Talk:Colposcopy
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nothing is mentioned
[edit]about the way in which the tool was invented and perfected for use by a nazi? http://www.forward.com/articles/9946/
the whole thing was invented by nazi studies carried out at Auschwitz! disgusting.--90.218.3.239 (talk) 11:55, 28 December 2009 (UTC)
Do we go around saying some life-saving test was discovered by "Dr. L who was an Abolitionist, Dr. M who was a Capitalist, Dr. N who was a Fascist, Dr. O who was an Anarchist, Dr. P who was a Socialist, Dr. Q. who was a Zionist, Dr. R. who was a Ku Klux Klanner, Dr. S. who was a Trotskyite, Dr. T. who was a Republican, Dr. U. who was a Royalist, Dr. V. who was a Libertarian, Dr. W. who was a Communist, Dr. X who was a Confederate, Dr. Y who was a Tradeunionist, Dr. Z who was a Democrat?" I do not think that in general it is at all encyclopedic in an article about medical science to enumerate the politics of everyone who discovered something, unless you propose to do so in every article about every test or scientific or medical advance. Edison (talk) 06:13, 4 February 2010 (UTC)
- It wasn't invented by a nazi Dr, but the inventor received contributions (pictures and samples) from experiments performed by a SS Dr (Eduard Wirth) during WWII. I just added this info --Dexter_prog (talk • contribs • count) @ 12:14, 2 February 2011 (UTC)
procedure
[edit]A pregnancy test is not usually administered before the exam as it states in the article.
- Changed sentence to read: "In some cases, a pregnancy test may be performed before the procedure." --Renice 13:39, 27 April 2007 (UTC)
Incorrect Information
[edit]- Editors should be aware that the user Drsavard (and apparently 71.224.215.219) who proposed these changes does consulting work for QIAGEN pharmaceutical company, which is the owner of Digene, maker of the HPV test. Therefore they have a potential WP:COI regarding HPV testing. Zodon (talk) 06:04, 11 May 2008 (UTC)
I am a medical doctor specializing in internal medicine with 25 years of experience. I found the following information in this article to be incorrect and I’d like to update it to include the correct information. If no one protests the updates below within 48 hours, I’d like to go ahead and make these edits to ensure that Wikipedians receive the correct information as soon as possible. All references are included below.
Existing Text
Adequate follow-up is critical for the success of this procedure. HPV is a common infection and the underlying cause for most cervical dysplasia. Women should be counseled on the benefits of safe sex for reducing the risks of contracting and spreading the HPV virus.
Updated Text
Adequate follow-up is critical for the success of this procedure. High-risk types of HPV are now recognized as the cause of cervical cancer.[1] Women should be counseled on the benefits of minimizing their number of sexual partners and the use of condoms to avoid getting or spreading the HPV virus. However, neither tactic provides complete protection. To detect any abnormal cells that develop on the cervix, regular Pap smears are important. In addition, several leading medical organizations recognize the benefits of HPV testing, along with the Pap, for women age 30 or older.[2][3][4]
Drsavard (talk) 14:19, 10 March 2008 (UTC)
- Think "benefits of safe sex" was better - other aspects besides just condom use that may be protective. More complete reference to the ACOG bulletin would help. Suggest tying multiple references to same item together (name= ) so don't get multiple numbers for same ref. Is min sex partners an especially major risk factor? (Was covered under safe-sex) Smoking and diet (and condom use) seem more relevant. Wording about HPV virus testing is misleading. It is of no known benefit in absence of abnormal pap. Suggest better to leave it out here and focus the information in Pap smear or HPV prevention articles. At least suggest clarify, and fix to NPOV. Zodon (talk) 08:26, 11 March 2008 (UTC)
It’s not clear to many people what “safe sex” means exactly. In this context, multiple partners is indeed a significant risk factor. On the other hand, that’s a very subjective principle. Just how many partners are “too many”? In addition, you are correct that smoking and generally staying healthy helps prevent infections from becoming persistent. I will revise my edit to read:
Adequate follow-up is critical for the success of this procedure. High-risk types of HPV are now recognized as the cause of cervical cancer. Women should be counseled on the benefits of condoms, although they don’t provide complete protection from HPV, and of building up their immune systems by not smoking and generally staying healthy through a good diet, etc. To detect any abnormal cells that develop on the cervix, regular Pap smears are important. In addition, most leading medical organizations now recognize the benefits of HPV testing, along with the Pap, for women age 30 and older.
Regarding your statement that there is “no known benefit of HPV testing in absence of an abnormal Pap,” I have to disagree strongly. There is a wealth of clinical data supporting the use of routine HPV testing of women age 30+, in conjunction with cytology. Below is just a sampling of these studies, beginning with the most recent: • Study results suggest that, in women aged 30 + years, co-testing with a Pap smear and HPV DNA test was more sensitive than reflex HPV testing for the detection of high-grade cervical lesions (91% vs. 54%), provided women with a positive hc2 test and negative Pap were referred to colposcopy and biopsy. Janet G. Baseman, Ph.D., Department of Epidemiology, University of Washington (American Journal of Obstetrics & Gynecology, March 2008)
• For both vaccinated and unvaccinated women, age-based screening by use of HPV DNA testing as a triage test for equivocal results in younger women and as a primary screening test in older women is expected to be more cost-effective than current screening recommendations. Sue J. Goldie MD, MPH, Department of Health Policy and Management, Harvard School of Public Health (Journal of the National Cancer Institute, Feb. 26, 2008) Compared with cytology, HPV testing has greater sensitivity for the detection of cervical intraepithelial neoplasia. The sensitivity of HPV testing for CIN grade 2 or 3 was 94.6%, whereas the sensitivity of cytology alone was 55.4%. The sensitivity of both tests used together was 100%, and the specificity was 92.5%. Franco, E. et al. Human Papillomavirus DNA versus Papanicolaou Screening Tests for Cervical Cancer. New England Journal of Medicine 2007; 357: 1579-1588.
Implementation of HPV DNA testing in cervical screening led to a substantial increase in the number of CIN 2/3+ lesions detected at the baseline screening round. At the subsequent round, combined HPV DNA and cytological testing was used in both study groups and significantly fewer CIN 2/3+ lesions were seen in the women who received both tests at the baseline round than in the control group. Therefore, the results show that implementation of HPV DNA testing in cervical screening leads to earlier detection of clinically relevant cervical lesions. Meijer, C. et al. Human papillomavirus DNA testing for the detection of cervical intraepithelial neoplasia grade 3 and cancer: 5-year follow-up of a randomized controlled implementation trial. The Lancet 2007; DOI:10.1016/S0140-6736(07)61450-0.
HPV testing in primary screening and HPV vaccination against the most common types have the potential to reduce the incidence of invasive adenocarcinoma. Castellsague, X. et al. Worldwide Human Papillomavirus Etiology of Cervical Adenocarcinoma and Its Cofactors: Implications for Screening and Prevention. Journal of the National Cancer Institute 2006; 98: 303-315. HPV testing is substantially more sensitive in detecting CIN 2+ than cytology (96.1% vs. 53%) but is less specific (90.7% vs.96.3%). In this analysis, the sensitivity of HPV testing was similar in all studies carried out in different areas of Europe and North America, whereas the sensitivity of cytology was highly variable. These results support the use of HPV testing as the sole primary screening test, with cytology reserved for women who test HPV-positive. Cuzick, J. et al. Overview of the European and North American studies on HPV testing in primary cervical cancer screening. International Journal of Cancer 2006; 119: 000-000. HPV testing alone was more sensitive than conventional cytology among women 35- 60 years old. Adding liquid-based cytology improved sensitivity only marginally, while increasing false-positives. HPV testing using Hybrid Capture 2 with a 2 pg/mL cutoff may be more appropriate than a 1 pg/mL cutoff for primary cervical cancer screening. Ronco, G. et al. Human Papillomavirus Testing and Liquid-Based Cytology: Results at Recruitment From the New Technologies for Cervical Cancer Randomized Controlled Trial. Journal of the National Cancer Institute 2006; 98: 765 – 74.
Because HPV DNA testing is more sensitive than cervical cytology in detecting CIN 2 and CIN 3, women with negative concurrent test results can be reassured that their risk of unidentified CIN 2 and CIN 3 or cervical cancer is approximately 1 in 1,000. ACOG Practice Bulletin No. 61, "Human Papillomavirus. Clinical Management Guidelines for Obstetrician-Gynecologists." April 2005. The negative predictive value of combined HPV/Pap testing is 99.21% for CIN 3. Sherman M.E., et al. Human Papillomavirus Testing, and Risk for Cervical Neoplasia: A 10-Year Cohort Analysis. Journal of the National Cancer Institute, 2003;95:46-52.
In another study of more than 11,000 women, the digene HPV Test was shown to be 97% sensitive for CIN 2+, compared to 77% for conventional Paps resulting in ASC-US or abnormal results. The study also documented that women infected with high-risk HPV and who have normal or borderline cytology can be managed as effectively with repeat testing after 12 months with immediate colposcopy. Cuzick, J. et al. Management of women who test positive for high-risk types of human papillomavirus: the HART study. The Lancet 2003;362:1871-76. Still another study demonstrated that HPV testing is a more sensitive indicator of high-grade CIN than either conventional or liquid cytology alone. Screening with both an HPV and Pap test offered a sensitivity and negative predictive value of almost 100%. Twenty-one percent of women who were persistently positive for high-risk HPV DNA types when tested with hc2 were diagnosed with CIN 2/3 within 36 months, compared to only 0.08% of women who were initially HPV-negative. Lorincz, A., Richart, R. Human Papillomavirus DNA Testing As An Adjunct To Cytology In Cervical Screening Programs. APLM 2003;127:959-968. A study of 8,466 women undergoing routine cervical cancer screening showed that when used in conjunction with a Pap, the sensitivity of the digene HPV Test test was 100% for detection of CIN 2+, while that of the Pap alone was 43.5%. Petry K., et al. Inclusion of HPV testing in routine cervical cancer screening for women above 29 years in Germany: results for 8,466 patients, British Journal of Cancer,2003;88:1570-1577. Women with persistent HPV infection are more than 300 times more likely than HPV-negative women to develop high-grade cervical disease. Bory J., et al. Recurrent Human Papillomavirus Infection Detected with the Hybrid Capture 2 Assay Selects Women with Normal Cervical Smears at Risk for Developing High Grade Cervical Lesions: A Longitudinal Study of 3,091 Women. Int. J. Cancer, 2002;102:519-525. In an ASC-US population, the sensitivity of the digene HPV Test for detecting high-grade precursors and cervical cancer is 96%, compared to 85% for a repeat liquid-based Pap test. Solomon D., et al. Comparison of Three Management Strategies for Patients with Atypical Squamous Cells of Undetermined Significance: Baseline Results from a Randomized Trial, J. Nat Cancer Inst, 2001; 93:293-299. A cohort analysis of 5,671 women older than 30 (conducted within a larger study of 7,932 women) showed that conventional cytology was 57% sensitive for HSIL; liquid cytology was 84% sensitive, and the digene HPV Test was 100% sensitive. Clavel C., et al. Human Papillomavirus Testing in Primary Screening for the Detection of High-Grade Cervical Lesions: A Study of 7,932 Women. Brit J Cancer, 2001; 89 (12):1616-1623. High-risk HPV types have been detected in 99.7% of cases of cervical cancer, confirming that the virus must be present for cervical cancer to develop. Walboomers J.M.M., et al. Human Papillomavirus is a Necessary Cause of Invasive Cervical Cancer Worldwide. Journal of Pathology 1999;189:12-19. 71.224.215.219 (talk) 19:50, 28 April 2008 (UTC)
References
- ^ ACOG Practice Bulletin #61, April 2005
- ^ ACOG Practice Bulletin #61, April 2005
- ^ Smith RA, Cokkinides V, Eyre HJ. American Cancer Society guidelines for the early detection of cancer, 2006. CA Cancer J Clin. 2006;56:11-25.
- ^ Castle PE, Sideri M, Jeronimo J, et al. Risk assessment to guide the prevention of cervical cancer. Am J Obstet Gynecol 2007;197:356.e1-356.e6.
Guidelines have been updated in 2006. Important changes have been made. Article needs updating.
[edit]SEE: Update on ASCCP Consensus Guidelines for Abnormal Cervical Screening Tests and Cervical Histology, American Family Physician, July 15, 2009 —Preceding unsigned comment added by Andrewjonathandorfman (talk • contribs) 02:58, 15 May 2010 (UTC)
Translation of the Hans Hinselmann wiki
[edit]There is a German language Wikipedia page for Hans Hinselmann.
https://de.m.wikipedia.org/wiki/Hans_Hinselmann
As it is a red link here on the English page for Colposcopy, is anyone able to translate and create a page for him so it can become a much appreciated blue, readable page? Thanks! Aequitas333 (talk) 05:16, 24 August 2015 (UTC) Aequitas333 (talk) 05:16, 24 August 2015 (UTC)
External links modified
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External links modified
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Cryptic illustration.
[edit]In section: "Indications," the illustration is meaningless to the average reader. (Too technical.) Unexplained, it is the graphical equiv of "jargon." This does not meet Wiki guidelines, — which in fact are specific regarding this scenario. That illustration needs explanation or deletion.
Quoting Google result:
"https://en.wikipedia.org/wiki/Wikipedia:Make_technical_articles_understandable Jump to Avoid overly technical language - Main guideline: Technical language in Wikipedia:Manual of Style. Use jargon and acronyms judiciously. Explain technical terms and expand acronyms when they are first used. In addition, you might consider using them sparingly thereafter, or not at all."
See also: https://en.wikipedia.org/wiki/Wikipedia:Manual_of_Style#Avoid_using_images_to_convey_text — Preceding unsigned comment added by 2602:306:CFCE:1EE0:39FA:784C:21C9:F793 (talk) 18:25, 8 April 2018 (UTC)
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