Wann ist Krebsfrüherkennung gute Medizin? (German Edition)
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Telomeres and telomerase in chronic myeloid leukaemia: impact for pathogenesis, disease progression and targeted therapy. Development of pulmonary hypertension in adults after ventriculoatrial shunt implantation. Current status and perspectives of tyrosine kinase inhibitor treatment in the post-transplant period in patients with chronic myeloid leukemia CML. Second-generation tyrosine kinase inhibitors in the post-transplant period in patients with chronic myeloid leukemia or Philadelphia-positive acute lymphoblastic leukemia. Post-transcriptional regulation of adapter molecules by IL inhibits TLR-mediated activation of antigen-presenting cells.
Intraperitoneal VEGF inhibition using bevacizumab: a potential approach for the symptomatic treatment of malignant ascites? High-dose chemotherapy in nonseminomatous germ cell cancer. Post-transplant immunotherapy with donor-lymphocyte infusion and novel agents to upgrade partial into complete and molecular remission in allografted patients with multiple myeloma. Risk factors for therapy-related myelodysplastic syndrome and acute myeloid leukemia treated with allogeneic stem cell transplantation.
Novel KRIT1 mutation and no molecular evidence of anticipation in a family with cerebral and spinal cavernous malformations. Isopathic treatment effects of Arsenicum album 45x on wheat seedling growth--further reproduction trials. Effective strategies for management of hypertension after vascular endothelial growth factor signaling inhibition therapy: results from a phase II randomized, factorial, double-blind study of Cediranib in patients with advanced solid tumors.
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HER-2 amplification is highly homogenous in gastric cancer. Heterozygous deficiency of PHD2 restores tumor oxygenation and inhibits metastasis via endothelial normalization.
Adeno-associated viral vectors and their redirection to cell-type specific receptors. Characterisation of extramedullary relapse in patients with chronic myeloid leukemia in advanced disease after allogeneic stem cell transplantation.
Supportivtherapie in der Onkologie. Phase II trial of vinorelbine and trastuzumab in patients with HER2-positive metastatic breast cancer. A prospective, open label, non-controlled, multicenter phase II trial to investigate efficacy and safety of this combination chemotherapy. Molecular determinants of response to matuzumab in combination with paclitaxel for patients with advanced non-small cell lung cancer.
Assembly and mobility of exon-exon junction complexes in living cells. Springer Verl: Everolimus-induced pneumonitis: report of the first case in a liver transplant recipient and review of treatment options.
IG:Value Sets für XDS – Hl7wiki
This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives License, which permits unrestricted reproduction and distribution, for non-commercial purposes only; and use and reproduction, but not distribution, of adapted material for non-commercial purposes only, provided the original work is properly cited. Abstract Aims Annual opportunistic screening for cervical carcinoma has been carried out in Germany since For more information, cf.
Citation format Prevention of Cervical Cancer. After constructive discussions by the ad-hoc committee, BVF re-joined the guideline authors on 4 September Open in a separate window. Targeted areas of patient care This S3 guideline on the prevention of cervical cancer covers the prevention of cervical cancer and the diagnosis, treatment and follow-up of cervical cancer including high-grade preinvasive cervical lesions.
Warum entsteht Krebs trotz Vorsorge?
Target patient groups This S3 guideline is aimed at all women aged 20 and above. Adoption and period of validity This guideline is valid from 31 December through to 31 December Grading of recommendations The methodology of the Oncology Guidelines Program requires guideline authors to assign a level of recommendation to each recommendation indicating the strength of the recommendation.
Statements Statements are expositions or explanations of specific facts, circumstances, or problems, with no direct recommendations for action. The previous Munich II classification of cytological findings must be switched to the new Munich III nomenclature but without including the recommendations of the new nomenclature.
Such testing would only lead to additional costs, stresses and anxieties.
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Vaccination should still be carried out even in women positive for HPV because, in it is rare for women to be simultaneously be infected with all HPV types for which there are vaccines. All girls aged 9 years and above must be vaccinated as soon as possible against HPV. As both vaccines have been approved for use in this age group, girls of this age can be vaccinated. Early vaccination also offers protection against infections which are not transmitted through sexual contact. The expected benefit of vaccination may be reduced once girls begin to be sexually active.
For persons who are already sexually active, the decision whether to vaccinate or not should be made on a case by case basis. However, there are indications that HPV vaccination can prevent recurrence after surgical therapy.
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HPV vaccination may be considered as part of surgical treatment to reduce the risk of recurrence. At the present point in time, women who are vaccinated against HPV should continue to attend screening sessions as the currently available vaccines do not prevent all forms of oncogenic HPV infection.
A standard cytological Pap smear obtained from the uterine cervix uteri must contain sufficient epithelial cells from the transformation zone; the cells must be spread as evenly as possible across the slide and must be adequately fixed and stained. When collecting cells for thin-layer cytology the recommended collection instrument must be immediately transferred into the approved fixation solution. Thin-layer cytology may be used for screening. Additional tests may be carried out using the specimens collected for thin-layer cytology without having to recall the woman for a separate appointment.
Computer-assisted cytology may be used for screening. Only HPV tests which meet the following criteria based on Meijer et al. The HPV test used for investigation must be stated on the test results. There is no evidence that there is any difference in the level of psychological stress experienced by women who have HPV-based screening compared to women who have cytological screening every 3 years. This also increases the risk of overdiagnosis and overtreatment in the population being screened.
This disadvantage is particularly pronounced in women under the age of 30 years. Shorter intervals between screening examinations increase the risk of overdiagnosis and overtreatment. The use of triage tests reduces overdiagnosis and overtreatment.
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For women under the age of 25 years, there are no indications that the benefits of organized cervical cancer screening outweigh the harm. Organized screening for cervical cancer can be started when women are aged 25 years. In Germany, women above the age of 20 are still entitled to have a screening test in accordance with the screening guideline key points of the resolution regarding the Cancer Screening Guideline [KFE-RL] passed on 15 September In Germany, women between 20 and 35 are still entitled to have organized cytology-based screening.
In women aged 30 years and above, organized HPV-based screening carried out every 3 to 5 years results in lower rates of new cases with cervical cancer compared to organized screening based on cytology alone carried out every 3 years. There is no evidence that cytological screening carried out annually is superior to cytological screening carried out every two years. In Germany, during the transition period at least another 6 years or until sufficient data is available from the 2nd round of screening women between the age of 20 and 35 will still be entitled to have an annual cytological examination.
After the end of the transition period, the intervals between screening appointments and the screening method itself must be adapted to conform to international recommendations after the data used to monitor this age group has been taken into account. In future, women aged 35 and above will be offered a combined screening examination consisting of an HPV test and a cytological examination instead of an annual cytological examination every 3 years.
If co-testing cytology and HPV test or HPV testing alone is done in women above the age of 30, it should be carried in the form of organized screening at intervals of least 3 years. RCTs have only investigated women up to the age of Women over the age of 65 must be encouraged to continue participating in cancer screening programs.
Discontinuing screening for cervical cancer may be considered for women over the age of 65 who have had multiple negative results following co-testing with a Pap smear and an HPV test. In Germany, cancer screening is offered to women irrespective of whether they have been vaccinated or not. The benefit of screening for women who have undergone total hysterectomy is not proven, irrespective of whether the screening is based on cytology or on testing for HPV.
HPV-positive Frauen who have undergone total hysterectomy should continue to participate in organized screening programs. Women who have undergone supracervical hysterectomy must continue to participate in organized screening programs. Immunosuppressed women have a higher risk of developing precancerous cervical conditions and invasive cervical cancer.
There are currently no data from longitudinal studies of more than 3 years for the biomarkers currently being tested in large studies, meaning that these biomarkers must not be used for primary screening. Guideline Program Editors. GRADE guidelines: 3. Rating the quality of evidence. J Clin Epidemiol.
Gross G. Should liquid-based cytology be performed prior to colposcopy? A comparison of the accuracy, unsatisfactory rates and cost in a tertiary referral setting. Accuracy of thin-layer cytology in patients undergoing cervical cone biopsy. Acta Cytol. Comparing conventional and liquid-based smears from a consecutive series of subjects referred to colposcopy assessment.
Cross sectional study of conventional cervical smear, monolayer cytology, and human papillomavirus DNA testing for cervical cancer screening.