Yu Tse Ka, Philip Pun Ching Ip, Karen Kar Loen Chan, 20160316034350
Cervical cancer is the fourth most common cancer in women in the world and there were about 528,000 new patients and 266,000 deaths in 2012. In Hong Kong, its crude incidence rate dropped from about 14 per 100,000 women in late 1990s to around 10.5 in early 2010s, and is currently the 9th commonest female cancer. (Table 1a and 1b)1 This phenomenon may be attributed to the implementation of cervical smear screening programme. Nevertheless, it remains as the 8-9th leading cause of female cancer death over the last decade and the crude mortality rate rose from its trough at 3.0 per 100,000 women in 2003 to 4.0 in 2011. From these results it is obvious that cervical cancer still poses a threat to women’s health. This article aims to review the causal relationship between human papillomavirus (HPV) and cervical cancer and discuss existing methods that prevent HPV from leading to cervical cancer.
Ultrasonography has been widely used as a routine component of antenatal care. During the assessment of the foetus and the placenta, an adnexal mass may be discovered at the time of the ultrasound examination. Occasionally, an adnexal mass can also be suspected either on physical examination or as a result of clinical symptoms.
Morbidly adherent placenta involves a spectrum of abnormal placental implantation. Placenta accreta occurs when chorionic villi attach to the myometrium. Placenta increta refers to the invasion of villi into the myometrium. Placenta percreta is defined by invasion extending deep beyond the uterine serosa. It may also involve adjacent organs, commonly the urinary bladder. Placenta accreta and its associated spectrum are often collectively described in the literature.1,2
The use of hormones has bought great convenience to a woman’s life, be it for therapeutic use or as a lifestyle drug, ie, contraceptives. However, the duration of hormone use is frequently long, in terms of years. Concerns have been raised about the possibility of a relationship between cancer development and long-term hormonal influence. This article reviews evidence regarding the relationship between hormonal contraceptive use and the development of cancer, with the discussion focusing mainly on carcinoma of the breast and female genital tract.
Human papillomavirus (HPV) infection is a prevalent disease worldwide. Consequences of HPV infection vary, depending on the infected individuals and the HPV genotype involved. Life-threatening consequences are not uncommon, and cervical cancer is a clear demonstration of the virus’s potency. While the incidence of cervical cancer is heavily concentrated on developing countries,1 the impact of HPV-related diseases on developed countries has not ceased. In the United States alone, HPV infections are the most common sexually transmitted disease with an estimated 5 million new cases being diagnosed in 2000 among young adults, incurring nearly US$3 billion in terms of direct medical costs.2 A multinational study involving 18,498 women showed that cervical HPV prevalence varied greatly geographically, ranging from the low of 1.6% in North Vietnam to the high of 27% in Nigeria. In general, HPV prevalence peaked among young, sexually active women and declined with age. In selected countries, however, a second peak was noted in women older than 55 years.3 The high prevalence of HPV-related diseases incurs a heavy burden on the healthcare systems of developed and developing countries alike, which renders HPV research and prevention a global public health imperative. On an individual level, the afflictions caused by HPV-related diseases go beyond that of physical suffering to affecting the psychological well-being of the infected. This is the focus of our paper.
Ovarian cancer is a major cause of mortality from malignancies in developed countries. It is the fourth and fifth most common cause of cancer death in women in the UK and US, respectively.1,2 In Asia, ovarian cancer ranks fifth and sixth in cancer mortality in Singapore and Hong Kong, respectively. Ovarian cancers have vague symptoms such as abdominal discomfort or bloating, and therefore the majority of the cases present at an advanced stage. A late diagnosis may be a major contributing factor in the overall poor prognosis. Stage I disease gives a relatively good 5-year survival of 85%, but this falls to about 15–30% for stage III and IV disease. Hence, ovarian screening has been proposed in order to improve early diagnosis of the disease and overall outcome. In this article, we will discuss:
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