Limits...
Project for the National Program of Early Diagnosis of Endometrial Cancer Part I.

Bohîlțea RE, Ancăr V, Cirstoiu MM, Rădoi V, Bohîlțea LC, Furtunescu F - J Med Life (2015 Jul-Sep)

Bottom Line: Annually, approximately 800 new cases are registered in our country.Improving medical practice based on diagnostic algorithms addresses the four risk groups, by improving information system reporting and record keeping.ACOG = American Society of Obstetricians and Gynecologists, ASCCP = American Society for Colposcopy and Cervical Pathology, PATT = Partial Activated Thromboplastin Time, BRCA = Breast Cancer Gene, CT = Computerized Tomography, IFGO = International Federation of Gynecology and Obstetrics, HLG = Hemoleucogram, HNPCC = Hereditary Nonpolyposis Colorectal Cancer (Lynch syndrome), IHC = Immunohistochemistry, BMI = Body Mass Index, INR = International Normalized Ratio, MSI = Microsatellites instability, MSI-H/ MSI-L = high (positive test)/ low (negative test) microsatellites instability, WHO = World Health Organization, PCR = Polymerase chain reaction, MRI = Magnetic Resonance Imaging, SGO = Society of Gynecologic Oncologists, SHG = Sonohysterography, SRU = Society of Radiologists in Ultrasound, TQ = Time Quick, BT = Bleeding Time, TVUS = Transvaginal ultrasound, USPIO = Ultrasmall superparamagnetic iron oxide.

View Article: PubMed Central - PubMed

Affiliation: "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania.

ABSTRACT

Rationale: Endometrial cancer recorded a peak incidence in ages 60-64 years in Romania, reaching in 2013 the average value of 8.06/ 100,000 women, and 15.97/ 100,000 women within the highest risk age range, having in recent years an increasing trend, being higher in urban than in rural population. Annually, approximately 800 new cases are registered in our country. The estimated lifetime risk of a woman to develop endometrial cancer is of about 1,03%. Based on an abnormal uterine bleeding, 35% of the endometrial cancers are diagnosed in an advanced stage of the disease, with significantly diminished lifetime expectancy.

Objective: Drafting a national program for the early diagnosis of endometrial cancer.

Methods and results: We proposed a standardization of the diagnostic steps and focused on 4 key elements for the early diagnosis of endometrial cancer: investigation of abnormal uterine bleeding occurring in pre/ post-menopausal women, investigating features/ anomalies of cervical cytology examination, diagnosis, treatment and proper monitoring of precursor endometrial lesions or cancer associated endometrial lesions and screening high risk populations (Lynch syndrome, Cowden syndrome).

Discussion: Improving medical practice based on diagnostic algorithms addresses the four risk groups, by improving information system reporting and record keeping. Improving addressability cases by increasing the health education of the population will increase the rate of diagnosis of endometrial cancer in the early stages of the disease.

Abbreviations: ACOG = American Society of Obstetricians and Gynecologists, ASCCP = American Society for Colposcopy and Cervical Pathology, PATT = Partial Activated Thromboplastin Time, BRCA = Breast Cancer Gene, CT = Computerized Tomography, IFGO = International Federation of Gynecology and Obstetrics, HLG = Hemoleucogram, HNPCC = Hereditary Nonpolyposis Colorectal Cancer (Lynch syndrome), IHC = Immunohistochemistry, BMI = Body Mass Index, INR = International Normalized Ratio, MSI = Microsatellites instability, MSI-H/ MSI-L = high (positive test)/ low (negative test) microsatellites instability, WHO = World Health Organization, PCR = Polymerase chain reaction, MRI = Magnetic Resonance Imaging, SGO = Society of Gynecologic Oncologists, SHG = Sonohysterography, SRU = Society of Radiologists in Ultrasound, TQ = Time Quick, BT = Bleeding Time, TVUS = Transvaginal ultrasound, USPIO = Ultrasmall superparamagnetic iron oxide.

No MeSH data available.


Related in: MedlinePlus

The objectives tree regarding endometrial cancer in Romania
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4556910&req=5

Figure 2: The objectives tree regarding endometrial cancer in Romania

Mentions: Taking into account the late diagnosis of endometrial cancer in at least a third of the cases, the identification of its determinants has been tried (the lack of real national statistical indicators, the report of the cases having a common diagnosis without etiological individualities, the absence of a computer system and of national databases, the lack of the updating of the clinical guide elaborated by the Ministry of Health, the centralized malfunction of the National Cancer Registry and the National Registry of Genetic Diseases, the variability of the reports of endometrial ultrasonographic examination as a selection method for the patients with high risk, the lack of use of reliable endometrial biopsy methods, the insufficient involvement of the family physician in the detection of risk factors and the abnormal uterine bleeding as well as in the informing of the patients and the low level of the national sanitary education) (Fig. 1) and offering with the help of the Program solutions with the purpose of improving the process of an early diagnosis of endometrial cancer (the standardization of the pre/ post menopause abnormal uterine bleeding at the level of hospital, specialty ambulatory and family physician; the standardization of cervical cytologic examination anomalies investigation; adequate management of endometrial lesions precursor/ associated to endometrial cancer; identification of high risk factors associated to endometrial cancer and screening of women in the high risk group; improvement of the addressability to women in early stages of the disease and the improvement of the information system in order to highlight the path of the cases) (Fig. 2).


Project for the National Program of Early Diagnosis of Endometrial Cancer Part I.

Bohîlțea RE, Ancăr V, Cirstoiu MM, Rădoi V, Bohîlțea LC, Furtunescu F - J Med Life (2015 Jul-Sep)

The objectives tree regarding endometrial cancer in Romania
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4556910&req=5

Figure 2: The objectives tree regarding endometrial cancer in Romania
Mentions: Taking into account the late diagnosis of endometrial cancer in at least a third of the cases, the identification of its determinants has been tried (the lack of real national statistical indicators, the report of the cases having a common diagnosis without etiological individualities, the absence of a computer system and of national databases, the lack of the updating of the clinical guide elaborated by the Ministry of Health, the centralized malfunction of the National Cancer Registry and the National Registry of Genetic Diseases, the variability of the reports of endometrial ultrasonographic examination as a selection method for the patients with high risk, the lack of use of reliable endometrial biopsy methods, the insufficient involvement of the family physician in the detection of risk factors and the abnormal uterine bleeding as well as in the informing of the patients and the low level of the national sanitary education) (Fig. 1) and offering with the help of the Program solutions with the purpose of improving the process of an early diagnosis of endometrial cancer (the standardization of the pre/ post menopause abnormal uterine bleeding at the level of hospital, specialty ambulatory and family physician; the standardization of cervical cytologic examination anomalies investigation; adequate management of endometrial lesions precursor/ associated to endometrial cancer; identification of high risk factors associated to endometrial cancer and screening of women in the high risk group; improvement of the addressability to women in early stages of the disease and the improvement of the information system in order to highlight the path of the cases) (Fig. 2).

Bottom Line: Annually, approximately 800 new cases are registered in our country.Improving medical practice based on diagnostic algorithms addresses the four risk groups, by improving information system reporting and record keeping.ACOG = American Society of Obstetricians and Gynecologists, ASCCP = American Society for Colposcopy and Cervical Pathology, PATT = Partial Activated Thromboplastin Time, BRCA = Breast Cancer Gene, CT = Computerized Tomography, IFGO = International Federation of Gynecology and Obstetrics, HLG = Hemoleucogram, HNPCC = Hereditary Nonpolyposis Colorectal Cancer (Lynch syndrome), IHC = Immunohistochemistry, BMI = Body Mass Index, INR = International Normalized Ratio, MSI = Microsatellites instability, MSI-H/ MSI-L = high (positive test)/ low (negative test) microsatellites instability, WHO = World Health Organization, PCR = Polymerase chain reaction, MRI = Magnetic Resonance Imaging, SGO = Society of Gynecologic Oncologists, SHG = Sonohysterography, SRU = Society of Radiologists in Ultrasound, TQ = Time Quick, BT = Bleeding Time, TVUS = Transvaginal ultrasound, USPIO = Ultrasmall superparamagnetic iron oxide.

View Article: PubMed Central - PubMed

Affiliation: "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania.

ABSTRACT

Rationale: Endometrial cancer recorded a peak incidence in ages 60-64 years in Romania, reaching in 2013 the average value of 8.06/ 100,000 women, and 15.97/ 100,000 women within the highest risk age range, having in recent years an increasing trend, being higher in urban than in rural population. Annually, approximately 800 new cases are registered in our country. The estimated lifetime risk of a woman to develop endometrial cancer is of about 1,03%. Based on an abnormal uterine bleeding, 35% of the endometrial cancers are diagnosed in an advanced stage of the disease, with significantly diminished lifetime expectancy.

Objective: Drafting a national program for the early diagnosis of endometrial cancer.

Methods and results: We proposed a standardization of the diagnostic steps and focused on 4 key elements for the early diagnosis of endometrial cancer: investigation of abnormal uterine bleeding occurring in pre/ post-menopausal women, investigating features/ anomalies of cervical cytology examination, diagnosis, treatment and proper monitoring of precursor endometrial lesions or cancer associated endometrial lesions and screening high risk populations (Lynch syndrome, Cowden syndrome).

Discussion: Improving medical practice based on diagnostic algorithms addresses the four risk groups, by improving information system reporting and record keeping. Improving addressability cases by increasing the health education of the population will increase the rate of diagnosis of endometrial cancer in the early stages of the disease.

Abbreviations: ACOG = American Society of Obstetricians and Gynecologists, ASCCP = American Society for Colposcopy and Cervical Pathology, PATT = Partial Activated Thromboplastin Time, BRCA = Breast Cancer Gene, CT = Computerized Tomography, IFGO = International Federation of Gynecology and Obstetrics, HLG = Hemoleucogram, HNPCC = Hereditary Nonpolyposis Colorectal Cancer (Lynch syndrome), IHC = Immunohistochemistry, BMI = Body Mass Index, INR = International Normalized Ratio, MSI = Microsatellites instability, MSI-H/ MSI-L = high (positive test)/ low (negative test) microsatellites instability, WHO = World Health Organization, PCR = Polymerase chain reaction, MRI = Magnetic Resonance Imaging, SGO = Society of Gynecologic Oncologists, SHG = Sonohysterography, SRU = Society of Radiologists in Ultrasound, TQ = Time Quick, BT = Bleeding Time, TVUS = Transvaginal ultrasound, USPIO = Ultrasmall superparamagnetic iron oxide.

No MeSH data available.


Related in: MedlinePlus