, organized screening has only been achieved in 2 of 10 provinces, and screening elsewhere is opportunistic. Screening in Canada begins at age 18-21, ends at age 69-70, and mostly occurs annually. This approach has yielded a significant reduction in cervical cancer incidence and mortality, but health service utilization costs have been high. The future should see full implementation of organized screening in all provinces, and when combined with the publicly funded human papillomavirus vaccination program of young girls begun in 2008, the result should be even better cancer control. Cancer (Cancer Cytopathol) 2012;. © 2011 American Cancer Society.
MeSH term(s)	Age Factors ; Canada/epidemiology ; Early Detection of Cancer/trends ; Early Detection of Cancer/utilization ; England/epidemiology ; Female ; Humans ; Uterine Cervical Neoplasms/diagnosis ; Uterine Cervical Neoplasms/epidemiology ; Uterine Cervical Neoplasms/prevention & control
Language	English
Publishing date	2012-04-25
Publishing country	United States
Document type	Comparative Study ; Editorial
ZDB-ID	2594979-2
ISSN	1934-6638 ; 1934-662X
ISSN (online)	1934-6638
ISSN	1934-662X
DOI	10.1002/cncy.20201
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Zs.A 6893: Show issues

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Article ; Online: Temporal changes in mammographic breast density and breast cancer risk among women with benign breast disease.

Mullooly, Maeve / Fan, Shaoqi / Pfeiffer, Ruth M / Bowles, Erin Aiello / Duggan, Máire A / Falk, Roni T / Richert-Boe, Kathryn / Glass, Andrew G / Kimes, Teresa M / Figueroa, Jonine D / Rohan, Thomas E / Abubakar, Mustapha / Gierach, Gretchen L

Breast cancer research : BCR

2024 Volume 26, Issue 1, Page(s) 52

Abstract: Introduction: Benign breast disease (BBD) and high mammographic breast density (MBD) are prevalent and independent risk factors for invasive breast cancer. It has been suggested that temporal changes in MBD may impact future invasive breast cancer risk, ...

Abstract	Introduction: Benign breast disease (BBD) and high mammographic breast density (MBD) are prevalent and independent risk factors for invasive breast cancer. It has been suggested that temporal changes in MBD may impact future invasive breast cancer risk, but this has not been studied among women with BBD. Methods: We undertook a nested case-control study within a cohort of 15,395 women with BBD in Kaiser Permanente Northwest (KPNW; 1970-2012, followed through mid-2015). Cases (n = 261) developed invasive breast cancer > 1 year after BBD diagnosis, whereas controls (n = 249) did not have breast cancer by the case diagnosis date. Cases and controls were individually matched on BBD diagnosis age and plan membership duration. Standardized %MBD change (per 2 years), categorized as stable/any increase (≥ 0%), minimal decrease of less than 5% or a decrease greater than or equal to 5%, was determined from baseline and follow-up mammograms. Associations between MBD change and breast cancer risk were examined using adjusted unconditional logistic regression. Results: Overall, 64.5% (n = 329) of BBD patients had non-proliferative and 35.5% (n = 181) had proliferative disease with/without atypia. Women with an MBD decrease (≤ - 5%) were less likely to develop breast cancer (Odds Ratio (OR) 0.64; 95% Confidence Interval (CI) 0.38, 1.07) compared with women with minimal decreases. Associations were stronger among women ≥ 50 years at BBD diagnosis (OR 0.48; 95% CI 0.25, 0.92) and with proliferative BBD (OR 0.32; 95% CI 0.11, 0.99). Discussion: Assessment of temporal MBD changes may inform risk monitoring among women with BBD, and strategies to actively reduce MBD may help decrease future breast cancer risk.
MeSH term(s)	Female ; Humans ; Breast Neoplasms/etiology ; Breast Density ; Breast Diseases/complications ; Case-Control Studies ; Risk Factors
Language	English
Publishing date	2024-03-26
Publishing country	England
Document type	Journal Article
ZDB-ID	2015059-3
ISSN	1465-542X ; 1465-5411
ISSN (online)	1465-542X
ISSN	1465-5411
DOI	10.1186/s13058-024-01764-2
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Zs.A 5494: Show issues

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Article ; Online: Host, reproductive, and lifestyle factors in relation to quantitative histologic metrics of the normal breast.

Abubakar, Mustapha / Klein, Alyssa / Fan, Shaoqi / Lawrence, Scott / Mutreja, Karun / Henry, Jill E / Pfeiffer, Ruth M / Duggan, Maire A / Gierach, Gretchen L

Breast cancer research : BCR

2023 Volume 25, Issue 1, Page(s) 97

Abstract: Background: Emerging data indicate that variations in quantitative epithelial and stromal tissue composition and their relative abundance in benign breast biopsies independently impact risk of future invasive breast cancer. To gain further insights into ...

Abstract	Background: Emerging data indicate that variations in quantitative epithelial and stromal tissue composition and their relative abundance in benign breast biopsies independently impact risk of future invasive breast cancer. To gain further insights into breast cancer etiopathogenesis, we investigated associations between epidemiological factors and quantitative tissue composition metrics of the normal breast. Methods: The study participants were 4108 healthy women ages 18-75 years who voluntarily donated breast tissue to the US-based Susan G. Komen Tissue Bank (KTB; 2008-2019). Using high-accuracy machine learning algorithms, we quantified the percentage of epithelial, stromal, adipose, and fibroglandular tissue, as well as the proportion of fibroglandular tissue that is epithelium relative to stroma (i.e., epithelium-to-stroma proportion, ESP) on digitized hematoxylin and eosin (H&E)-stained normal breast biopsy specimens. Data on epidemiological factors were obtained from participants using a detailed questionnaire administered at the time of tissue donation. Associations between epidemiological factors and square root transformed tissue metrics were investigated using multivariable linear regression models. Results: With increasing age, the amount of stromal, epithelial, and fibroglandular tissue declined and adipose tissue increased, while that of ESP demonstrated a bimodal pattern. Several epidemiological factors were associated with individual tissue composition metrics, impacting ESP as a result. Compared with premenopausal women, postmenopausal women had lower ESP [β (95% Confidence Interval (CI)) = -0.28 (- 0.43, - 0.13); P < 0.001] with ESP peaks at 30-40 years and 60-70 years among pre- and postmenopausal women, respectively. Pregnancy [β (95%CI) Conclusion: Our findings revealed that cumulative exposure to etiological factors over the lifespan impacts normal breast tissue composition metrics, individually or jointly, to alter their dynamic equilibrium, with potential implications for breast cancer susceptibility and tumor etiologic heterogeneity.
MeSH term(s)	Pregnancy ; Female ; Humans ; Breast Neoplasms/epidemiology ; Breast Neoplasms/etiology ; Breast Neoplasms/pathology ; Benchmarking ; Risk Factors ; Breast/pathology ; Obesity/pathology ; Life Style
Language	English
Publishing date	2023-08-15
Publishing country	England
Document type	Journal Article
ZDB-ID	2015059-3
ISSN	1465-542X ; 1465-5411
ISSN (online)	1465-542X
ISSN	1465-5411
DOI	10.1186/s13058-023-01692-7
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Zs.A 5494: Show issues

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Article ; Online: Associations Between Intraluminal Tumor Cell Involvement in Serially Examined Fallopian Tubes and Endometrial Carcinoma Characteristics and Outcomes.

Rodriquez, Monica / Felix, Ashley S / Brett, Mary Anne / Samimi, Goli / Duggan, Máire A

International journal of gynecological pathology : official journal of the International Society of Gynecological Pathologists

2021 Volume 41, Issue 5, Page(s) 520–529

Abstract: Approximately 12% of routinely examined fallopian tubes of endometrial carcinoma (EC) cases have intraluminal tumor cells (ILTCs). ILTC associations with EC characteristics and outcomes are understudied, and unknown in serially examined and embedded ... ...

Abstract	Approximately 12% of routinely examined fallopian tubes of endometrial carcinoma (EC) cases have intraluminal tumor cells (ILTCs). ILTC associations with EC characteristics and outcomes are understudied, and unknown in serially examined and embedded tubal fimbriae. Glass slides of serially examined and embedded tubal fimbriae for 371 EC cases were independently reviewed by 2 pathologists who recorded ILTC presence and characterized them as mucosal if involved and floating if not. Disagreements were reviewed by a third pathologist, and agreement between any 2 determined final ILTC status. Clinico-pathologic associations and ILTC presence were tested for significance ( P <0.05) by univariable analysis, and stage and histotype determinants were included in a multivariable analysis. The Kaplan-Meier estimates and log-rank tests compared overall and EC-specific survival, and Cox proportional regression estimated hazard ratios. ILTCs were present in 56 (15.1%) cases: 30 mucosal and 26 floating. FIGO stage 3/4, lymph-vascular space invasion, deep myometrial invasion, nonendometrioid histotype, and adjunctive chemotherapy were significantly associated with ILTC presence, and only stage was significant in the multivariable analysis. Overall, 61 women died: 30 of whom died of EC. ILTCs were nonsignificantly associated with higher overall and EC-specific mortality and mucosal ILTCs had the highest hazard ratios (1.64 and 1.89, respectively). Serially examined and embedded tubal fimbriae have a higher prevalence of ILTCs than routinely examined tubes, and high FIGO stage is an independent determinant. A prognostic effect was not found, but the higher trending hazard ratios suggest additional study is needed to determine whether ILTCs and in particular mucosal ILTCs adversely affect prognosis.
MeSH term(s)	Endometrial Neoplasms/pathology ; Fallopian Tubes/pathology ; Female ; Humans ; Neoplasm Staging ; Pelvis/pathology ; Prognosis
Language	English
Publishing date	2021-08-11
Publishing country	United States
Document type	Journal Article
ZDB-ID	604859-6
ISSN	1538-7151 ; 0277-1691
ISSN (online)	1538-7151
ISSN	0277-1691
DOI	10.1097/PGP.0000000000000819
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Zs.A 1814: Show issues

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Article ; Online: Napsin A: Another milestone in the subclassification of ovarian carcinoma.

Köbel, Martin / Duggan, Máire A

American journal of clinical pathology

2014 Volume 142, Issue 6, Page(s) 735–737

MeSH term(s)	Adenocarcinoma, Clear Cell/diagnosis ; Aspartic Acid Endopeptidases/biosynthesis ; Biomarkers, Tumor/analysis ; Female ; Humans ; Ovarian Neoplasms/diagnosis
Chemical Substances	Biomarkers, Tumor ; Aspartic Acid Endopeptidases (EC 3.4.23.-) ; NAPSA protein, human (EC 3.4.23.-)
Language	English
Publishing date	2014-12
Publishing country	England
Document type	Comment ; Editorial
ZDB-ID	2944-0
ISSN	1943-7722 ; 0002-9173
ISSN (online)	1943-7722
ISSN	0002-9173
DOI	10.1309/AJCPAVGZKA1A1HVC
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Ud II Zs.91: Show issues

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Article ; Online: Testing Algorithms for the Diagnosis of Malignant Glandular Tumors of the Uterine Cervix Histotyped per the International Endocervical Adenocarcinoma Criteria and Classification (IECC) System.

Duggan, Máire A / Duan, Qiuli / Pfeiffer, Ruth M / Brett, Mary Anne / Lee, Sandra / Abubakar, Mustapha / Köbel, Martin / Rodriguez, Monica / Sar, Aylin

Applied immunohistochemistry & molecular morphology : AIMM

2021 Volume 30, Issue 2, Page(s) 91–98

Abstract: The International Endocervical adenocarcinoma Criteria and Classification (IECC) categorizes tumors into human papilloma virus (HPV) associated (HPVA), not associated (NHPV), and invasive adenocarcinoma not otherwise specified (IA NOS). HPVA and NHPV ... ...

Abstract	The International Endocervical adenocarcinoma Criteria and Classification (IECC) categorizes tumors into human papilloma virus (HPV) associated (HPVA), not associated (NHPV), and invasive adenocarcinoma not otherwise specified (IA NOS). HPVA and NHPV encompass 11 histotypes and an algorithm of mucin content, HPV ribonucleic acid (RNA), estrogen receptor and GATA3 is proposed for the diagnosis of most. In this study, the IECC algorithm's diagnoses were compared with hematoxylin and eosin (H&E) based IECC histotyping. Kappa statistics measured performance agreement. With additional markers, hierarchical clustering by random forest (RF) classification identified the most discriminating between tumor types, and investigated other algorithms. Three pathologists independently reviewed digitized H&E images of n=152 primary cervical adenocarcinomas for IECC histotype and mucin content, and tissue microarrays for expression of HPV RNA by in situ hybridization and 16 antibodies by immunohistochemistry. Results were finalized by consensus. There were n=113 HPVA, n=22 NHPV, and n=17 IA NOS. Mucin was obvious in n=36 and limited in n=116. Among n=124 with satisfactory test results, HPV RNA was positive in n=96, estrogen receptor in n=72, and GATA3 in n=15. The IECC algorithm diagnosed n=99 which agreed with H&E histotyping in n=64 for a fair κ of 0.36 (95% confidence interval, 0.21-0.50): n=12 were undiagnosed and n=13 were IA NOS. Small sample sizes restricted RF to HPVA versus NHPV which were discriminated by p16, HPV RNA, and MUC6 with an area under the curve of 0.74 (95% confidence interval, 0.58-0.90). The IECC algorithm for histotyping under-performed. The RF algorithmin for categorization was favorable, but validation in larger studies and investigation of additional algorithms to discriminate between all IECC histotypes are needed.
MeSH term(s)	Adenocarcinoma/diagnosis ; Adenocarcinoma/pathology ; Algorithms ; Alphapapillomavirus/genetics ; Biomarkers, Tumor ; Carcinoma ; Cervix Uteri/pathology ; Female ; Humans ; Mucins ; Papillomaviridae/genetics ; Papillomavirus Infections/diagnosis ; RNA ; Receptors, Estrogen ; Uterine Cervical Neoplasms/pathology
Chemical Substances	Biomarkers, Tumor ; Mucins ; Receptors, Estrogen ; RNA (63231-63-0)
Language	English
Publishing date	2021-11-15
Publishing country	United States
Document type	Journal Article
ZDB-ID	1473273-7
ISSN	1533-4058 ; 1062-3345 ; 1541-2016
ISSN (online)	1533-4058
ISSN	1062-3345 ; 1541-2016
DOI	10.1097/PAI.0000000000000988
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Zs.A 3783: Show issues

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Article ; Online: Loss of ARID1B and SMARCB1 expression are specific for the diagnosis of dedifferentiated/undifferentiated carcinoma in tumours of the upper gynaecological tract and cervix.

Kang, Eun-Young / Tessier-Cloutier, Basile / Duggan, Máire A / Stewart, Colin J R / Lee, Cheng-Han / Köbel, Martin

Histopathology

2021 Volume 79, Issue 2, Page(s) 160–167

Abstract: Aims: Genomic inactivation of ARID1B in ARID1A-inactivated tumour and genomic inactivation of SMARCB1 represent two recurrent mechanisms, core SWItch/sucrose non-fermentable (SWI/SNF) complex inactivation, that are associated with de-differentiation in ... ...

Abstract	Aims: Genomic inactivation of ARID1B in ARID1A-inactivated tumour and genomic inactivation of SMARCB1 represent two recurrent mechanisms, core SWItch/sucrose non-fermentable (SWI/SNF) complex inactivation, that are associated with de-differentiation in endometrial carcinoma. Approximately one-third of dedifferentiated/undifferentiated endometrial carcinomas (DDEC/UEC) show loss of ARID1B expression with a minor subset showing loss of SMARCB1 expression, but little is known regarding the specificity of ARID1B or SMARCB1 loss in gynaecological tract tumours in general. The aim of this study was to examine the frequency of ARID1B and SMARCB1 loss by immunohistochemistry in a series of gynaecological tract epithelial/mesenchymal neoplasms. Methods and results: We evaluated 1849 tumours that included 748 endometrial carcinomas, 101 uterine carcinosarcomas/adenosarcomas, 64 uterine sarcomas, 221 cervical carcinomas and 715 ovarian carcinomas/borderline tumours by tissue microarrays (TMA). We observed ARID1B loss in 35 of 86 (41%) and SMARCB1 loss in three of 86 (3%) DDEC/UEC, but not in any other uterine tumour types examined. ARID1B-deficient DDEC/UEC also showed concurrent loss of ARID1A expression. All SMARCB1-deficient tumours showed loss of MLH1 and PMS2, while 29 of 35 ARID1B-deficient tumours showed loss of MLH1 and PMS2 or loss of MSH6. All ovarian carcinomas/borderline tumours and cervical carcinomas showed intact expression of ARID1B and SMARCB1. Conclusion: Our findings indicate that the loss of expression of ARID1B or SMARCB1 by immunohistochemistry is highly specific for undifferentiated carcinoma among tumours of the upper gynaecological tract and cervix, and therefore can be used to identify these highly aggressive malignant tumours.
MeSH term(s)	Biomarkers, Tumor/metabolism ; Carcinoma/diagnosis ; Carcinoma/metabolism ; Carcinoma/pathology ; Cell Dedifferentiation/genetics ; Cohort Studies ; DNA-Binding Proteins/deficiency ; DNA-Binding Proteins/genetics ; DNA-Binding Proteins/metabolism ; Female ; Genital Neoplasms, Female/diagnosis ; Genital Neoplasms, Female/genetics ; Genital Neoplasms, Female/metabolism ; Genital Neoplasms, Female/pathology ; Humans ; Immunohistochemistry ; SMARCB1 Protein/deficiency ; SMARCB1 Protein/genetics ; SMARCB1 Protein/metabolism ; Sarcoma/diagnosis ; Sarcoma/metabolism ; Sarcoma/pathology ; Transcription Factors/deficiency ; Transcription Factors/genetics ; Transcription Factors/metabolism ; Uterine Cervical Neoplasms/diagnosis ; Uterine Cervical Neoplasms/metabolism ; Uterine Cervical Neoplasms/pathology
Chemical Substances	ARID1A protein, human ; ARID1B protein, human ; Biomarkers, Tumor ; DNA-Binding Proteins ; SMARCB1 Protein ; SMARCB1 protein, human ; Transcription Factors
Language	English
Publishing date	2021-06-02
Publishing country	England
Document type	Journal Article
ZDB-ID	131914-0
ISSN	1365-2559 ; 0309-0167
ISSN (online)	1365-2559
ISSN	0309-0167
DOI	10.1111/his.14333
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Zs.A 1328: Show issues

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Article ; Online: Intraluminal tumor cells and prognostic accuracy of endometrial cancer stage criteria: A multi-institution study.

Felix, Ashley S / Sinnott, Jennifer A / Cohn, David E / Duggan, Máire A / Havrilesky, Laura J / Olawaiye, Alexander B / Mariani, Andrea / Rodriquez, Monica / Brett, Mary Anne / Dinoi, Giorgia / Meade, Caitlin E / Hall, Bobbie / Goldfeld, Ester / Elishaev, Esther / Sherman, Mark E / Suarez, Adrian A

Gynecologic oncology

2023 Volume 178, Page(s) 130–137

Abstract: Objective: Endometrial cancer stage is a strong prognostic factor; however, the current stage classification does not incorporate transtubal spread as determined by intraluminal tumor cells (ILTCs). We examined relationships between ILTCs and survival ... ...

Abstract	Objective: Endometrial cancer stage is a strong prognostic factor; however, the current stage classification does not incorporate transtubal spread as determined by intraluminal tumor cells (ILTCs). We examined relationships between ILTCs and survival outcomes according to histological subtype and stage and examined whether identification of ILTCs improves prognostic accuracy of endometrial cancer staging. Methods: We conducted a retrospective cohort study of women diagnosed with endometrial cancer at five academic hospitals between 2007 and 2012. Pathologists determined ILTC presence (no vs. yes) and location (free in lumen vs. attached to epithelial surface) based on pathology review of hematoxylin and eosin-stained sections of fallopian tubes. Associations between ILTCs with time to recurrence (TTR) and overall survival (OS) were examined with Cox proportional hazards models adjusted for other prognostic factors. Model discrimination metrics were used to assess the addition of ILTCs to stage for prediction of 5-year TTR and OS. Results: In the overall study population (N = 1303), ILTCs were not independently associated with TTR (HR = 0.95, 95% CI = 0.69-1.32) or OS (HR = 0.97, 95% CI = 0.72-1.31). Among 805 women with stage I disease, ILTCs were independently associated with worse TTR (HR = 2.31, 95% CI = 1.06-5.05) and OS (HR = 2.16, 95% CI = 1.14-4.11). Upstaging early-stage cases with ILTCs present did not increase model discrimination. Conclusion: While our data do not suggest that endometrial cancer staging guidelines should be revised to include ILTCs, associations between ILTCs and reduced survival observed among stage I cases suggest this tumor feature holds clinical relevance for subgroups of endometrial cancer patients.
MeSH term(s)	Humans ; Female ; Prognosis ; Retrospective Studies ; Neoplasm Staging ; Endometrial Neoplasms/pathology ; Fallopian Tubes/pathology
Language	English
Publishing date	2023-10-19
Publishing country	United States
Document type	Journal Article
ZDB-ID	801461-9
ISSN	1095-6859 ; 0090-8258
ISSN (online)	1095-6859
ISSN	0090-8258
DOI	10.1016/j.ygyno.2023.10.004
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Zs.A 885: Show issues

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Article: Universal Testing to Identify Lynch Syndrome Among Women With Newly Diagnosed Endometrial Carcinoma.

Cameron, Anna / Chiarella-Redfern, Helene / Chu, Pamela / Perrier, Renee / Duggan, Máire A

Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstetrique et gynecologie du Canada : JOGC

2019 Volume 42, Issue 2, Page(s) 137–143

Abstract: Background: Lynch syndrome (LS) is an autosomal dominant cancer syndrome caused by a germline mutation in the mismatch repair (MMR) genes. Protocols based on immunohistochemical expression of MMR proteins in cancer are used to identify patients with LS.! ...

Abstract	Background: Lynch syndrome (LS) is an autosomal dominant cancer syndrome caused by a germline mutation in the mismatch repair (MMR) genes. Protocols based on immunohistochemical expression of MMR proteins in cancer are used to identify patients with LS. Methods: The universal LS screening protocol of the Tom Baker Cancer Centre (Calgary, AB) of all patients diagnosed between April 1, 2013 and April 1, 2015 with endometrioid carcinoma of the endometrium was audited through a retrospective chart review. LS status and frequency of protocol compliance at each of the key steps were calculated (Canadian Task Force Classification II-2). Results: The cohort consisted of 375 patients. MMR immunohistochemical testing was requested for 321 (85.6%). Expression of at least one protein was lost in 86 (26.8%). Twenty-one (6.5%) patients were eligible for genetic counselling because PMS2, MSH2, or MSH6 protein expression was lost in 19, and two patients had a family history of LS. Eleven (91.7%) of 12 (57.1%) who attended had germline testing, and six (54.5%) showed a mutation diagnostic of LS. LS status among the cohort of 375 patients was positive in six (1.6%), negative in 294 (78.4%), and unknown in 75 (20%) because of protocol non-compliance. LS was confirmed in six (2%) of the 321 women who completed the protocol. Conclusion: This is the first audit of a Canadian-based universal LS screening protocol of patients with endometrial cancer. The success of the protocol is endorsed by the 80% compliance and by the 2% prevalence of LS, which is within the published range.
MeSH term(s)	Adult ; Canada/epidemiology ; Cohort Studies ; Colorectal Neoplasms, Hereditary Nonpolyposis/complications ; Colorectal Neoplasms, Hereditary Nonpolyposis/diagnosis ; Colorectal Neoplasms, Hereditary Nonpolyposis/epidemiology ; Colorectal Neoplasms, Hereditary Nonpolyposis/genetics ; Endometrial Neoplasms/complications ; Female ; Genetic Counseling ; Genetic Predisposition to Disease ; Genetic Testing ; Guideline Adherence ; Humans ; Medical Audit ; Middle Aged ; Practice Guidelines as Topic ; Prevalence ; Retrospective Studies
Language	English
Publishing date	2019-11-01
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	2171082-X
ISSN	1701-2163
ISSN	1701-2163
DOI	10.1016/j.jogc.2019.06.018
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Zs.A 6445: Show issues

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Article ; Online: An audit of the cervical cancer screening histories of 246 women with carcinoma.

Duggan, Máire A / Nation, Jill

Journal of lower genital tract disease

2012 Volume 16, Issue 3, Page(s) 263–270

Abstract: Objective: Women with cervical carcinoma and residing in the Calgary Health Region between 1996 and 2001 were audited to characterize factors in the opportunistic cervical cancer screening pathway contributing to screening failures.: Materials and ... ...

Abstract	Objective: Women with cervical carcinoma and residing in the Calgary Health Region between 1996 and 2001 were audited to characterize factors in the opportunistic cervical cancer screening pathway contributing to screening failures. Materials and methods: The cohort consisted of 246 women. Information on their Pap tests and colposcopic/gynecologic examinations was obtained from the files of Calgary Laboratory Services and their colposcopic/cancer center treatment charts. Screening failure factors were defined, and frequencies were calculated. Results: Screening failure factors were as follows: (1) 41 (16.7%) were not screened, that is, no Pap test screening; (2) 29 (11.8%) were underscreened, that is, no Pap test within 12 months of diagnosis; (3) 28 (13.7%) were undersampled, that is, the Pap test result was negative; (4) 34 (13.8%) had no referral for a colposcopy/gynecology examination, and/or it was delayed for more than 3 months; (5) 18 (13.2%) had delayed referral for examination of an atypical glandular cell-high-grade squamous intraepithelial lesion and higher Pap test for more than 3 months; and (6) 73 (55.3%) were underdiagnosed, that is, the diagnosis in colposcopy examination was less than malignant. Underreported Pap tests and delayed Pap test reporting could not be fully investigated, but limited evidence suggested that underreporting contributed to some failures. Conclusions: Factors other than recruitment to cytological screening need targeted improvement if the region's cervical cancer prevention program is to be more effective.
MeSH term(s)	Adult ; Aged ; Alberta ; Benchmarking ; Cohort Studies ; Colposcopy/standards ; Colposcopy/trends ; Confidence Intervals ; Cytodiagnosis/standards ; Cytodiagnosis/trends ; Databases, Factual ; Early Detection of Cancer/standards ; Early Detection of Cancer/trends ; Female ; Gynecological Examination/standards ; Gynecological Examination/trends ; Health Knowledge, Attitudes, Practice ; Humans ; Mass Screening/standards ; Mass Screening/trends ; Medical Audit ; Middle Aged ; Needs Assessment ; Patient Compliance/statistics & numerical data ; Retrospective Studies ; Risk Assessment ; Sensitivity and Specificity ; Time Factors ; Uterine Cervical Dysplasia/pathology ; Uterine Cervical Dysplasia/prevention & control ; Uterine Cervical Neoplasms/pathology ; Uterine Cervical Neoplasms/prevention & control ; Vaginal Smears/standards ; Vaginal Smears/trends
Language	English
Publishing date	2012-07
Publishing country	United States
Document type	Comparative Study ; Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2041332-4
ISSN	1526-0976 ; 1089-2591
ISSN (online)	1526-0976
ISSN	1089-2591
DOI	10.1097/LGT.0b013e31823da811
Database	MEDical Literature Analysis and Retrieval System OnLINE

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