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  1. Article ; Online: Comment on "Management of small (T1-T2) anal margin squamous cell carcinoma: clinical outcomes following local excision alone".

    Cuming, Tamzin / Nathan, Mayura

    Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland

    2023  Volume 25, Issue 9, Page(s) 1929

    MeSH term(s) Humans ; Anus Neoplasms/surgery ; Anus Neoplasms/pathology ; Neoplasm Staging ; Digestive System Surgical Procedures ; Carcinoma, Squamous Cell/surgery ; Carcinoma, Squamous Cell/pathology
    Language English
    Publishing date 2023-07-05
    Publishing country England
    Document type Journal Article ; Comment
    ZDB-ID 1440017-0
    ISSN 1463-1318 ; 1462-8910
    ISSN (online) 1463-1318
    ISSN 1462-8910
    DOI 10.1111/codi.16655
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Zs.A 5799: Show issues Location:
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  2. Article ; Online: Spontaneous rectouterine fistula in a posterior wall fibroid.

    Reilly, Suzanne / Nyarko, Eric / Cuming, Tamzin

    Journal of obstetrics and gynaecology : the journal of the Institute of Obstetrics and Gynaecology

    2020  Volume 41, Issue 3, Page(s) 487–488

    MeSH term(s) Female ; Humans ; Leiomyoma/complications ; Leiomyoma/pathology ; Medical Illustration ; Middle Aged ; Rectal Fistula/etiology ; Rectal Fistula/pathology ; Uterine Diseases/etiology ; Uterine Diseases/pathology ; Uterine Neoplasms/complications ; Uterine Neoplasms/pathology ; Uterus/pathology
    Language English
    Publishing date 2020-02-08
    Publishing country England
    Document type Case Reports ; Journal Article
    ZDB-ID 604639-3
    ISSN 1364-6893 ; 0144-3615
    ISSN (online) 1364-6893
    ISSN 0144-3615
    DOI 10.1080/01443615.2019.1706463
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  3. Article ; Online: Author response to: Comment on: Sexual harassment, sexual assault and rape by colleagues in the surgical workforce, and how women and men are living different realities: observational study using NHS population-derived weights.

    Begeny, Christopher T / Arshad, Homa / Cuming, Tamzin / Dhariwal, Daljit K / Fisher, Rebecca A / Franklin, Marieta D / Jackson, Philippa C / McLachlan, Greta M / Searle, Rosalind H / Newlands, Carrie

    The British journal of surgery

    2024  Volume 111, Issue 1

    Language English
    Publishing date 2024-01-19
    Publishing country England
    Document type Observational Study ; Journal Article
    ZDB-ID 2985-3
    ISSN 1365-2168 ; 0263-1202 ; 0007-1323 ; 1355-7688
    ISSN (online) 1365-2168
    ISSN 0263-1202 ; 0007-1323 ; 1355-7688
    DOI 10.1093/bjs/znad441
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  4. Article ; Online: Re: 'Outcomes following local excision of early anal squamous cell carcinomas of the anal canal and perianal margin'.

    Cuming, Tamzin / Cappello, Carmelina / Bowring, Julie / Chindawi, Noreen / Rosenthal, Adam / Nathan, Mayura

    Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland

    2021  Volume 23, Issue 5, Page(s) 1268–1269

    MeSH term(s) Anal Canal/surgery ; Anus Diseases ; Anus Neoplasms/surgery ; Carcinoma, Squamous Cell/surgery ; Humans ; Perineum
    Language English
    Publishing date 2021-02-15
    Publishing country England
    Document type Letter ; Comment
    ZDB-ID 1440017-0
    ISSN 1463-1318 ; 1462-8910
    ISSN (online) 1463-1318
    ISSN 1462-8910
    DOI 10.1111/codi.15558
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  5. Article ; Online: The Authors Reply.

    Cuming, Tamzin / Cappello, Carmelina / Bowring, Julie / Rosenthal, Adam N / Chindawi, Noreen / Nathan, Mayura

    Diseases of the colon and rectum

    2021  Volume 64, Issue 6, Page(s) e379

    Language English
    Publishing date 2021-04-02
    Publishing country United States
    Document type Letter ; Comment
    ZDB-ID 212581-x
    ISSN 1530-0358 ; 0012-3706
    ISSN (online) 1530-0358
    ISSN 0012-3706
    DOI 10.1097/DCR.0000000000002080
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: High-Resolution Anoscopy Surveillance After Anal Squamous Cell Carcinoma: High-Grade Squamous Intraepithelial Lesion Detection and Treatment May Influence Local Recurrence.

    Cappello, Carmelina / Cuming, Tamzin / Bowring, Julie / Rosenthal, Adam N / Chindawi, Noreen / Nathan, Mayura

    Diseases of the colon and rectum

    2020  Volume 63, Issue 10, Page(s) 1363–1371

    Abstract: Background: Local recurrence is a significant risk after anal squamous cell carcinoma.: Objectives: This study aimed to examine the occurrence of high-grade squamous intraepithelial lesions and local recurrence after anal cancer at surveillance with ... ...

    Abstract Background: Local recurrence is a significant risk after anal squamous cell carcinoma.
    Objectives: This study aimed to examine the occurrence of high-grade squamous intraepithelial lesions and local recurrence after anal cancer at surveillance with high-resolution anoscopy.
    Design: This is a retrospective observational study.
    Setting: This study was conducted at an anogenital neoplasia referral center.
    Patients: There were 76 anal/perianal cancers from 1998 to 2018. Sixty-three patients were eligible and 3 were excluded, for a total of 60 patients; 35 of 60 (58%) patients were male.
    Intervention: High-resolution anoscopy after chemoradiation or excision only for anal squamous cell carcinoma was performed.
    Main outcome measures: The primary outcomes measured were local recurrence and high-grade squamous intraepithelial lesion detection rates.
    Results: Sixty patients, 27% HIV positive, underwent surveillance over a median 42 (range 7-240) months of follow-up. Seven had had a prior local recurrence at study entry so were analyzed separately. Thirty of 53 underwent chemoradiation (57%) and 23 of 53 underwent excision alone (43%); 33 had perianal cancer and 20 had anal cancer. Ten of 30 of the chemoradiation group had had stage 1 (33%) disease in comparison with 22 of 23 of the excision only group (96%, p < 0.001).
    Outcomes: High-grade squamous intraepithelial lesions were detected in 4 of 30 (13%) patients after chemoradiation and in 17 of 23 (74%) patients after excision only (p < 0.001). Twenty of 21 (95%) high-grade lesions were treated with ablation. Six of 7 (86%) patients with prior local recurrence had high-grade squamous intraepithelial lesions over a median of 21 months follow-up. One local recurrence (T1N0M0) occurred during surveillance after primary chemoradiation (0.56/1000 person-months), none occurred after excision only, and 2 of 7 with prior local recurrence developed further local recurrence (6.86/1000 person-months). All 3 local recurrences occurred after treatment of high-grade squamous intraepithelial lesions. There were no metastases, abdominoperineal excisions, or deaths from anal squamous cell carcinoma.
    Limitations: Retrospective data were used for this study.
    Conclusions: High-grade squamous intraepithelial lesions after anal squamous cell carcinoma are more common after excision only than after chemoradiation. Local recurrence is low in this high-resolution anoscopy surveillance group in which high-grade squamous intraepithelial disease was ablated. Excision of small perianal cancers appears safe; however, a subset of patients is at excess risk. See Video Abstract at http://links.lww.com/DCR/B285. VIGILANCIA POR ANOSCOPÍA DE ALTA RESOLUCIÓN EN CASOS DE CARCINOMA ANAL A CÉLULAS ESCAMOSAS: LA DETECCIÓN Y TRATAMIENTO DE UNA LESIÓN INTRAEPITELIAL ESCAMOSA DE ALTO GRADO (HSIL) PUEDE INFLUIR EN LA RECURRENCIA LOCAL: La recurrencia local tiene un riesgo significativo después del carcinoma anal a células escamosas.Evaluar la aparición de lesiones intraepiteliales escamosas de alto grado (HSIL) y su recurrencia local durante la vigilancia con anoscopía de alta resolución en casos de cancer anal.Estudio observacional retrospectivo.Centro de referencia de neoplasia anogenital.Se diagnosticaron 76 cánceres anales / perianales entre 1998 y 2018. Un total de 63 pacientes fueron elegidos, 3 excluidos (n = 60), 35/60 (58%) fueron varones.Anoscopía de alta resolución después de la quimio-radioterapia, o solo excisión en casos de carcinoma anal a células escamosas.Recurrencia local primaria y tasas de detección de lesión intraepitelial escamosa de alto grado.Sesenta pacientes, 27% VIH positivos, fueron sometidos a vigilancia durante una mediana de 42 (rango 7-240) meses de seguimiento. Siete habían tenido una recurrencia local antes de ser incluidos en el estudio, por lo que se analizaron por separado. Treinta de 53 se sometieron a quimio-radioterapia (57%) y 23/53 solo a excisión (43%). 33 eran lesiones perianales, 20 de canal anal. 10/30 del grupo de quimio-radioterpia se encontraban en Fase 1 (33%) comparados con 22/23 del grupo de excisión (96%, p <0.001).Se detectaron lesiones intraepiteliales escamosas de alto grado en 4/30 (13%) después de la quimio-radioterapia, y en 17/23 (74%) solo después de la excisión (p < 0.001). 20/21 (95%) lesiones de alto grado fueron tratadas con ablación. Seis de siete (86%) con recurrencia local previa tenían lesiones intraepiteliales escamosas de alto grado durante una mediana de seguimiento de 21 meses. Se produjo una recurrencia local (T1N0M0) durante la vigilancia después de la quimio-radioterapia primaria (0.56/1000 persona-meses), ninguna después de la excisión sola y 2/7 con recurrencia local previa desarrollaron una recurrencia local adicional (6.86/1000 persona-meses). Las 3 recidivas locales ocurrieron después del tratamiento de las lesiones intraepiteliales escamosas de alto grado. No hubieron metástasis, excisiones abdominoperineales o muertes por carcinoma anal a células escamosas.Datos retrospectivos.Las lesiones intraepiteliales escamosas de alto grado en casos de carcinoma escamocelular anal son más comunes después de la excisión sola que después de la quimio-radioterapia. La recurrencia local es baja en este grupo de vigilancia de anoscopía de alta resolución en el que se retiró la enfermedad intraepitelial escamosa de alto grado. La excisión de pequeños cánceres perianales parece segura; sin embargo, un subconjunto de pacientes tiene un riesgo excesivo. Consulte Video Resumen en http://links.lww.com/DCR/B285. (Traducción-Dr. Xavier Delgadillo).
    MeSH term(s) Adult ; Aged ; Anus Neoplasms/pathology ; Anus Neoplasms/therapy ; Carcinoma, Squamous Cell/pathology ; Carcinoma, Squamous Cell/therapy ; Female ; HIV Seropositivity ; Humans ; Male ; Middle Aged ; Neoplasm Recurrence, Local/diagnosis ; Neoplasm Staging ; Proctoscopy ; Retrospective Studies ; Squamous Intraepithelial Lesions/diagnosis
    Language English
    Publishing date 2020-09-23
    Publishing country United States
    Document type Journal Article ; Observational Study ; Research Support, Non-U.S. Gov't
    ZDB-ID 212581-x
    ISSN 1530-0358 ; 0012-3706
    ISSN (online) 1530-0358
    ISSN 0012-3706
    DOI 10.1097/DCR.0000000000001750
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  7. Article ; Online: Bridging that gap: a qualitative study of perceptions of equality, diversity and inclusivity in colorectal surgery in the UK and Ireland.

    Harji, Deena / Sarmah, Panchali / Gwyther, Bethany / Lyons, M K / Boereboom, Catherine Louise / Siddiqi, S / Arnott, R / Harikrishnan, Athur / Maxwell-Armstrong, Charles / Cuming, Tamzin

    BMJ open

    2023  Volume 13, Issue 7, Page(s) e069297

    Abstract: Background: There is a growing recognition on the importance of equality, diversity and inclusion (EDI) within surgery and the need to diversify the surgical community and its various organisations, in a bidto reflect the diverse populations they serve. ...

    Abstract Background: There is a growing recognition on the importance of equality, diversity and inclusion (EDI) within surgery and the need to diversify the surgical community and its various organisations, in a bidto reflect the diverse populations they serve. To create, sustain and encourage a diverse surgical workforce requires an in-depth understanding of the current makeup of key surgical institutions, relevant issues pertaining to EDI and appropriate solutions and strategies to ensure tangible change.
    Objectives: Following on from the recent Kennedy Review into Diversity and Inclusion commissioned by the Royal College of Surgeons of England, the aim of this qualitative study was to understand the EDI issues which affected the membership of the Association of Coloproctology of Great Britain and Ireland, while seeking appropriate solutions to address them.
    Design: Dedicated, online and qualitative focus groups.
    Participants: Colorectal surgeons, trainees and nurse specialists were recruited using a volunteer sampling strategy.
    Methods: A series of online, dedicated, qualitative focus groups across the 20 chapter regions were held. Each focus group was run informed by a structured topic guide. All participants who were given the opportunity to remain anonymous were offered a debriefing at the end. This study has been reported in keeping with the Standards for Reporting Qualitative Research.
    Results: Between April and May 2021, a total number of 20 focus groups were conducted, with a total of 260 participants across 19 chapter regions. Seven themes and one standalone code pertaining to EDI were identified: support, unconscious behaviours, psychological consequences, bystander behaviour, preconceptions, inclusivity and meritocracy and the one standalone code was institutional accountability. Five themes were identified pertaining to potential strategies and solutions: education, affirmative action, transparency, professional support and mentorship.
    Conclusion: The evidence presented here is of a range of EDI issues which affect the working lives of those within colorectal surgery in the UK and Ireland, and of potential strategies and solutions which can help build a more inclusive, equitable and diverse colorectal community.
    MeSH term(s) Humans ; Colorectal Surgery ; Qualitative Research ; Focus Groups ; Digestive System Surgical Procedures ; Colorectal Neoplasms
    Language English
    Publishing date 2023-07-10
    Publishing country England
    Document type Journal Article
    ZDB-ID 2599832-8
    ISSN 2044-6055 ; 2044-6055
    ISSN (online) 2044-6055
    ISSN 2044-6055
    DOI 10.1136/bmjopen-2022-069297
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  8. Article ; Online: Sexual harassment, sexual assault and rape by colleagues in the surgical workforce, and how women and men are living different realities: observational study using NHS population-derived weights.

    Begeny, Christopher T / Arshad, Homa / Cuming, Tamzin / Dhariwal, Daljit K / Fisher, Rebecca A / Franklin, Marieta D / Jackson, Philippa M / McLachlan, Greta M / Searle, Rosalind H / Newlands, Carrie

    The British journal of surgery

    2023  Volume 110, Issue 11, Page(s) 1518–1526

    Abstract: Background: This observational study, paired with National Health Service (NHS) workforce population data, examined gender differences in surgical workforce members' experiences with sexual misconduct (sexual harassment, sexual assault, rape) among ... ...

    Abstract Background: This observational study, paired with National Health Service (NHS) workforce population data, examined gender differences in surgical workforce members' experiences with sexual misconduct (sexual harassment, sexual assault, rape) among colleagues in the past 5 years, and their views of the adequacy of accountable organizations in dealing with this issue.
    Methods: This was a survey of UK surgical workforce members, recruited via surgical organizations.
    Results: Some 1704 individuals participated, with 1434 (51.5 per cent women) eligible for primary unweighted analyses. Weighted analyses, grounded in NHS England surgical workforce population data, used 756 NHS England participants. Weighted and unweighted analyses showed that, compared with men, women were significantly more likely to report witnessing, and be a target of, sexual misconduct. Among women, 63.3 per cent reported being the target of sexual harassment versus 23.7 per cent of men (89.5 per cent witnessing versus 81.0 per cent of men). Additionally, 29.9 per cent of women had been sexually assaulted versus 6.9 per cent of men (35.9 per cent witnessing versus 17.1 per cent of men), with 10.9 per cent of women experiencing forced physical contact for career opportunities (a form of sexual assault) versus 0.7 per cent of men. Being raped by a colleague was reported by 0.8 per cent of women versus 0.1 per cent of men (1.9 per cent witnessing versus 0.6 per cent of men). Evaluations of organizations' adequacy in handling sexual misconduct were significantly lower among women than men, ranging from a low of 15.1 per cent for the General Medical Council to a high of 31.1 per cent for the Royal Colleges (men's evaluations: 48.6 and 60.2 per cent respectively).
    Conclusion: Sexual misconduct in the past 5 years has been experienced widely, with women affected disproportionately. Accountable organizations are not regarded as dealing adequately with this issue.
    MeSH term(s) Male ; Humans ; Female ; Sexual Harassment ; Rape ; State Medicine ; Sex Offenses ; Surveys and Questionnaires
    Language English
    Publishing date 2023-09-12
    Publishing country England
    Document type Observational Study ; Journal Article
    ZDB-ID 2985-3
    ISSN 1365-2168 ; 0263-1202 ; 0007-1323 ; 1355-7688
    ISSN (online) 1365-2168
    ISSN 0263-1202 ; 0007-1323 ; 1355-7688
    DOI 10.1093/bjs/znad242
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  9. Article ; Online: International Anal Neoplasia Society's consensus guidelines for anal cancer screening.

    Stier, Elizabeth A / Clarke, Megan A / Deshmukh, Ashish A / Wentzensen, Nicolas / Liu, Yuxin / Poynten, I Mary / Cavallari, Eugenio Nelson / Fink, Valeria / Barroso, Luis F / Clifford, Gary M / Cuming, Tamzin / Goldstone, Stephen E / Hillman, Richard J / Rosa-Cunha, Isabela / La Rosa, Luciana / Palefsky, Joel M / Plotzker, Rosalyn / Roberts, Jennifer M / Jay, Naomi

    International journal of cancer

    2024  Volume 154, Issue 10, Page(s) 1694–1702

    Abstract: The International Anal Neoplasia Society (IANS) developed consensus guidelines to inform anal cancer screening use among various high-risk groups. Anal cancer incidence estimates by age among risk groups provided the basis to identify risk thresholds to ... ...

    Abstract The International Anal Neoplasia Society (IANS) developed consensus guidelines to inform anal cancer screening use among various high-risk groups. Anal cancer incidence estimates by age among risk groups provided the basis to identify risk thresholds to recommend screening. Guided by risk thresholds, screening initiation at age 35 years was recommended for men who have sex with men (MSM) and transgender women (TW) with HIV. For other people with HIV and MSM and TW not with HIV, screening initiation at age 45 years was recommended. For solid organ transplant recipients, screening initiation beginning from 10 years post-transplant was recommended. For persons with a history of vulvar precancer or cancer, screening initiation was recommended starting within 1 year of diagnosis of vulvar precancer or cancer. Persons aged ≥45 years with a history of cervical/vaginal HSIL or cancer, perianal warts, persistent (>1 year) cervical HPV16, or autoimmune conditions could be considered for screening with shared decision-making, provided there is adequate capacity to perform diagnostic procedures (high-resolution anoscopy [HRA]). Anal cytology, high-risk (hr) human papillomavirus (HPV) testing (including genotyping for HPV16), and hrHPV-cytology co-testing are different strategies currently used for anal cancer screening that show acceptable performance. Thresholds for referral for HRA or follow-up screening tests are delineated. These recommendations from IANS provide the basis to inform management of abnormal screening results, considering currently available screening tools. These guidelines provide a pivotal foundation to help generate consensus among providers and inform the introduction and implementation of risk-targeted screening for anal cancer prevention.
    MeSH term(s) Male ; Humans ; Female ; Adult ; Middle Aged ; Homosexuality, Male ; Papillomavirus Infections ; Early Detection of Cancer ; Sexual and Gender Minorities ; Anus Neoplasms ; Human papillomavirus 16 ; HIV Infections ; Papillomaviridae
    Language English
    Publishing date 2024-01-31
    Publishing country United States
    Document type Journal Article
    ZDB-ID 218257-9
    ISSN 1097-0215 ; 0020-7136
    ISSN (online) 1097-0215
    ISSN 0020-7136
    DOI 10.1002/ijc.34850
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  10. Article ; Online: Multizonal anogenital neoplasia in women: a cohort analysis.

    Albuquerque, Andreia / Godfrey, Michelle A L / Cappello, Carmelina / Pesola, Francesca / Bowring, Julie / Cuming, Tamzin / De Masi, Anke / Rosenthal, Adam N / Sasieni, Peter / Nathan, Mayura

    BMC cancer

    2021  Volume 21, Issue 1, Page(s) 232

    Abstract: Background: There is currently a lack of information on full anogenital evaluation of women with a previous history of anogenital neoplasia.: Methods: Retrospective analysis of the Homerton Anogenital Neoplasia Service records from January 2012 to ... ...

    Abstract Background: There is currently a lack of information on full anogenital evaluation of women with a previous history of anogenital neoplasia.
    Methods: Retrospective analysis of the Homerton Anogenital Neoplasia Service records from January 2012 to March 2017, to identify all new referrals of women with previous anogenital neoplasia, who had had at least one complete examination of all anogenital sites. Multizonal anogenital disease (MZD) was defined as the presence of high-grade squamous intraepithelial lesions (HSIL)/carcinoma concurrently at two or more of the following sites/zones: perianus, anal canal, vulva, vagina or cervix.
    Results: 253 women were included, mean age was 47 (SD=15) years and median duration of follow-up was 12 (IQR=21) months. Fifty-six women (22%) were diagnosed with MZD at first assessment and/or during follow-up. Current smokers (RR=1.84, 95% CI 1.21-2.79, p=0.004) and women on immunodulators/immunosuppressive drugs (RR=2.57, 95% CI 1.72-3.86, p<0.001) had an increased risk for MZD. The risk was lower for women without a previous history of anogenital high-grade lesions/cancer compared to those with this history (RR=0.06, 95% CI 0.01-0.45, p=0.006).
    Conclusions: Multizonal assessment was important to diagnose occult areas of disease and should be especially considered in current smokers, pharmacologically immunocompromised and those with a previous history of anogenital HSIL/cancer.
    MeSH term(s) Adult ; Anal Canal/diagnostic imaging ; Anal Canal/pathology ; Anal Canal/virology ; Anus Neoplasms/diagnosis ; Anus Neoplasms/epidemiology ; Anus Neoplasms/pathology ; Anus Neoplasms/virology ; Biopsy ; Carcinoma, Squamous Cell/diagnosis ; Carcinoma, Squamous Cell/epidemiology ; Carcinoma, Squamous Cell/pathology ; Carcinoma, Squamous Cell/virology ; Cervix Uteri/diagnostic imaging ; Cervix Uteri/pathology ; Cervix Uteri/virology ; Colposcopy ; Female ; Follow-Up Studies ; Genital Neoplasms, Female/diagnosis ; Genital Neoplasms, Female/epidemiology ; Genital Neoplasms, Female/pathology ; Genital Neoplasms, Female/virology ; Humans ; Middle Aged ; Neoplasm Grading ; Neoplasms, Second Primary/diagnosis ; Neoplasms, Second Primary/epidemiology ; Neoplasms, Second Primary/pathology ; Neoplasms, Second Primary/virology ; Papillomavirus Infections/diagnosis ; Papillomavirus Infections/epidemiology ; Papillomavirus Infections/pathology ; Papillomavirus Infections/virology ; Retrospective Studies ; Tertiary Care Centers/statistics & numerical data ; Vagina/diagnostic imaging ; Vagina/pathology ; Vagina/virology ; Vulva/diagnostic imaging ; Vulva/pathology ; Vulva/virology
    Language English
    Publishing date 2021-03-06
    Publishing country England
    Document type Journal Article
    ZDB-ID 2041352-X
    ISSN 1471-2407 ; 1471-2407
    ISSN (online) 1471-2407
    ISSN 1471-2407
    DOI 10.1186/s12885-021-07949-8
    Database MEDical Literature Analysis and Retrieval System OnLINE

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