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5 results

  • 1 - Morphological sub-types of ovarian carcinoma: new developments and pathogenesis

  • from SECTION 1 - BIOLOGY OF GYNAECOLOGICAL CANCERS: OUR CURRENT UNDERSTANDING
  • Edited by Sean Kehoe, Richard J. Edmondson, Martin Gore, Iain A. McNeish
  • Book:
    Gynaecological Cancers
    Published online:
    05 February 2014
    Print publication:
    01 June 2011, pp 3-16

  • Summary

    In most developed countries, ovarian carcinoma is the second most common malignancy of the female genital tract, following endometrial carcinoma. This chapter reviews the major morphological sub-types of ovarian carcinoma including their pathogenesis, and discusses problematic areas in typing. Most of the grading systems are universal in that they can be applied to all the major morphological sub-types of ovarian carcinoma. The major morphological sub-types of ovarian carcinoma are serous, endometrioid, clear cell and mucinous. Two relatively recent population-based studies that included central pathology review have provided updated information regarding the relative frequencies of the major sub-types. The perceived relationship between benign, borderline and malignant ovarian serous neoplasms was controversial. The morphological features of ovarian carcinomas treated by chemotherapy often differ markedly from native tumours. The chapter also summarizes the evidence that most high-grade pelvic serous carcinomas arise from the fimbria of the fallopian tube.

  • 7 - Long-term health risks of polycystic ovary syndrome

  • Edited by Adam Balen, University of Leeds, Stephen Franks, Roy Homburg, Sean Kehoe
  • Book:
    Current Management of Polycystic Ovary Syndrome
    Published online:
    05 July 2014
    Print publication:
    01 October 2010, pp 85-92

  • Summary

    Polycystic ovary syndrome (PCOS) is most often diagnosed in adolescents and young women who present with symptoms of hyperandrogenism and/or disorders of ovulation. The individuals and their doctors must be aware that PCOS carries various long-term health risks owing to its intrinsic hormonal derangement and also to the associated metabolic disorders such as obesity, hyperinsulinism and insulin resistance, and hyperlipidaemia. Many abnormalities found in young women with PCOS suggest that they are at risk for cardiovascular disease. The more commonly used parameters are the traditional measures of family history, body mass index (BMI), waist circumference, blood pressure and standard biochemical indices including fasting glycaemia, total cholesterol, high-density lipoprotein (HDL) cholesterol and triglycerides. Obesity has a great impact on the prevalence of type 2 diabetes but the risk persists in non-obese women with PCOS. The risk factors for endometrial carcinoma include obesity, hypertension, type 2 diabetes, unopposed estrogen and nulliparity.

  • Reproducibility of systematic literature reviews on food, nutrition, physical activity and endometrial cancer

  • RL Thompson, EV Bandera, VJ Burley, JE Cade, D Forman, JL Freudenheim, D Greenwood, DR Jacobs, Jr, RV Kalliecharan, LH Kushi, ML McCullough, LM Miles, DF Moore, JA Moreton, T Rastogi, MJ Wiseman
  • Journal:
    Public Health Nutrition / Volume 11 / Issue 10 / October 2008
    Published online by Cambridge University Press:
    01 October 2008, pp. 1006-1014
    • Article
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  • Objective

    Despite the increasing dependence on systematic reviews to summarise the literature and to issue public health recommendations, the formal assessment of the reliability of conclusions emerging from systematic reviews has received little attention. The main goal of the present study was to evaluate whether two independent centres, in two continents, draw similar conclusions regarding the association of food, nutrition and physical activity and endometrial cancer, when provided with the same general instructions and with similar resources.

    Design

    The assessment of reproducibility concentrated on four main areas: (1) paper search and selection; (2) assignment of study design; (3) inclusion of ‘key’ papers; and (4) individual studies selected for meta-analysis and the summary risk estimate obtained.

    Results

    In total 310 relevant papers were identified, 166 (54 %) were included by both centres. Of the remaining 144 papers, 72 (50 %) were retrieved in the searches of one centre and not the other (54 in centre A, 18 in centre B) and 72 were retrieved in both searches but regarded as relevant by only one of the centres (52 in centre A, 20 in centre B). Of papers included by both centres, 80 % were allocated the same study design. Agreement for inclusion of cohort-type and case–control studies was about 63 % compared with 50 % or less for ecological and case series studies. The agreement for inclusion of 138 ‘key’ papers was 87 %. Summary risk estimates from meta-analyses were similar.

    Conclusions

    Transparency of process and explicit detailed procedures are necessary parts of a systematic review and crucial for the reader to interpret its findings.

  • 18 - Endometrial cancer: prevention, screening, and early detection

  • from Part IV - Cancer prevention
  • Edited by Jo Ann Rosenfeld, The Johns Hopkins University
  • Book:
    Women's Health in Mid-Life
    Published online:
    21 August 2009
    Print publication:
    25 March 2004, pp 293-310

  • Summary

    Endometrial carcinoma is one of the most common cancers in women, with an incidence of 2.6%. This chapter examines the effects of the woman's hormonal environment on the development of endometrial hyperplasia and endometrial carcinoma, additional risk factors, and preventive measures for this common malignancy. When hormonetherapy consisted of unopposed estrogen, a higher incidence of endometrial hyperplasia and carcinoma was found in women on this therapy compared with non-treated women. A systematic review of randomized controlled trials found unopposed estrogen therapy in moderate to high doses to be associated with significant increases in rates of endometrial hyperplasia. The risk of endometrial carcinoma in complex atypical hyperplasia is approximately 25%, and warrants surgical management with hysterectomy and salpingoophorectomy. The accuracy of endometrial biopsy as compared with dilation and curettage in detection of endometrial carcinoma ranges from 91 to 99.6% with sampling devices such as the Pipelle.