Screening for Female Genital Tract Malignancy

Screening for Female Genital Tract Malignancy BY Prof.Mohammad Ahmed Emam M.D OB & GYN Director of Early Cancer Detection Unit OB & GYN Dept. Mansoura Faculty of Medicine

Screening Generally ,[object Object]

Validity of Screening Test ,[object Object]

Validity of Screening Test cont... ,[object Object],[object Object],[object Object],[object Object]

[object Object],[object Object],[object Object],[object Object],[object Object],Validity of Screening Test cont...

When to Suspect Gynecologic Cancer ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

When to Suspect Gynecologic Cancer cont…. ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Concept ,[object Object],[object Object],[object Object]

Phases of Tumourgenesis ,[object Object],Invasive asymptomatic Invasive symptomati Cancer cx. End. C. As cancer ovary Normal cells

Most Cancers Develop In The Unscreened And The Underscreened.

CRITERIA FOR SCREENING ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Criteria for Screening Test ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Incidence of Gynecologic Cancers in Egyptian Women with cancer 0 5 10 15 20 25 Breast Cancer Cervical Cancer Ovarian Cancer Uterine Cancer Percent Source: GLOBOCAN 2000.

Epidemiology of Cervical Cancer ,[object Object],[object Object],[object Object],[object Object],Magnitude of the Problem : -

Epidemiology of Cervical Cancer cont…. ,[object Object],[object Object],[object Object]

Epidemiology of Cervical Cancer cont…. ,[object Object],1)Exo cx: ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

2. Endo cx Like endometrial C. ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Epidemiology of Cervical Cancer cont….

Pathogenesis of CIN ,[object Object],St.sq. epith. CIN ,[object Object],Chlamydia – H.S.V. - H.P.V- TV. Histones & protamines Metaplasia Dysplasia Micro-organism. Sperm Ptn.

Morphological Changes of Cervical Cancer

Prevention of Cervical Cancer ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Secondary Prevention of Ca.Cx. ,[object Object],[object Object],[object Object],[object Object]

Why screening for cervical cancer? ,[object Object],[object Object],[object Object]

Why screening for cervical cancer? Cont… ,[object Object],[object Object]

Screening by Pap. Cx. Smear unscreened female have ten fold risk > screened female - Every sexually active female (18-35 y) - Specially, high risk group. - Annually up to the age of 35y - No need to extend screening > 35y if smear is N. - At each pregnancy - If new risk factors appear after 35y. d- If + ve smear colposcopy c. When: b. To whom : a. Importance:

Alternatives to Cytology ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Limitations of Pap Smear ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

COMPARISON BETWEEN SCREENING METHODS Source-Program for Appropriate Technology in Health [PATH] 1997.

“ VIA ..represents a proven, simple means of identifying cervical intraepithelial neoplasia in developing countries .” ,[object Object]

Comparison between : VIA and Cytology ,[object Object],[object Object],[object Object]

VIA& PAP SMEAR ,[object Object]

MEANING OF Acetowhite ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

MEANING OF Acetowhite cont…. ,[object Object],[object Object],[object Object],[object Object]

Endometrial Cancer Screening ,[object Object],[object Object],[object Object],[object Object],[object Object]

PRE-INVASIVE LESIONS OF END. 23% over 10y Atypisim + back to back + budding Atypical hyperplasia 3-4% over 13y Back to back glands, budding, papillary process, minor stratification Complex hyperplasia 1-3% over 15y Irregular glands, minor budding or out pouching Simle hyperplasia Little or none Replacement of usual gland cell by cells having cilia, sq. cells Metaplasia Malig. Potential Pathology

Early Cancer Detection of ENDO. ,[object Object],[object Object],[object Object],[object Object]

Ovarian Cancer Screening ,[object Object],[object Object],[object Object],[object Object],[object Object]

Screening For Early Diagnosis Ovarian Malignancy ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

PRE-INVASIVE LESIONS OF VULVA ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Dermatoses Leukoplekia Krausons vulva Lichen simplex

Early Cancer Detection of Vulva ,[object Object]

OB& GYN, Mansoura Faculty of Medicine Mansoura Integrated Fertility Center (MIFC) EGYPT Telfax 0020502319922 & 0020502312299 Email. mae335@hotmail.com Prof. MOHAMMAD EMAM Thank you

Screening for Female Genital Tract Malignancy

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