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Cervical cancer.
NIH Consens Statement 1996 Apr 1-3; 14(1):1-38; quiz 4pNC

Abstract

OBJECTIVE

To provide physicians and the general public with a responsible assessment of current screening, prevention, and treatment approaches to cervical cancer.

PARTICIPANTS

A non-Federal, nonadvocate, 13-member panel representing the fields of obstetrics and gynecology, gynecologic oncology, radiation oncology, and epidemiology. In addition, 28 experts in obstetrics and gynecology, gynecologic oncology, radiation oncology, gynecologic surgery, and psychology presented data to the panel and a conference audience of 500.

EVIDENCE

The literature was searched through Medline and an extensive bibliography of references was provided to the panel and the conference audience. Experts prepared abstracts with relevant citations from the literature. Scientific evidence was given precedence over clinical anecdotal experience.

CONSENSUS PROCESS

The panel, answering predefined questions, developed its conclusions based on the scientific evidence presented in open forum and the scientific literature. The panel composed a draft statement that was read in its entirety and circulated to the experts and the audience for comment. Thereafter, the panel resolved conflicting recommendations and released a revised statement at the end of the conference. The panel finalized the revisions within a few weeks after the conference.

CONCLUSIONS

Carcinoma of the cervix is causally related to infection with the human papillomavirus (HPV). Reducing the rate of HPV infection by changes in sexual behaviors in young people and/or through the development of an effective HPV vaccine would reduce the incidence of this disease. Pap smear screening remains the best available method of reducing the incidence and mortality of invasive cervical cancer. Persons with stage IA1 disease have a high cure rate with either simple hysterectomy or, where fertility preservation is an issue, by cone biopsy with clear margins. For patients with other stage I and stage IIA disease, radical surgery and radiation are equally effective treatments. These patients should be carefully selected to receive one treatment or the other but not both, as their combined use substantially increases the cost and morbidity of treatment. Women with more advanced, nonmetastatic disease should be treated with radiation. Recurrent cervical cancer confined to the pelvis should be treated with the modality not previously received. Radiation is recommended to palliate symptoms in patients with metastatic disease.

Pub Type(s)

Consensus Development Conference
Consensus Development Conference, NIH
Journal Article
Review

Language

eng

PubMed ID

9407932

Citation

"Cervical Cancer." NIH Consensus Statement, vol. 14, no. 1, 1996, 1-38; quiz 4p.
Cervical cancer. NIH Consens Statement. 1996;14(1):1-38; quiz 4p.
(1996). Cervical cancer. NIH Consensus Statement, 14(1), 1-38; quiz 4p.
Cervical Cancer. NIH Consens Statement. 1996;14(1):1-38; quiz 4p. PubMed PMID: 9407932.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Cervical cancer. PY - 1996/4/1/pubmed PY - 1998/1/4/medline PY - 1996/4/1/entrez SP - 1-38; quiz 4p JF - NIH consensus statement JO - NIH Consens Statement VL - 14 IS - 1 N2 - OBJECTIVE: To provide physicians and the general public with a responsible assessment of current screening, prevention, and treatment approaches to cervical cancer. PARTICIPANTS: A non-Federal, nonadvocate, 13-member panel representing the fields of obstetrics and gynecology, gynecologic oncology, radiation oncology, and epidemiology. In addition, 28 experts in obstetrics and gynecology, gynecologic oncology, radiation oncology, gynecologic surgery, and psychology presented data to the panel and a conference audience of 500. EVIDENCE: The literature was searched through Medline and an extensive bibliography of references was provided to the panel and the conference audience. Experts prepared abstracts with relevant citations from the literature. Scientific evidence was given precedence over clinical anecdotal experience. CONSENSUS PROCESS: The panel, answering predefined questions, developed its conclusions based on the scientific evidence presented in open forum and the scientific literature. The panel composed a draft statement that was read in its entirety and circulated to the experts and the audience for comment. Thereafter, the panel resolved conflicting recommendations and released a revised statement at the end of the conference. The panel finalized the revisions within a few weeks after the conference. CONCLUSIONS: Carcinoma of the cervix is causally related to infection with the human papillomavirus (HPV). Reducing the rate of HPV infection by changes in sexual behaviors in young people and/or through the development of an effective HPV vaccine would reduce the incidence of this disease. Pap smear screening remains the best available method of reducing the incidence and mortality of invasive cervical cancer. Persons with stage IA1 disease have a high cure rate with either simple hysterectomy or, where fertility preservation is an issue, by cone biopsy with clear margins. For patients with other stage I and stage IIA disease, radical surgery and radiation are equally effective treatments. These patients should be carefully selected to receive one treatment or the other but not both, as their combined use substantially increases the cost and morbidity of treatment. Women with more advanced, nonmetastatic disease should be treated with radiation. Recurrent cervical cancer confined to the pelvis should be treated with the modality not previously received. Radiation is recommended to palliate symptoms in patients with metastatic disease. SN - 1080-1707 UR - https://www.unboundmedicine.com/medline/citation/9407932/Cervical_cancer_ L2 - http://www.diseaseinfosearch.org/result/7949 DB - PRIME DP - Unbound Medicine ER -