Oncoprevention in Gynecology

• Main Author: S Dhakal
• Format: Article
• Language: English
• Published: Nepal Medical Association 2010-06-01
• Series: Journal of Nepal Medical Association
• Online Access: http://jnma.com.np/jnma/index.php/jnma/article/view/126

Gynaecological cancers are one of the preventive cancers. There are some preventive factors like change in life style, food habits and some screening tests. Cancer can be prevented and premalignant conditions can be detected before invasion. Cervical cancer can be detected early by VIA, VILI, Pap smear, colposcopy and HPV testing. Identifying high risk population, transvaginal ultrasound to determine endometrial thickness and endometrial sampling by endocervical curettage, dilation and curettage, fractional curettage and hysteroscopy guided endometrial biopsy are the various modalities for earlier detection of endometrial cancers. For ovarian cancer, prevention or early diagnosis is done by identifying high risk factors, creating awareness in women, routine pelvic examination, ultrasonogram, checking tumour marker and prophylactic oophorectomy in indicated cases. The main screening methods for early detection of breast cancer are clinical breast examination and mammography. Oral contraceptive and HRT are associated with small increase in breast cancer risk. Vulval and vaginal carcinomas are not so common. All molar pregnancies should be followed after evacuation to look for malignant transformation. Hereditary/familial gynaecological cancer like ovarian and breast cancer are manifestation of genetic disorder. Mass screening for gene mutation is very expensive so it is not recommended.