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Despite a significant decrease in the incidence and mortality of cervical carcinoma in the United States, 10,520 women are expected to develop the disease in 2004, with 3,900 expected deaths. Because cervical cytology screening is the current method for early detection of this neoplasm, the purpose of the NCCN Cervical Cancer Screening Guidelines is to provide direction for the evaluation and management of cervical cytology.

For the most recent version of the guidelines, please visit NCCN.org

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The key to a continued reduction in mortality from breast cancer is early detection and accurate diagnosis made in a cost-effective manner. These practice guidelines are designed to facilitate clinical decision making on the important issues in screening for breast cancer.

For the most recent version of the guidelines, please visit NCCN.org

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Rodger J. Winn

One of the cancer-related Healthy People 2010 goals is to decrease deaths from cancer of the cervix in the U.S. from 3/100,000 to 2/100,000. The basis for this goal is the tremendous impact of the Papanicolaou (Pap) test in reducing mortality from this once common and devastating cancer. Over the past 50 years, U.S. death rates have dropped by 75%, and the target is certainly possible if screening and appropriate follow-up can be extended to all women. Given the remarkable effectiveness of cervical screening in lowering mortality, we must still recognize that the Pap test is only moderately accurate. Fortunately, the long preinvasive phase of cervical cancer and the successful public health initiatives that foster regular follow-up examinations lead to repeated opportunities to discover the neoplasm when it is curable. The NCCN Cervical Screening Clinical Practice Guidelines in Oncology provide a valuable roadmap for ensuring that appropriate steps are taken when routine examination shows abnormalities. A third factor leading to success has been the concerted educational and quality assurance programs to minimize laboratory variation and error. Therefore, noting the two major advances in the science of cervical screening in the past several years is gratifying: the use liquid-based cytology (LBC) to process Pap specimens and the use of human papillomavirus (HPV) testing to help guide the interpretation abnormal tests. In his review of the extensive trials comparing conventional Pap and LBC preparations, Cox notes that the new modality appears to be more sensitive in finding both low- and high-grade squamous...
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Randall W. Burt

Colon cancer screening has been one of the great successes of cancer prevention. The decrease in colon cancer incidence and mortality in recent years is thought to be at least partly from the application and acceptance of screening. Colon cancer

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The University of Alabama at Birmingham Comprehensive Cancer Center

The lifetime risk of a woman developing breast cancer has increased over the past 5 years in the United States: of every 7 women, 1 is at risk based on a life expectancy of 85 years. An estimated 214,640 new cases (212,920 women and 1,720 men) of breast cancer and 41,430 deaths (40,970 women and 460 men) from this disease will occur in the United States in 2006. However, mortality from breast cancer has decreased slightly, attributed partly to mammographic screening. Early detection and accurate diagnosis made in a cost-effective manner are critical to a continued reduction in mortality. These practice guidelines are designed to facilitate clinical decision making.

For the most recent version of the guidelines, please visit NCCN.org

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Margaret Tempero

foolishly. I thought about this after reading a study in JAMA 1 regarding cancer screening in individuals with different life expectancies. The investigators, from the University of North Carolina, used a validated mortality index specific for the

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Harold J. Burstein

The week of November 16, 2009, the U.S. Preventive Services Task Force (USPSTF) issued updated guidelines on breast cancer screening, with the controversial recommendation that women aged 40 to 49 years no longer undergo screening mammography

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Howard A. Chang, Saro H. Armenian and Thanh H. Dellinger

with HPV will mount an effective immune response to clear the infection within 2 years. 18 Those who are unable to do so may develop cervical, vulvar, or vaginal dysplasia. Screening with Papanicolaou (Pap) smears detects cytologic abnormalities such

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Philip J. Saylor and Matthew R. Smith

treated with ADT, a statistically significant ADT-associated elevation in the risk for diabetes was observed (HR, 1.16; 95% CI, 1.11–1.21). The observed greater risk for diabetes in these analyses argues for diabetes screening among men on ADT. Diabetes

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Ann M. Berger, Amy Pickar Abernethy, Ashley Atkinson, Andrea M. Barsevick, William S. Breitbart, David Cella, Bernadine Cimprich, Charles Cleeland, Mario A. Eisenberger, Carmen P. Escalante, Paul B. Jacobsen, Phyllis Kaldor, Jennifer A. Ligibel, Barbara A. Murphy, Tracey O'Connor, William F. Pirl, Eve Rodler, Hope S. Rugo, Jay Thomas and Lynne I. Wagner

clinically indicated. Screening should identify fatigue. Patients and families should be informed that managing fatigue is an integral part of total health care, and all patients should undergo symptom management. Furthermore, if patients cannot tolerate