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Background Although the patient perspective is implicit in the practice of medicine, research evaluating this remains scarce. In a climate where clinicians and policy-makers constantly strive to achieve more patient-centred models of care, this omission warrants attention. Aim To assess health-related quality of life (HrQoL) in women under 25 years of age with cervical intra-epithelial neoplasia grade 2 (CIN2) receiving conservative management (colposcopy follow-up, with treatment if necessary) compared with those receiving immediate excisional treatment with large loop excision of the transformation zone (LLETZ). Methods An observational study evaluating HrQoL was conducted at Christchurch Women's Hospital, New Zealand. Women undergoing conservative management for CIN2 were compared with those undergoing immediate excisional treatment in an age-matched sample. The Short Form Health Survey 12 version 2 (SF-12v2) was used to evaluate HrQoL. Secondary outcomes of anxiety and sexual function were also assessed. Results One hundred and four women with CIN2 participated in the study. Of these, 63 (60%) received conservative management and 41 (40%) received immediate excisional treatment with LLETZ. We found no significant difference in HrQoL between the groups in a multivariate regression analysis adjusted for parity, smoking and socioeconomic status. There were also no significant differences in sexual function or anxiety. Conclusion We found no difference in HrQoL by management strategy. Conservative management of CIN2 in women under 25 is unlikely to have an adverse impact on self-reported HrQoL, anxiety or sexual functioning compared with conventional management.

The risk of ovarian cancer is reduced in women who undergo tubal ligation. Although it has been suggested that tubal ligation is also associated with reduced risk of breast, endometrial, and cervical cancers, there is no clear evidence for these tumors. The Million Women Study is a prospective study that investigated associations for 26 site-specific cancers among 1.3 million UK women enrolled in 1996–2001. At enrollment, participants completed a questionnaire on sociodemographic, reproductive, and lifestyle factors; follow-up outcomes for cancer and death were obtained from national registries. Cox regression models were used to estimate adjusted relative risks (aRRs) of developing 26 cancer types or sites among women with and without tubal ligation. Of 1,278,783 women without previous cancer, 167,430 developed incident cancers after a mean follow-up of 13.8 years. Risks were significantly reduced in women with tubal ligation for cancers of the ovary (aRR, 80; 95% confidence interval [CI], 0.76–0.85; P < 0.001; n = 8035), peritoneum (aRR, 0.81; 95 CI%, 0.66–0.98; P = 0.03; n = 730), and fallopian tube (aRR, 0.60; 95 CI%, 0.37–0.96; P = 0.04; n = 168). There were no significant associations for cancers of the breast, endometrium, or cervix. The findings are consistent with the hypothesis that cancers of the ovary, peritoneum, and fallopian tube have a shared origin in the fallopian tube and that tubal ligation reduces cancer risk. These data, as well as findings of other investigators, suggest that the fallopian tube is a barrier to cells, carcinogens, or other agents reaching the ovary and peritoneal cavity.

The aim of this study was to assess trends in the age-specific incidence of vulvar cancer in 13 high-income countries satisfying a priori conditions regarding the availability of cancer registry data over a 20-year period; these were Canada, the United States, nine European countries, Australia and Japan. Five-yearly incidence and population at risk were obtained from the International Agency for Research on Cancer's Cancer Incidence in Five Continents for the years 1988-1992 (Volume 7) to 2003-2007 (Volume 10). The 5-yearly average percent change (AvPC) over the period and standardised rate ratios (SRRs) for 2003-2007 versus 1988-1992 were used to assess changes in the age-standardised incidence rates of vulvar cancer for all ages, and for