Gynaecological screening--the benefits and pitfalls
Salmon, Y.M.
Singapore Medical Journal 30(3): 297-301
1989
ISSN/ISBN: 0037-5675 PMID: 2686036 Document Number: 335573
Gynaecological screening, as with all screening, must have clear indications, objectives and modus operandi. The types of screening addressed are osteoporotic screening, gynaecological oncological screening involving the various hormonal target organs and breast cancer screening. Apropos osteoporotic screening, a suggestion is made that assessment of bone mineral content be used as a research tool in following the progress of therapy in osteoporosis rather than a screening modality. Cervical cytological screening remains the mainstay of screening for pre-invasive cancer of the cervix, and has contributed significantly to reduction of the incidence and mortality in cervical cancer over the past decade in many countries worldwide. Data should be standardised. Causes of false negative smears are outlined. Colposcopy, with colposcopically directed biopsies where necessary, is advocated in selected cases, namely all CIN, atypical and persistently inflammatory cytological smears. In the near future, DNA hybridisation tests could become desirable for the detection of HPV in targetted cases. Oncology screening for vagina and vulva follow a similar pattern for the cervix. Ultrasound screening of the uterine body and endometrium as well as the ovaries has had favourable reports. Mammographic screening is recommended in patients at higher risk for breast cancer. The benefits and pitfalls of screening are outlined both for individual screening modalities and generally.