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• Outcome in the largest series of palliative gynaecological pelvic radiotherapy. • Overall 80.4% symptom response rate. • Toxicity low: ≥Grade v3 GI 2.2% and urinary 3.8%. • 1 year OS was 25.1% and the median survival was 5.9 months. Background and purpose: Metastatic and incurable cancers of the gynaecological tract (FGTC) represent a major global health burden. Systemic treatment has modest efficacy and radiotherapy is often used for local symptoms. This study combines experience from two large UK centres in palliative radiotherapy for gynaecological cancers. Materials and methods : Pooled data from two major centres was analysed. Advanced FGTC patients who received at least one fraction of palliative radiotherapy to the pelvis between 2013 and 2018 were included. Data collected included demographic and tumour details, radiotherapy dose fractionation and details of previous and subsequent treatment. Response was defined in terms of toxicity, symptomatic response and survival. Comorbidities were recorded using a modified ACE 27 score which is adjusted for the presence of uncontrolled FGTC in all the patients. Results: A total of 184 patients were included for treatment response and toxicity; survival data was available for 165 patients. Subjective response in pre-radiotherapy symptoms was documented in 80.4%. Grade 3 or worse gastrointestinal, urinary and other (vomiting, fatigue, pain) toxicity incidence was 2.2%, 3.8%, and 2.7% respectively. No statistically significant correlation between the prescribed EQD2 10 and symptom control or toxicity was seen. 1 year overall survival was 25.1% (median 5.9 months). Absent distant metastases, completion of the intended course of radiotherapy, response to radiotherapy, and receipt of further lines of treatment were independent prognostic factors. Conclusion: Palliative radiotherapy is effective for symptoms of advanced FGTC with low toxicity. The absence of a dose response argues for short low dose palliative radiotherapy schedules to be used. [ABSTRACT FROM AUTHOR]

Cervical cancer remains a killer. In the UK it is the third most common gynaecological malignancy with approximately 3200 new cases diagnosed each year and over 900 deaths. The NHS Cervical Screening Programme (NHSCSP) aims to reduce the incidence and mortality associated with cervical cancer. Since its introduction in 1988 there has been a 49% reduction in the incidence of cervical cancer in the UK. Our understanding of cervical cancer has increased dramatically since the inception of the NHSCSP and has resulted in the evolution of the screening programme. Human papilloma virus (HPV) is now recognized as pivotal in the development and progression of cervix intraepithelial neoplasia (CIN). The NHSCSP has recently changed to primary HPV testing for the cervical screening programme. Future interventions must consider the need for ongoing population education and vaccination for HPV in order to decrease the incidence of this entirely preventable disease, and the obstetric risks associated with over-treatment. [ABSTRACT FROM AUTHOR]

Objective To identify the current status of specialist preterm labour ( PTL) clinic provision and management within the UK. Design Postal survey of clinical practice. Setting UK Population All consultant-led obstetric units within the UK. Methods A questionnaire was sent by post to all 210 NHS consultant-led obstetric units within the UK. Units that had a specialist PTL clinic were asked to complete a further 20 questions defining their protocol for risk stratification and management. Main outcome measures Current practice in specialist preterm labour clinics.. Results We have identified 23 specialist clinics; the most common indications for attendance were previous PTL (100%), preterm prelabour rupture of membranes (95%), two large loop excisions of the transformation zone (95%) or cone biopsy (95%). There was significant heterogeneity in the indications for and method of primary treatment for short cervix, with cervical cerclage used in 45% of units, progesterone in 18% of units and Arabin cervical pessary in 5%. A further 23% used multiple treatment modalities in combination. Conclusions A significant heterogeneity in all topics surveyed suggests an urgent need for networking, more evidence-based guidelines and prospective comparative audits to ascertain the real impact of specialist PTL clinics on the reduction in preterm birth and its sequelae. [ABSTRACT FROM AUTHOR]

Abstract: Full implementation of liquid-based cervical cytology (LBC) coupled with changes in the screening age range and frequency have resulted in an annual workload reduction equivalent to 10 average-sized cytology laboratories. This and increased productivity of LBC have resulted in a growing mismatch between laboratory capacity and workload, which is a strong driver for laboratory amalgamation and reconfiguration as recommended in the Carter reports. Other drivers for reconfiguration will come from human papillomavirus (HPV) testing for triage of low-grade abnormality and test of cure, automation and HPV vaccination. Automation will potentially play a significant role in the achievement of the Cancer Reform Strategy targets for the NHS Cervical Screening Programme (NHSCSP), but call into question the role of the cytology screener as currently utilized. Progressive HPV vaccination may well result in adoption of HPV genotyping as the primary screening modality with secondary triage to cytology, which would have a further major impact on laboratory staffing and configuration. [Copyright &y& Elsevier]

This study used published mortality data and regression techniques to look at time trends in cervical cancer mortality between 1970 and 2000 in the UK and the Republic of Ireland. Mortality from cancer of the cervix has been declining in the UK for at least the past 30 years. The rate of decrease has been greatest in England, Wales and Scotland and has accelerated in these countries since the reorganisation of screening services in the late 1980s. Mortality in Northern Ireland is also decreasing, but at a lesser rate and without significant change over the same period. In contrast, cervical cancer mortality in the Irish Republic, which, unlike the UK, does not have comprehensive population-based screening, has been increasing by an average of 1.5% per year since 1978. The mortality rate, which was half of that in the UK in the late 1970s, now exceeds that in any of the region of the UK. The absence of population-based screening for cervical cancer in the Republic of Ireland is the most plausible explanation for these differences in trend. [ABSTRACT FROM AUTHOR]

Introduction: The aim of the QUIDS study is to develop a decision support tool for the management of women with symptoms and signs of preterm labour, based on a validated prognostic model using quantitative fetal fibronectin (fFN) concentration, in combination with clinical risk factors., Methods and Analysis: The study will evaluate the Rapid fFN 10Q System (Hologic, Marlborough, Massachusetts, USA) which quantifies fFN in a vaginal swab. In QUIDS part 2, we will perform a prospective cohort study in at least eight UK consultant-led maternity units, in women with symptoms of preterm labour at 22 +0  to 34 +6 weeks gestation to externally validate a prognostic model developed in QUIDS part 1. The effects of quantitative fFN on anxiety will be assessed, and acceptability of the test and prognostic model will be evaluated in a subgroup of women and clinicians (n=30). The sample size is 1600 women (with estimated 96-192 events of preterm delivery within 7 days of testing). Clinicians will be informed of the qualitative fFN result (positive/negative) but be blinded to quantitative fFN result. Research midwives will collect outcome data from the maternal and neonatal clinical records. The final validated prognostic model will be presented as a mobile or web-based application., Ethics and Dissemination: The study is funded by the National Institute of Healthcare Research Health Technology Assessment (HTA 14/32/01). It has been approved by the West of Scotland Research Ethics Committee (16/WS/0068)., Version: Protocol V.2, Date 1 November 2016., Trial Registration Number: ISRCTN 41598423andCPMS: 31277., Competing Interests: Competing interests: SJS and JEN work at the University of Edinburgh, who received £1000 sponsorship from Hologic to support a meeting (The Society of Reproductive Investigation and MRC Centre for Reproductive Health Scientific Symposium on Targeting Inflammation to Improve Reproductive Health across the Lifecourse – August 2017). AS has in the past (over last 5 years; not in the last 3 years) received funding for expenses related to advisory board and internal staff education from Hologic. MC received sponsorship from Hologic to organise an educational teaching focusing on prediction of Preterm Birth at the 2017 annual meeting of the British Maternal and Fetal Medicine Society. Hologic, the makers of fFN have provided analysers and technical support for their use to sites participating in the QUIDS prospective cohort study. They have no access to the data, or other involvement in the conduct, data analysis, interpretation of results or decision to publish the results of the study., (© Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.)

The article focuses on a medical study to find justification for cervical smear screening programme for teenagers in Great Britain. The age of 20 years has been fixed for screening for cervical neoplasia. The patients who went under screening were between the age of 13 to 65 years, out of those, only five patients under the age of 20 had cervical intraepithelial neoplasia. It was thus established that most of the abnormalities in women under 20 were mild.