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Objective: To determine if cervical intraepithelial neoplasia grade 3 (CIN-3) and cervical cancer are associated with adverse obstetrical outcomes. Methods: Women with diagnoses of CIN-3 and cervical cancer were first identified from the University of Pittsburgh Medical Center (UPMC) Network Cancer Registry by using respective ICD-3 codes. Identified records were then linked to the Magee Obstetrical Maternal and Infant (MOMI) database to identify women who subsequently delivered pregnancies at Magee-Womens Hospital. Women with cervical disease were compared with women without known disease to determine the impact of cervical disease on various maternal and neonatal outcomes. The latter group consisted of those women who delivered singleton pregnancies at our institution, as determined by the MOMI database, but who did not have any matching records in the UPMC Cancer Registry. Statistical significance was defined by a p value <0.05. Results: We identified CIN-3 ( n = 52) and cervical cancer patients ( n = 83) who later had documented pregnancies delivered at Magee-Womens Hospital between 1989 and 2006. Women with cervical cancer and CIN-3 were at greater risk to deliver small-for-gestational age (SGA) neonates compared with women without known cervical disease (RR 1.54, 95% confidence interval [CI] 1.0-2.46). A secondary analysis of risk factors for SGA neonates demonstrated a significant association with cervical cancer ( p = 0.04). After accounting for variables known to be risk factors for SGA, cervical cancer was associated with a 1.9-fold increased risk of a SGA delivery (OR 1.9, 95% CI 1.1-3.4). Conclusions: Cervical cancer is a risk factor for delivery of an SGA neonate in a subsequent pregnancy. [ABSTRACT FROM AUTHOR]

Background: Women with ovarian cancer have reported abdominal/pelvic pain, bloating, difficulty eating or feeling full quickly, and urinary frequency/urgency prior to diagnosis. We explored these findings in a general population using a dataset of insured women aged 40–64 and investigated the potential effectiveness of a routine review of claims data as a prescreen to identify women at high risk for ovarian cancer. Methods: Data from a large Washington State health insurer were merged with the Seattle-Puget Sound Surveillance, Epidemiology and End Results (SEER) cancer registry for 2000–2004. We estimated the prevalence of symptoms in the 36 months prior to diagnosis for early and late-stage ovarian cancer cases and for two comparison groups. The potential performance of a passive screener that would flag women with two or more visits for any of the symptoms in the previous 2-month period was examined. Results: Of the 223,903 insured women, 161 had incident cases of ovarian cancer. Both early and late-stage patients had a higher prevalence of abdominal/pelvic pain and bloating than the comparison groups, primarily in the 3 months before diagnosis. The passive screener had a sensitivity of 0.31 and specificity of 0.83 and usually identified women right before diagnosis. Assuming an average cost of $500 per false positive, the screener would be considered cost-effective if the true positives had an average increase of 8.5 years of life expectancy. Conclusions: These results support previous findings that ovarian cancer symptoms were reported in health insurance claims and were more prevalent before diagnosis, but the symptoms may occur too close to the diagnosis date to provide useful diagnostic information. The passive screening approach should be reevaluated in the future using electronic medical records; if found to be effective, the method may be potentially useful for other incident diseases. [ABSTRACT FROM AUTHOR]

The quadrivalent human papillomavirus (HPV) vaccine was recommended in 2006 for routine vaccination of 11 or 12-year-old girls, with catchup through age 26 years, for the prevention of genital HPV-related diseases. The Vaccine Adverse Event Reporting System (VAERS) is a national spontaneous surveillance system of adverse events following vaccination in the United States. The objective of this study was to identify and review VAERS reports of invasive and in situ cervical cancer in women immunized with the quadrivalent HPV vaccine. A VAERS database search was performed to identify such cases reported in the United States from January 1, 2006, through April 9, 2009. Medical Dictionary for Regulatory Activities (MedDRA) search terms used were “cervix carcinoma,” “cervix carcinoma stage 0,” “cervix carcinoma stage III,” “carcinoma in situ,” and “cervical dysplasia.” Case inclusion required a report to contain a clear statement of a cervical carcinoma or carcinoma in situ diagnosis on any screening or diagnostic test after at least one dose of the HPV vaccine. All reports were reviewed by two investigators. Four VAERS reports for MedDRA term “cervix carcinoma,” one for “cervix carcinoma stage 0,” none for “cervix carcinoma stage III,” three for “carcinoma in situ,” and 53 for “cervical dysplasia” were identified. Of these, three cases of carcinoma in situ and one case of microinvasive cervical cancer met study inclusion criteria. Cases of cervical cancer and precancers are not unexpected in vaccinated women. Cervical cancer screening continues to be important, even for women who have received the HPV vaccine. [ABSTRACT FROM AUTHOR]

Objective: The primary objective of the present study was to evaluate the effects of a community-based pilot intervention that combined cervical cancer education with patient navigation on cervical cancer screening behaviors among Chinese American women residing in New York City. Methods: Chinese women ( n = 134) who had not had a Pap test within the previous 12 months were recruited from four Asian community-based organizations (CBOs). Women from two of the CBOs received the intervention ( n = 80) consisting of education, interaction with a Chinese physician, and navigation assistance, including help in identifying and accessing free or low-cost screening services. The control group ( n = 54) received education delivered by Chinese community health educators and written materials on general health and cancer screening, including cervical cancer, the Pap test, and information about sites that provided free screening. Study assessments were obtained in-person at baseline and postintervention. Screening behavior was self-reported at 12-month postintervention and verified by medical staff. Results: In the 12-month interval following the program, screening rates were significantly higher in the intervention group (70%) compared to the control group (11.1%). Hierarchical logistic regression analyses indicated that screening behavior was associated with older age (OR = 1.08, 95% CI = 1.01–1.15, p < .05). In addition, women with poorer English language fluency (OR = 0.30, 95% CI = 0.10–0.89, p < .05) and who did not have health insurance were less likely to obtain screening (OR = 0.15, 95% CI = 0.02–0.96, p < .05). Among health beliefs, greater perceived severity of disease was positively associated with screening behavior (OR = 4.26, 95% CI = 1.01-18.04, p < .05). Conclusions: Community-based programs that provide combined education and patient navigation may be effective in overcoming the extensive linguistic and access barriers to screening faced by Chinese American women. [ABSTRACT FROM AUTHOR]

The article presents abstracts related to women diseases-related studies, which include a comparison of liquid-based cytology with conventional cytology for detection of cervical cancer precursors, the efficacy of daily fiber intake on reproductive function and fertility preservation in young women with epithelial ovarian cancer.

Background: Patient satisfaction is an important outcome measure in determining quality of care. There are few data evaluating patient satisfaction in nonwhite, low-income populations. The objective of this study was to identify the structure, process, and outcome factors that impact patient satisfaction with care in a low-income population of women with breast cancer. Methods: In a cross-sectional survey of low-income women newly diagnosed with breast cancer, eligible women enrolled in the California Breast and Cervical Cancer Treatment Program (BCCTP) from February 2003 through September 2005 were interviewed by phone 6 months after their enrollment. This was a population-based sample of women aged ≥18 years ( n = 924) with a definitive diagnosis of breast cancer and enrolled in the BCCTP. The main outcome measure was satisfaction with care received. Results: Random effects logistic regression revealed that less acculturated Latinas were more likely (odds ratio, [OR] = 5.36, p < 0.000) to be extremely satisfied with their care compared with non-Hispanic white women. Women who believed they could have been diagnosed sooner were less likely to be extremely satisfied (OR = 0.61, p < 0.000). Women who had received or were receiving radiotherapy or chemotherapy had nearly twice the odds of being extremely satisfied (OR = 2.02, p < 0.000, and OR = 2.13, p < 0.000, respectively). Greater information giving was associated with greater satisfaction (OR = 1.17, p < 0.000). Women reporting greater physician emotional support were more likely to report being extremely satisfied (OR = 1.26, p < 0.000). A higher participatory treatment decision-making score was associated with greater satisfaction (OR = 1.78, p < 0.000). Conclusions: In a low-income population, satisfaction is also reported at high levels. In addition to age, ethnicity/acculturation, receipt of chemotherapy and radiotherapy, physician emotional support, and collaborative decision making, perception of diagnostic delay is a predictor of dissatisfaction in this population. [ABSTRACT FROM AUTHOR]

Background: Although it is widely accepted that Papanicolaou (Pap) screening can reduce cervical cancer mortality, many women still do not maintain regular cervical cancer screenings. Objective: To describe the prevalence of cervical cancer screening and the demographic, behavioral, psychological, and cancer-related knowledge factors associated with adherence to U.S. Preventive Services Task Force (USPSTF) cervical cancer screening guidelines among women in the United States. Methods: Data for women aged 25–64 were obtained from the National Cancer Institute's (NCI) 2005 Health Information National Trends Survey (HINTS). Women were considered adherent to screening guidelines if they had two consecutive, on-schedule screenings and planned to have another within the next 3 years. The sample comprised 2070 women. Results: Ninety-eight percent of women reported ever having a Pap smear, 90% reported having had a recent Pap smear (within 3 years), and 84% were adherent to USPSTF screening guidelines. Maintaining regular cervical cancer screening was significantly associated with having health insurance, normal body mass index (BMI), smoking status (nonsmoker), mood (absence of a mood disturbance), and being knowledgeable about cervical cancer screening and human papillomavirus (HPV) infection. Conclusions: Based on the observation that women who were current smokers, obese, or experiencing a substantial degree of psychological distress were significantly less likely to adhere to recommended screening guidelines, we suggest that healthcare providers pay particular attention to the screening needs of these more vulnerable women. [ABSTRACT FROM AUTHOR]

Objective: To estimate the lifetime prevalence of Pap smear among women in Kuwait and to assess their knowledge about and attitude toward Pap smears. Methods: This was a descriptive cross-sectional study using a multistage cluster sampling method. We interviewed 299 women attending polyclinics in Kuwait using a self-administered questionnaire. Factors related to history of having a Pap smear, knowledge level, and willingness to participate in a screening program were evaluated. Results: The lifetime prevalence of Pap smear was found to be 37% (95% CI 33-43). Forty-four percent of women in our study had a Pap smear only once in their lives. History of having at least one Pap smear was significantly related to such factors as age, total family income, marital status, history of cervical infection, and knowledge. The level of knowledge about cervical cancer varied among the participants. Forty-six percent of women were uncertain about the symptoms of cervical cancer. About half the women recognized cervical infection, smoking, and having multiple sexual partners as risk factors for cervical cancer; however, only 10% recognized early sexual intercourse as a risk factor. Willingness to participate in a future screening program varied significantly according to educational level, employment status, and total family income. Conclusions: Although cervical cancer incidence and mortality are relatively low in Kuwait, they may be underreported in the absence of a screening program. Moreover, lifetime prevalence of having a Pap smear was found to be considerably lower in Kuwait compared with developed countries. [ABSTRACT FROM AUTHOR]

Objective: The aim of this work was to determine whether minority women are more likely to die of cervical cancer. A population-based cohort study was performed using Texas Cancer Registry (TCR) data from 1998 to 2002. Methods: A total of 5,166 women with cervical cancer were identified during 1998–2002 through the TCR. Measures of socioeconomic status (SES) and urbanization were created using census block group-level data. Multilevel logistic regression was used to calculate the odds of dying from cervical cancer by race, and Cox proportional hazards modeling was used for cervical cancer-specific survival analysis. Results: After adjusting for age, SES, urbanization, stage, cell type, and treatment, Hispanic women were significantly less likely than non-Hispanic White women to die from cervical cancer (adjusted hazard ratio [aHR] = 0.69; 95% CI [confidence interval] = 0.59–0.80), whereas Black women were more likely to die (aHR = 1.26; 95% CI = 1.06–1.50). Black and Hispanic women were more likely to be diagnosed at a later stage than White women. Black women were significantly less likely to receive surgery among those diagnosed with localized disease ( p = 0.001) relative to both White and Hispanic women. Conclusions: Relative to non-Hispanic White women, Black women were more likely to die of cervical cancer while Hispanic women were less likely to die; these survival differences were not explained by SES, urbanization, age, cell type, stage at diagnosis, or treatment. [ABSTRACT FROM AUTHOR]

The article presents several topics related to women. A website in human health was developed by the Office of Research on Women's Health and the Food and Drug Administration. An increasing number of patients admitted to the hospital for medication of osteoporosis-associated fractures was reported by the Agency for Healthcare Research and Quality. A British study reveals that women with breast and ovarian cancer often choose to surgically remove their breasts or ovaries to reduce cancer risk.

Aim: Thyroid cancer is more frequent in women than in men, suggesting the potential role of reproductive and menstrual factors in this cancer. To investigate the association with these factors, we examined 37,986 women involved in the Japan Collaborative Cohort (JACC) Study from 1988 to 1997. Methods: Reproductive and menstrual factors were assessed with a self-administered questionnaire at baseline. Hazard ratios (HR) and 95% confidence intervals (95% CI) of thyroid cancer incidence were estimated using Cox proportional hazards regression. Results: Eighty-six new cases of thyroid cancer were recorded during 379,281 person-years of follow-up. Overall incidence rate was 22.7 per 100,000 person-years, with a diagnosed peak of 38.2 per 100,000 at 55–59 years old. Multivariate HRs of 0.56 (95% CI 0.25–1.24) and 0.52 (95% CI 0.24–1.16) were observed for women who had experienced pregnancy or a live birth, respectively, but without statistical significance. Further, we saw no associations with other factors, such as age at menarche, age at menopause, age at first birth, or hormone use. Conclusions: There was no significant association between thyroid cancer and reproductive and menstrual factors in the present study. Additional cohort studies should further examine this possible relationship among Japanese women. [ABSTRACT FROM AUTHOR]

Diabetes is a common and costly disease. In 2007, an estimated 24 million people in the United States had diabetes, with almost half of these being women. Diabetes increases the risk of morbidity and mortality from several conditions, including cardiovascular disease, several types of cancers, influenza and pneumococcal infection, and kidney, eye, and periodontal diseases. The aim of this study was to examine the quality of care that women with diabetes receive and to assess how receipt of some clinical preventive services and screening for common conditions associated with diabetes vary according to socioeconomic factors. Our findings indicate that use of diabetes-specific preventive care among women is low, with the youngest women (≤45 years) and those with low educational levels being the least likely to receive the recommended services. Women with diabetes were less likely than women without diabetes to receive a Pap smear, with the oldest women (≥65 years) being the most vulnerable. Women with diabetes who were poor and nonwhite were less likely than more affluent and white women to receive a pneumococcal vaccination. This study's findings suggest that having a chronic disease may serve as a barrier to the receipt of recommended preventive care among women. Effective interventions should be designed to meet the needs of the most vulnerable women with diabetes, in particular, those who are at the extremes of the life cycle, are poor, and have low levels of education. Programs should use a life stage approach to address the unique needs of women with diabetes. [ABSTRACT FROM AUTHOR]

Objective: Recent attention has focused on moving women from having initial mammograms to maintaining adherence to regular mammography schedules. We examined behavioral intentions to maintain mammography adherence, which include the likelihood of performing a behavior, and implementation intentions, specific action plans to obtain mammograms. Potential predictors were Theory of Planned Behavior constructs, previous barriers, previous mammography maintenance, and age. Methods: Respondents were 2062 currently adherent women due for their next mammograms in 3–4 months according to American Cancer Society recommendations for annual screening. Statistical models were used to examine predictors of behavioral and two implementation intentions, including having thought about where women would get their next mammograms and having thought about making appointments. Results: With the exception of pros, cons, and subjective norms, all variables predicted behavioral intentions ( p ≤ 0.05). Stronger perceived control, previous mammography maintenance, and one barrier (vs. none) predicted being more likely to have thought about where to get their next mammograms. Previous maintenance and no barriers (vs. two) predicted being more likely to have thought about making appointments. Conclusions: Our findings suggest that among women currently adherent to mammography, volitional factors, such as barriers, may be better predictors of implementation intentions than motivational factors, such as attitudes. Implementation variables may be useful in understanding how women move from intentions to action. Future research should examine how such factors relate to mammography maintenance behaviors and can be integrated into behavior change interventions. [ABSTRACT FROM AUTHOR]

Background: Medical pluralism can be defined as the employment of more than one medical system or the use of both conventional and complementary and alternative medicine (CAM) for health and illness. American women use a variety of health services and practices for women's health conditions, yet no national study has specifically characterized women's medical pluralism. Our objective was to describe medical pluralism among American women. Methods: A nationally representative telephone survey of 808 women ≥18 years of age was conducted in 2001. Cross-sectional observations of the use of 11 CAM domains and the use of an additional domain—spirituality, religion, or prayer for health—during the past year are reported. Women's health conditions, treatments used, reasons for use, and disclosure to conventional physicians are described, along with predictors of CAM use. Results: Over half (53%) of respondents used CAM for health conditions, especially for those involving chronic pain. The majority of women disclosed such practices at clinical encounters with conventional providers. Biologically based CAM therapies, such as nutritional supplements and herbs, were commonly used with prescription and over-the-counter (OTC) pharmaceuticals for health conditions. Conclusions: Medical pluralism is common among women and should be accepted as a cultural norm. Although disclosure rates of CAM use to conventional providers were higher than in previous population-based studies, disclosure should be increased, especially for women who are pregnant and those with heart disease and cancer. The health risks and benefits of polypharmacy should be addressed at multiple levels of the public health system. [ABSTRACT FROM AUTHOR]

The article presents abstracts of papers concerning women's health which include "Diabetes and endometrial cancer: An evaluation of the modifying effects of other known risk factors," "Hormone replacement therapy and ovarian cancer risk: A meta-analysis," and "Double jeopardy: Depressive symptoms and rapid subsequent pregnancy in adolescent mothers."

BACKGROUND: Evidence that long-term hormone therapy (HT) may increase the risk of serious adverse events led to a sharp reduction in all HT use, including short-term use for vasomotor symptom relief. We estimated women's willingness to accept adverse event risks in exchange for vasomotor symptom relief when risks are communicated in absolute vs. relative terms. METHODS: We developed a conjoint survey to elicit preferences across benefit and risk attributes of HT. The survey was administered via the Internet to 523 U.S. women aged 46-60 years. Participants evaluated pairs of hypothetical treatments and indicated preferences using a Likert-based scale. Risks were presented in absolute and relative terms. Satisfaction scores for HT risks and benefits were estimated using random-effects, ordered-probit regression. Maximum acceptable risk (MAR) was calculated as the increase in risk that reduces the satisfaction score for a given level of HT benefit to 0. RESULTS: For both risk versions, the least important attribute (smallest difference in satisfaction scores) was night sweat frequency; heart attack risk was the most important (largest difference in scores). Participants were more willing to accept risks in return for symptom relief when shown absolute vs. relative risks, although differences in MAR were statistically significant only for breast cancer risk. MARs for breast cancer and heart attack exceeded reported rates in most cases. CONCLUSIONS: Many women may be willing to accept risks to control vasomotor symptoms. However, describing risks in different, but technically equivalent, ways affects women's willingness to trade risks for benefits. [ABSTRACT FROM AUTHOR]

Background: Several national medical organizations recommend more intensive screening or screening at an earlier age for individuals with a family history of breast, colorectal, or skin cancer. This study examined whether women with a family history of cancer were more likely to use breast, colorectal, or skin cancer screenings compared with those without such a family history. Methods:The data for this study came from female respondents who participated in the 2000 National Health Interview Survey. The age range of the study subjects and the definitions of cancer screening were determined based on the American Cancer Society recommendations on cancer screening. Results: When compared with women without a family history of breast cancer, women with a family history were more likely to undergo a screening mammogram. Women who had a family history of colorectal cancer were twice as likely to use colorectal cancer screening than women without a family history of colorectal cancer. The association of family history with colorectal and breast cancer screening was stronger among the younger age group for which a screening test is recommended if one has such a family history. The association between skin cancer screening and family history of skin cancer was significant only in younger women. Conclusions: Women with a family history of cancer were more likely to have colorectal, breast, and skin cancer screening examinations. This may be a result of more physicians′ recommendations and higher personal motivation for getting cancer screening, suggesting that the efficacy of national guidelines has been increasing somewhat. [ABSTRACT FROM AUTHOR]

Purpose: The authors sought to determine if colorectal cancer stage at diagnosis varies by gender in the state of Ohio. Methods: We conducted a retrospective cohort study. Included in the cohort were patients diagnosed with colorectal cancer from 1996 to 2001 who had their data reported to the State of Ohio Tumor Registry. We collected data on gender, stage of cancer, and three potential confounding variables: age, location of colon cancer, and race. The colorectal cancer was determined to be at one of four stages: (1) carcinoma in situ, (2) local disease, (3) regional disease, and (4) distant disease. In addition, we combined stages 1 and 2 to create a good prognosis category, and we combined stages 3 and 4 to create a bad prognosis category. Results: Our cohort consisted of 27,041 patients [13,807 women (51%) and 13,234 men]. The women with colon cancer were significantly older and had more right-sided colon cancer, ( p < 0.05). With the use of logistic regression, the women were significantly less likely to have carcinoma in situ compared with the men (OR = 0.82, 95% CI 0.75–0.89). The women also had a significant decrease in local disease (OR = 0.94, 95% CI 0.89–0.99). In contrast, the women showed significantly more regional disease than men (OR = 1.11, 95% CI 1.05–1.16). The women were less likely to have a good prognostic stage (OR = 0.89, 95% CI 0.85–0.94) and more likely to have a bad prognostic stage (OR = 1.12, 95% CI 1.07–1.18). Conclusions: In the State of Ohio from 1996 to 2001, women had more advanced colon cancer at diagnosis than men. [ABSTRACT FROM AUTHOR]

The article reports on the public health response concerning ovarian cancer. Ovarian cancer is often diagnosed in its late stage because there isn't effective screening tool for its early detection that is why there is a need for further study of the disease. The research includes diagnostic patterns and symptoms, optimal treatment, risk perception as well as end-of-life care of patients with ovarian cancer. The development of the research program aims to decrease morbidity and to improve survival time.

Background: There is limited information available regarding the characteristics of patients who elect to gather and share information about their malignancy on the Internet. Methods: Using a proprietary decision support program embedded into a number of established websites, individuals entered personal clinical data into disease site profilers designed to provide information about evidence-based treatment options, based on specific characteristics (e.g., stage of disease, prior therapy) provided by the patients. The aggregate data were evaluated to examine the characteristics of patients with gynecological cancer (with a focus on newly diagnosed and recurrent ovarian cancer) using such a tool. Results: From early 2000 through November 2004, >15,000 patients with gynecological cancer have entered data into one of four profilers: newly diagnosed ( n = 5604)/recurrent ( n = 2803) ovarian, endometrial, and cervical cancers. Internal data consistency includes similar ages and general health histories of the ovarian and endometrial cancer populations and younger age of the cervical cancer patients. Whereas 90% of the women with ovarian cancer considered themselves to be in "good health," 64% of newly diagnosed vs. only 50% of recurrent disease patients declared their activity level was "normal." Of the recurrent patients, 32% stated they had undergone a secondary surgery. The overall aggressive management philosophy of the recurrent patients in this series is supported by the observation that 33% had received ≥4 prior chemotherapy regimens, 97% desired additional treatment, and 81% were interested in clinical trials. Conclusions: Women with ovarian cancer seeking assistance from web-based decision support programs may represent a subgroup with unique clinical features compared with the general patient population. [ABSTRACT FROM AUTHOR]

The article presents abstracts of medical research. They include "Screen-and-treat approaches for cervical cancer prevention in low-resource settings: A randomized controlled trial," "Trends in the incidence of venous thromboembolism during pregnancy or postpartum: A 30-year population-based study," "Routine ultrasound screening in the third trimester: A population-based study," "Gestational diabetes: A reappraisal of HBA1c as a screening test," and "Breast cancer risk with postmenopausal hormonal treatment."

Several abstracts of articles about human diseases is presented, including "Gabapentin for Hot Flashes in 420 Women With Breast Cancer: A Randomised Double-Blind Placebo-Controlled Trial," "Testosterone Patch Increases Sexual Activity and Desire in Surgically Menopausal Women With Hypoactive Sexual Desire Disorder," "Does Maternal Race or Ethnicity Affect the Expression of Severe Preeclampsia?" "The Probability for a Pap Test to be Abnormal is Directly Proportional to HPV Viral Load: Results From a Swiss Study Comparing HPV Testing and Liquid-Based Cytology to Detect Cervical Cancer Precursor in 13,842 Women" and "Comorbidity and Survival Disparities Among Black and White Patients With Breast Cancer."

Objective: To determine if colon cancer stage at diagnosis varies by gender. Methods: We conducted a retrospective cohort study comprising of patients diagnosed with colon cancer from 1990 to 2002 and had their data reported to the TriHealth Tumor Registry, Cincinnati, OH. We classified the colon cancer into one of four stages: carcinoma in situ (CIS), local, regional, and distant disease. Results: Our cohort consisted of 2891 patients (1467 women and 1424 men). The women with colon cancer were significantly older and more likely to be single or widowed; in addition, more of them were African American ( p < 0.05). The men with colon cancer were more likely to smoke tobacco and consume alcohol ( p < 0.05). There was no difference between the genders for family history of colon cancer (8.5% vs. 9.6%). We found that women were significantly less likely to have CIS compared with men (OR = 0.51, 95% CI 0.09-0.85). Women also possessed a nonsignificant decrease in local disease. In contrast, the women showed significantly more regional disease than men (OR = 1.19, 95% CI 1.06-1.30) and had a non-significant increase in distant disease. Conclusion: After controlling for multiple variables, at diagnosis and staging of colon cancer, women had more advanced disease than men. [ABSTRACT FROM AUTHOR]

Objective: To determine factors that influence sexual minority women's coping responses and adjustment to breast cancer. Methods: We conducted a cross-sectional study with 64 sexual minority women with breast cancer who were recruited through targeted community-based sampling. In this study, sexual minority women consisted of three sexual orientation groups: those who self-reported partnering with women and those with a lesbian or bisexual identity. We determined the number of years of sexual minority status and disclosure of sexual orientation and used standardized measures to assess these women's coping and adjustment to breast cancer. Data were analyzed using statistical methods as appropriate for the level of data. Results: We determined that sexual minority factors, such as sexual orientation group, influenced coping and adjustment even after illness and social support factors were controlled. In multivariate analyses, women who identified as lesbians or bisexuals used less maladaptive coping compared with women who reported partnering with women. The association between reporting a lesbian identity and lower distress approached significance in multivariate regression equations. Conclusions: Of the sexual minority factors that were considered, sexual orientation group, number of years of sexual minority status, and disclosure of sexual minority status, only sexual orientation group was related to coping and lower distress. Contrary to expectations, disclosure of sexual orientation did not relate to coping and lower distress. The findings support the need for future studies to include different aspects of sexual minority status, in particular, clearly defined sexual orientation groups. [ABSTRACT FROM AUTHOR]

In the mid-1990's, the U.S. Congress funding an innovative demonstration program to promote the health of underinsured and uninsured women aged 40-64. The program, known as Well- Integrated Screening and Evaluation for Women Across the Nation (WISEWOMAN), builds on the longtime success of the National Breast and Cervical Cancer Early Detection Program (NBCCEDP). Financially, disadvantaged women who qualify for NBCCEDP services are also eligible to receive WISEWOMAN screening and lifestyle interventions, which aim to reduce their risk for heart disease, diabetes, and other chronic diseases.

The article discusses public health services. The Well-Integrated Screening and Evaluation for Women Across the Nation (WISE-WOMAN) health promotion projects are ground- breaking in that they expand on an existing cancer control infrastructure to address additional chronic diseases and disease disparities. The WISEWOMAN approach is exciting because it begins to dismantle the territorial, disease-circumscribed silos that have long prevented optimal utilization of scarce public health resources in the face of an ever-increasing disease burden and service demand.

Media coverage of scientific research plays a major role in shaping public opinion and influencing medical practice. When an association is controversial, such as with hormone replacement therapy (HRT) and breast cancer, it is important that a balanced picture of the scientific literature be reported. The objective of this study was to assess whether scientific publications that do and do not support an HRT/breast cancer association were cited in the media in proportions similar to those with which they appear in the scientific literature. Scientific publications reporting on the HRT/breast cancer association published from January 1, 1995, to June 30, 2000, were identified through a systematic Medline search. Media reports from newspapers, magazines, television, and radio that reported on HRT and breast cancer were retrieved from an online database. Investigators independently recorded characteristics of the scientific publications and media reports. A total of 32 scientific publications were identified: 20 (62.5%) concluded there was an increased risk of breast cancer associated with HRT (positive publications), and 12 (37.5%) concluded there was no evidence for an association (null publications). Nearly half (47%) of the scientific publications were not cited by the media. There were 203 media citations of scientific publications: 82% were of positive publications and 18% were of null publications, representing a significant excess of citations of positive publications (p < 0.01). Media coverage of this controversial issue is based on a limited sample of the scientific publications. Moreover, the excess of media citations for positive scientific publications suggests a bias against null scientific publications. [ABSTRACT FROM AUTHOR]

The prevalence of ductal carcinoma in situ (DCIS) has increased through more widespread use of screening mammography. Little is known about what women with DCIS understand about their disease and future health. Although there is a wealth of information about the psychological characteristics of women with invasive breast cancer, there is virtually no information about women who have received treatment for DCIS. Seventy-six women diagnosed with DCIS who were identified through the Duke University Tumor Registry completed a mailed self-administered questionnaire including a broad range of items to measure knowledge, satisfaction with care, risk perceptions, and psychological distress. Women with DCIS have knowledge deficits about DCIS and breast cancer, as well as concerns about recurrence and misperceptions about the likelihood for DCIS metastasis. Women were generally satisfied with their care. They were less satisfied with information related to prognosis and with perceived support from their doctors. The results of this study suggest several areas of concern for women diagnosed with DCIS. Data about risk perceptions, knowledge, and attitudes in women diagnosed with DCIS provide important preliminary ideas for future studies. In view of the frequency of the DCIS diagnosis, future investigation should be conducted to build on these findings. [ABSTRACT FROM AUTHOR]

Postmenopausal women with coronary heart disease (CHD) who volunteered for the Heart and Estrogen/Progestin Replacement Study (HERS) randomized clinical trial had high rates of gynecological abnormalities. We examined compliance with gynecological cancer screening and factors affecting this behavior. Women who met inclusion criteria for HERS and were seen for screening by the study gynecologist were considered eligible for this study. Data were abstracted from study records, and additional information was obtained by telephone questionnaire. Adherence to mammography, breast examination, pelvic examination, and Pap smear recommendations was assessed. Provider behavior and its effect on compliance were assessed. Compliance rates were 59.1% for monthly breast self-examination (BSE), 67.2% for yearly mammography, 73% for yearly Pap smear and pelvic examination, and 75.7% for provider breast examination. Over 50% of patients had most of their screening tests done within the last year. Provider behavior was significantly related to patient screening compliance for mammography, breast examination, Pap smear, and pelvic examination. Provider gender was not significantly related to adherence. There were no significant differences in compliance rates based on the type of most recent coronary event. Compliance rates did not differ significantly between patients with and without gynecological abnormalities, except for mammography (78.3% versus 48.3%, p = 0.02). The majority of patients were compliant with gynecological screening. Among patients with gynecological abnormalities, mammography compliance was significantly lower. Provider behavior was an important factor in influencing women to obtain preventive screening. There were no significant differences in compliance based on provider gender or type of coronary event preceding HERS enrollment. [ABSTRACT FROM AUTHOR]

One in nine women can expect to develop breast cancer over the course of a lifetime, which suggests that a posture of vigilance is appropriate. The form of breast imaging known as mammography will detect masses that self-examination and yearly clinical examinations may miss. Given that most types of breast cancer are not clinically preventable, early detection of such masses offers the best opportunity for survival for the affected women. Recognizing the need to ensure quality testing and interpreting procedures for so many women, the federal government has enacted legislation that requires breast imagers to read 240 mammograms in 6 months to qualify for certification and another 960 mammograms in the following 2 years. The burdensome nature of these requirements has had the effect of reducing the number of radiologists certified to read mammograms, and this has decreased the overall availability of this service to women. I explore two possible rationales for instituting such strict federal regulation of breast imagers: that breast cancer is more prevalent than other diseases that affect women and that legislating such high standards ensures the accuracy of interpretation. On neither ground is such legislation justified. Instead, I contend that this regulation was instituted as a way for politicians to make up for disregarding women and women's health concerns in the past by focusing on a current issue that predominantly affects women. As a consequence, I argue that more women may be harmed than benefited by such legislation. [ABSTRACT FROM AUTHOR]

Women tend to fear breast cancer and thus overestimate their risk of developing it, have less concern about developing heart disease, and do not know that lung cancer is the major cause of cancer death. Death certificate data, consolidated into a national database by the National Center for Health Statistics, were used to compare age-specific mortality due to selected cardiovascular diseases and cancers among women who died in 1997 in the United States. The outcomes examined included underlying cause of death categorized as all circulatory system disease, cerebrovascular disease, and heart disease, including coronary and noncoronary disease, and as all cancers combined plus cancer of the lung, breast, and colon/rectum. In 1997, 500,703 women in the United States died from diseases of the circulatory system, including 370,357 deaths from heart disease. Most deaths from heart disease were due to coronary heart disease, which exceeded mortality from cerebrovascular disease at all ages except under age 40. In 1997, 258,463 women in the United States died from cancer, and before age 55, breast cancer death rates exceeded lung and colorectal cancer death rates. Mortality due to total heart disease exceeded breast and lung cancer mortality among women at all ages, but before age 55, when absolute death rates are low, breast cancer death rates exceeded those for coronary heart disease. In conclusion, aside from mortality due to all cancers combined and circulatory system disease, only accidents, which were not included in this study, and total heart disease caused more deaths than breast cancer before age 55. [ABSTRACT FROM AUTHOR]

Women's health education is an emerging interdisciplinary field that has recently received national attention. The American Board of Internal Medicine and the American Academy of Family Practice recently have published competencies in women's health for their residents, with increased attention to gynecological and mental health issues. Increasing women's health in the curricula of internal medicine (IM) and family practice (FP) residents will certainly require faculty development among IM and FP teaching faculty. We report a multiinstitution needs assessment among IM and FP teaching faculty for continuing medical education (CME) in multidisciplinary women's health topics. The survey (n = 100) asked whether faculty desired CME in 30 women's health topics. It also requested rates of referral to specialists for breast and menstrual problems and performance of tests commonly carried out in the care of women (e.g., endometrial biopsy, colposcopy, skin biopsy, and sigmoidoscopy) as measures of possible need for CME. Of the 69 respondents, 37% were IM physicians and 63% were FP physicians. Among the 30 women's health topics listed, breast cancer treatment alternatives, infertility for primary care providers, cervical dysplasia, medical treatment in pregnancy, vulvar disease, indications for pelvic ultrasound/endometrial biopsy, and menstrual disorders were of highest interest. The ranking of desirability of topics by IM and FP faculty correlated by .54 (Spearman rank, df = 28, p < 0.01). Analysis of variance revealed a significantly higher interest overall by IM than FP physicians, 58% vs. 42% (F = 41, df = 1,50, p < 0.05). None of the IM teaching faculty performed endometrial biopsy or colposcopy compared with 57% of FP physicians, and only 12.5% of internists performed skin biopsy and sigmoidoscopy come pared with 70% of FP physicians (F = 33, df = 1,38, p < 0.001). We conclude that faculty development in women's health would benefit resident training in IM and FP, and topics of interest are identifiable. The correlation in interests between the KM and FP teaching faculty might make joint programs successful, although gynecological skills and knowledge clearly are needed more by IM teaching faculty. Obstetrics and gynecology (OB/GYN) faculty could be instrumental in improving women's health education among their IM and FP colleagues. [ABSTRACT FROM AUTHOR]

The article presents an update on women's health issues. As everyone concerned with women's health must know, a number of factors have been found that affect a woman's risk of developing breast cancer. Physicians look at a woman's age, history of breast cancer in her family, age at menarche and pregnancy history in assessing the likelihood of her becoming one of the 180,000 American women diagnosed each year with the disease. Pressure from United Nations agencies, private groups and women themselves has made inroads against the tradition of genital mutilation of girls, practiced widely in certain parts of tribal and Muslim Africa. This has become a public health concern in the U.S. communities of recent African immigrants. Progesterone synthesized from yams, structurally identical to the hormone produced naturally in the human female, has been approved by the U.S. Food and Drug Administration (FDA), for treatment of secondary amenorrhea and for use with estrogen therapy to prevent an overgrowth of cells in the uterine lining in premenopausal women who are taking conjugated estrogens.

The fear of breast cancer has been suggested as a potential reason why only a relatively small percentage of postmenopausal women who would benefit from hormone replacement therapy (HRT) are current users. The equivocal results from a large number of epidemiologic studies make it difficult to evaluate whether an association does indeed exist between the use of HRT and the incidence of breast cancer. The inability to provide conclusive evidence for or against this relationship may be attributed to methodologic problems in these studies, including small sample sizes, lack of information, on specific hormonal preparations (e.g., dose and type), failure to control for the type of menopause, and surveillance bias. In an attempt to generalize results from different studies in a systematic manner, several meta-analyses have been conducted of the effects of estrogen replacement therapy (ERT) or HRT on the risk of breast cancer. This article summarizes the data from these meta-analyses and incorporates data from studies published after these meta-analyses that have addressed this question Data from ongoing studies that use a randomized, controlled, longitudinal design on large numbers of women are necessary before a possible association between the use of HRT and breast cancer can be ascertained. [ABSTRACT FROM AUTHOR]

The article offers women's health news briefs. The Office of Research on Women's Health will celebrate its 20th anniversary at the Natcher Conference Center on the National Institutes of Health campus in Bethesda, Maryland. A Safety Communication about an ongoing safety review of oral bisphosphonate medications is issued by the U.S. Food and Drug Administration. Heart disease was the leading killer of women in 2006 followed by cancer and stroke.

The article offers information on various topics related to women's health. The Women's Health 2010: The 18th Annual Congress to be held in Washington, DC on March 26-28, 2010 accepts and encourages submitting abstracts on issues related to women's health to be used for the conference. The blood test OVA1 that detects ovarian cancer has been approved by the U.S. Food and Drug Administration. A research from California notes that obese women have high risk of having severe asthma. In addition, guidelines for women with abnormal vaginal bleeding were released by the American College of Radiology (ACR).

Presents an article about a female patient who developed non-Hodgkin's lymphoma. Medical background of the patient; Psychological aspects of the disease; Description of the patient's end-of-life condition.

This article presents information on diagnosis and treatment of cancer in women. October was National Breast Cancer Awareness Month, a nation-wide educational campaign dedicated to increasing awareness of the importance of the early detection of breast cancer. Since breast cancer is the leading cause of death in women between the ages of 40 and 55, and 1 in 8 women in the United States will develop the disease sometime during her lifetime, such campaigns for awareness arc crucial. Lung cancer is, in fact, the number-one cancer killer of American women today. The public is just beginning to hear that the primary cause of lung cancer--cigarette smoking-affects women differently than it does men. The public is also learning that the so-called "male cancer," colon cancer-affects women. Gender-based research at the genetic level re-minds us that gender differences are at work from the first cell division after conception. Increasing amounts of evidence point toward genetic underpinnings for many cancers. Understanding why there are such large differences between how women and men experience certain diseases is at the heart of women's health.