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Abstract

Rationale for the early diagnosis of gynecologic cancer. Is there an evidence for screening?

A favorable benefit/risk ratio for mammography has been demonstrated for 50 to 69 years old women only. Mortality from breast cancer is reduced by 16.5 % in this population. In 40 to 50 years old women, mammography reduces death only by 3 to 10 % compared to a nonscreened population. The main limitation are false-positive results leading to substantial costs and psychological distress. In cervical cancer, cytology is a traditional column of screening. However, efficacy in squamous and adenosquamous carcinomas is significantly higher than in adenocarcinomas (risik reduction by 75 % and 83 % vs. 43 % respectively). Screening studies support the additional use of HPV high-risk testing due to its higher sensitivity (95 % vs. 55 %, respectively). In Germany, HPV high-risk testing is performed routinely in women over 30 years of age. In endometrial, ovarian, vulvar and vagi-nal cancer none of the studies have revealed efficacy in screening.

CME Prakt Fortbild Gynakol Geburtsmed Gynakol Endokrinol 2011; 7(3): 256-271

Keywords
Screening, early detection, mammography, HPV testing, ovarian cancer

Edgar Petru, Tina Idris
Universitätsklinik für Frauenheilkunde und Geburtshilfe, Klinische
Abteilung für Gynäkologie, Medizinische Universität Graz, Österreich
Reviewer: Wolfgang Friedmann, Bremerhaven
und Friederike Gieseking, Hamburg

Petru E. Rationale ... Gynakol Geburtsmed Gynakol Endokrinol 2011; 7(3): 256-271 publiziert 30.11.11 www.akademos.de/gyn ©akademos Wissenschaftsverlag 2011 ISSN 1614-8533