Screening for gynaecological conditions

• Published in: Current obstetrics & gynaecology 2001-02, Vol.11 (1), p.31-37
• Main Authors: Latthe, P.M., Shafi, M.I.
• Format: Article
• Language: English
• Subjects: mass screening, breast and ovarian cancer, cervical screening, HPV, BRCA 1 and BRCA 2, chlamydia
• ISSN: 0957-5847; 1532-205X
• DOI: 10.1054/cuog.2000.0146

Screening is one of the most often discussed areas of gynaecology today. In this chapter, after a brief review of WHO criteria for a screening programme and relevant statistical terms, the pros and cons of screening are considered. Its role in gynaecological cancers, genetic conditions and chlamydial infection is discussed. Ultrasound and multimodal screening can detect ovarian cancer in asymptomatic women, but there is insufficient evidence on whether screening improves outcome including mortality for women in any risk group. BRCA 1 and 2 screening is offered to women with families in which two or more first-degree relatives are affected by ovarian or premenopausal breast cancer. This gives a 65% chance of identifying a mutation. We have considered some of the interesting developments in cervical screening like PAPNET, thin prep and HPV testing. After discussing some of the controversies in breast cancer screening programmes, the case for introduction of chlamydia screening is debated.