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
Screening, early detection, mammography, HPV testing,
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