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Background: A population-based cervical cancer screening programme is implemented in the Czech Republic. However, participation is insufficient among women over 50 years. This study aimed to estimate the potential improvement in participation through directly mailed HPV self-sampling kits (HPVssk) compared with standard invitation letters in women aged 50-65 non-participating in screening. Methods: The study recruited 1564 eligible women (no cervical cancer screening in the last 3 years or more, no previous treatment associated with cervical lesions or cervical cancer). Eight hundred women were mailed with an HPVssk (HPVssk group), and 764 women were sent a standard invitation letter (control group) inviting them to a routine screening (Pap test). The primary outcome was a comparison of the overall participation rate between study groups using a binominal regression model. Results: The participation rate in the HPVssk group was 13.4% [95% confidence interval (CI) 11.2-15.9%; 7.4% of women returned the HPVssk and 6.0% attended gynaecological examination] and 5.0% (95% CI 3.6-6.8%) in the control group. Using the binominal regression model, the difference between the groups was estimated as 7.6% (95% CI 5.0-10.2%; P<0.001). In the HPVssk group, 22% of women who returned HPVssk had a positive result and 70% of them underwent a follow-up examination. Conclusions: Compared with traditional invitation letters, the direct mailing of the HPVssk achieved a significantly higher participation rate, along with a notable HPV positivity rate among HPVssk responders. This approach offers a potentially viable method for engaging women who have not yet attended a cervical screening programme. [ABSTRACT FROM AUTHOR]

Borderline ovarian tumors represent a heterogeneous group of noninvasive tumors of uncertain malignant potential with characteristic histology. They occur in younger women, are present at an early stage, and have a favorable prognosis, but symptomatic recurrence and death may be found as long as 20 years after therapy in some patients. The molecular changes in borderline ovarian tumors indicate linkage of this disease to type I ovarian tumors (lowgrade ovarian carcinomas). The pathological stage of disease and subclassification of extraovarian disease into invasive and noninvasive implants, together with the presence of postoperative macroscopic residual disease, appear to be the major predictor of recurrence and survival. However, it should be emphasized that the most important negative prognostic factor for recurrence is just the use of conservative surgery, but without any impact on patient survival because most recurrent diseases are of the borderline type--easily curable and with an excellent prognosis. Borderline tumors are difficult masses to correctly preoperatively diagnose using imaging methods because their macroscopic features may overlap with invasive and benign ovarian tumors. Over the past several decades, surgical therapy has shifted from a radical approach to more conservative treatment; however, oncologic safety must always be balanced. Follow-up is essential using routine ultrasound imaging, with special attention paid to the remaining ovary in conservatively treated patients. Current literature on this topic leads to a number of controversies that will be discussed thoroughly in this article, with the aim to provide recommendations for the clinical management of these patients. [ABSTRACT FROM AUTHOR]

Background: The aim was to evaluate changes of bone mineral density (BMD) and markers of bone turnover in healthy adolescents, and in adolescent users of combined oral contraceptives (COCs) with different ethinylestradiol (EE) contents. Methods: Inthis prospective crossover study,56healthy females (15-19.5 years)with desire touse hormonal contraception were randomized to COC with either 30 or 15 mg of EE in crossover design of 9-month intervention each in reverse order. Nonusers of the same age (nZ28) served as controls. BMD at lumbar spine (LS), total femur, femoral neck, distal radius, and total body, and serummarkers (N-propeptide of type I procollagen, and type I collagen C-telopeptide) were measured at baseline and after 9 and 18 months. Results: In COC nonusers, BMD significantly increased at LS and radius, whilemarkers decreased. In COC users, BMD did not increase, with the exception of LS BMD in the 30 mg COC group (P!0.05). In the crossover design, a difference between the low- and very low-dose COC users was found in LS BMD changes (P!0.05),where increase in BMD was more impaired in the 15 mg COC users. The skeletal effects of COC remained significant after adjustments for age and smoking status. Markers declined faster in COC users during the first period, while they remained stable or even increased during the second 9 months. Conclusion: Physiological acquisition of LS BMD during adolescent age may be prevented by use of COC, especially those containing very low dose of EE. [ABSTRACT FROM AUTHOR]

This article presents the results of representative national studies comparing the behavior and attitudes of Czech and Romanian women regarding abortion and contraception use. Describe the attitudes to abortion and incidence of abortion in female population of these countries. Independently and anonymously conducted questionnaire with 1,011 Czech and 1,001 Romanian women, with the participants' age from 15 to 50 years. The sample represented both Czech and Romanian female populations with respect to age, education, and the size of their place of residence. Questionnaire studies awareness, attitudes, and behavior related to the area of sexual life, contraception, and family planning. Based on the acquired information, it can be postulated that Romanian women, despite having a less liberal opinion on abortions than their Czech peers, undergo abortion more often than Czech women (Romanian 28%, Czech 16%), are less informed about potential side effects, and more often use less reliable methods of contraception (the so-called 'natural contraception'-vs. hormonal contraception, which is the method of choice of Czech women). These results indicate that despite more liberal attitudes toward abortion, Czech women have less frequent incidence of abortion than Romanian women and they have more relevant information about contraception and their sexual behavior is more conscious and responsible. [ABSTRACT FROM AUTHOR]