National Institutes of Health Consensus Development Conference Statement on Cervical Cancer

P. S. Braly, A. S. Lichter, D. K. Ash, J. L. Bader, R. S. Berkowitz, J. M. Cain, A. M. Fremgen, I. Gage, J. S. Hutchison, D. C. Ihde, A. F. Saftlas, P. E. Saigo, R. L. Sweet, B. L. Andersen, J. A. Benda, C. L. Brown, Sr Eddy G.L., P. J. Eifel, P. W. Grigsby, K. D. Hatch & 37 others M. R. Henry, R. Herrero, A. E. Howes, D. Kapp, H. M. Keys, R. M. Lanciano, D. Lowy, J. F. Magrina, M. F. Mitchell, M. Morris, G. A. Omura, J. Overgaard, M. A. Penalver, D. G. Petereit, M. E. Randall, A. H. Rusell, Jr Spanos W.J., Frederick Stehman, M. A. Steller, M. H N Tattersall, G. M. Thomas, J. M. Elliott, A. H. Epstein, J. H. Ferguson, W. H. Hall, P. J. Hitchcock, C. P. Hunter, B. S. Kramer, H. W. Lawson, J. R. Lunney, C. McNeil, N. Munoz, C. Nichols, R. C. Park, V. W. Pinn, J. Ruffin, S. Scherr

Research output: Contribution to journalArticle

74 Citations (Scopus)

Abstract

Objective. To provide physicians and the general public with a responsible assessment of current screening, prevention, and treatment approaches to cervical cancer. Participants. The participants were a non- Federal, nonadvocate, 13-member panel representing the fields of obstetrics and gynecology, gynecologic oncology, radiation oncology, and epidemiology. In addition, 28 experts in obstetrics and gynecology, gynecologic oncology, radiation oncology, gynecologic surgery, and psychology presented data to the panel and a conference audience of 500. Evidence. The literature was searched through Medline and an extensive bibliography of references was provided to the panel and the conference audience. Experts prepared abstracts with relevant citations from the literature. Scientific evidence was given precedence over clinical anecdotal experience. Consensus process. The panel, answering predefined questions, developed their conclusions based on the scientific evidence presented in open forum and the scientific literature. The panel composed a draft statement that was read in its entirety and circulated to the experts and the audience for comment. Thereafter, the panel resolved conflicting recommendations and released a revised statement at the end of the conference. The panel finalized the revisions within a few weeks after the conference. Conclusions. Carcinoma of the cervix is causally related to infection with the human papillomavirus (HPV). Reducing the rate of HPV infection by changes in sexual behaviors in young people and/or through the development of an effective HPV vaccine would reduce the incidence of this disease. Pap smear screening remains the best available method of reducing the incidence and mortality of invasive cervical cancer. Persons with stage IA1 disease have a high cure rate with either simple hysterectomy or, where fertility preservation is an issue, by cone biopsy with clear margins. For patients with stage I and stage IIA disease, radical surgery and radiation are equally effective treatments. These patients should be carefully selected to receive one treatment or the other, but not both, as their combined use substantially increases the cost and morbidity of treatment. Women with more advanced, nonmetastatic disease should be treated with radiation. Recurrent cervical cancer confined to the pelvis should be treated with the modality not previously received. Radiation is recommended to palliate symptoms in patients with metastatic disease.

Original languageEnglish (US)
Pages (from-to)351-361
Number of pages11
JournalGynecologic Oncology
Volume66
Issue number3
DOIs
StatePublished - 1997
Externally publishedYes

Fingerprint

Consensus Development Conferences
National Institutes of Health (U.S.)
Uterine Cervical Neoplasms
Radiation Oncology
Radiation
Gynecology
Obstetrics
Fertility Preservation
Literature
Papanicolaou Test
Papillomavirus Vaccines
Gynecologic Surgical Procedures
Papillomavirus Infections
Incidence
Bibliography
Hysterectomy
Pelvis
Cervix Uteri
Sexual Behavior
Health Care Costs

ASJC Scopus subject areas

  • Obstetrics and Gynecology
  • Oncology

Cite this

Braly, P. S., Lichter, A. S., Ash, D. K., Bader, J. L., Berkowitz, R. S., Cain, J. M., ... Scherr, S. (1997). National Institutes of Health Consensus Development Conference Statement on Cervical Cancer. Gynecologic Oncology, 66(3), 351-361. https://doi.org/10.1006/gyno.1997.4849

National Institutes of Health Consensus Development Conference Statement on Cervical Cancer. / Braly, P. S.; Lichter, A. S.; Ash, D. K.; Bader, J. L.; Berkowitz, R. S.; Cain, J. M.; Fremgen, A. M.; Gage, I.; Hutchison, J. S.; Ihde, D. C.; Saftlas, A. F.; Saigo, P. E.; Sweet, R. L.; Andersen, B. L.; Benda, J. A.; Brown, C. L.; Eddy G.L., Sr; Eifel, P. J.; Grigsby, P. W.; Hatch, K. D.; Henry, M. R.; Herrero, R.; Howes, A. E.; Kapp, D.; Keys, H. M.; Lanciano, R. M.; Lowy, D.; Magrina, J. F.; Mitchell, M. F.; Morris, M.; Omura, G. A.; Overgaard, J.; Penalver, M. A.; Petereit, D. G.; Randall, M. E.; Rusell, A. H.; Spanos W.J., Jr; Stehman, Frederick; Steller, M. A.; Tattersall, M. H N; Thomas, G. M.; Elliott, J. M.; Epstein, A. H.; Ferguson, J. H.; Hall, W. H.; Hitchcock, P. J.; Hunter, C. P.; Kramer, B. S.; Lawson, H. W.; Lunney, J. R.; McNeil, C.; Munoz, N.; Nichols, C.; Park, R. C.; Pinn, V. W.; Ruffin, J.; Scherr, S.

In: Gynecologic Oncology, Vol. 66, No. 3, 1997, p. 351-361.

Research output: Contribution to journalArticle

Braly, PS, Lichter, AS, Ash, DK, Bader, JL, Berkowitz, RS, Cain, JM, Fremgen, AM, Gage, I, Hutchison, JS, Ihde, DC, Saftlas, AF, Saigo, PE, Sweet, RL, Andersen, BL, Benda, JA, Brown, CL, Eddy G.L., S, Eifel, PJ, Grigsby, PW, Hatch, KD, Henry, MR, Herrero, R, Howes, AE, Kapp, D, Keys, HM, Lanciano, RM, Lowy, D, Magrina, JF, Mitchell, MF, Morris, M, Omura, GA, Overgaard, J, Penalver, MA, Petereit, DG, Randall, ME, Rusell, AH, Spanos W.J., J, Stehman, F, Steller, MA, Tattersall, MHN, Thomas, GM, Elliott, JM, Epstein, AH, Ferguson, JH, Hall, WH, Hitchcock, PJ, Hunter, CP, Kramer, BS, Lawson, HW, Lunney, JR, McNeil, C, Munoz, N, Nichols, C, Park, RC, Pinn, VW, Ruffin, J & Scherr, S 1997, 'National Institutes of Health Consensus Development Conference Statement on Cervical Cancer', Gynecologic Oncology, vol. 66, no. 3, pp. 351-361. https://doi.org/10.1006/gyno.1997.4849
Braly, P. S. ; Lichter, A. S. ; Ash, D. K. ; Bader, J. L. ; Berkowitz, R. S. ; Cain, J. M. ; Fremgen, A. M. ; Gage, I. ; Hutchison, J. S. ; Ihde, D. C. ; Saftlas, A. F. ; Saigo, P. E. ; Sweet, R. L. ; Andersen, B. L. ; Benda, J. A. ; Brown, C. L. ; Eddy G.L., Sr ; Eifel, P. J. ; Grigsby, P. W. ; Hatch, K. D. ; Henry, M. R. ; Herrero, R. ; Howes, A. E. ; Kapp, D. ; Keys, H. M. ; Lanciano, R. M. ; Lowy, D. ; Magrina, J. F. ; Mitchell, M. F. ; Morris, M. ; Omura, G. A. ; Overgaard, J. ; Penalver, M. A. ; Petereit, D. G. ; Randall, M. E. ; Rusell, A. H. ; Spanos W.J., Jr ; Stehman, Frederick ; Steller, M. A. ; Tattersall, M. H N ; Thomas, G. M. ; Elliott, J. M. ; Epstein, A. H. ; Ferguson, J. H. ; Hall, W. H. ; Hitchcock, P. J. ; Hunter, C. P. ; Kramer, B. S. ; Lawson, H. W. ; Lunney, J. R. ; McNeil, C. ; Munoz, N. ; Nichols, C. ; Park, R. C. ; Pinn, V. W. ; Ruffin, J. ; Scherr, S. / National Institutes of Health Consensus Development Conference Statement on Cervical Cancer. In: Gynecologic Oncology. 1997 ; Vol. 66, No. 3. pp. 351-361.
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abstract = "Objective. To provide physicians and the general public with a responsible assessment of current screening, prevention, and treatment approaches to cervical cancer. Participants. The participants were a non- Federal, nonadvocate, 13-member panel representing the fields of obstetrics and gynecology, gynecologic oncology, radiation oncology, and epidemiology. In addition, 28 experts in obstetrics and gynecology, gynecologic oncology, radiation oncology, gynecologic surgery, and psychology presented data to the panel and a conference audience of 500. Evidence. The literature was searched through Medline and an extensive bibliography of references was provided to the panel and the conference audience. Experts prepared abstracts with relevant citations from the literature. Scientific evidence was given precedence over clinical anecdotal experience. Consensus process. The panel, answering predefined questions, developed their conclusions based on the scientific evidence presented in open forum and the scientific literature. The panel composed a draft statement that was read in its entirety and circulated to the experts and the audience for comment. Thereafter, the panel resolved conflicting recommendations and released a revised statement at the end of the conference. The panel finalized the revisions within a few weeks after the conference. Conclusions. Carcinoma of the cervix is causally related to infection with the human papillomavirus (HPV). Reducing the rate of HPV infection by changes in sexual behaviors in young people and/or through the development of an effective HPV vaccine would reduce the incidence of this disease. Pap smear screening remains the best available method of reducing the incidence and mortality of invasive cervical cancer. Persons with stage IA1 disease have a high cure rate with either simple hysterectomy or, where fertility preservation is an issue, by cone biopsy with clear margins. For patients with stage I and stage IIA disease, radical surgery and radiation are equally effective treatments. These patients should be carefully selected to receive one treatment or the other, but not both, as their combined use substantially increases the cost and morbidity of treatment. Women with more advanced, nonmetastatic disease should be treated with radiation. Recurrent cervical cancer confined to the pelvis should be treated with the modality not previously received. Radiation is recommended to palliate symptoms in patients with metastatic disease.",
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language = "English (US)",
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TY - JOUR

T1 - National Institutes of Health Consensus Development Conference Statement on Cervical Cancer

AU - Braly, P. S.

AU - Lichter, A. S.

AU - Ash, D. K.

AU - Bader, J. L.

AU - Berkowitz, R. S.

AU - Cain, J. M.

AU - Fremgen, A. M.

AU - Gage, I.

AU - Hutchison, J. S.

AU - Ihde, D. C.

AU - Saftlas, A. F.

AU - Saigo, P. E.

AU - Sweet, R. L.

AU - Andersen, B. L.

AU - Benda, J. A.

AU - Brown, C. L.

AU - Eddy G.L., Sr

AU - Eifel, P. J.

AU - Grigsby, P. W.

AU - Hatch, K. D.

AU - Henry, M. R.

AU - Herrero, R.

AU - Howes, A. E.

AU - Kapp, D.

AU - Keys, H. M.

AU - Lanciano, R. M.

AU - Lowy, D.

AU - Magrina, J. F.

AU - Mitchell, M. F.

AU - Morris, M.

AU - Omura, G. A.

AU - Overgaard, J.

AU - Penalver, M. A.

AU - Petereit, D. G.

AU - Randall, M. E.

AU - Rusell, A. H.

AU - Spanos W.J., Jr

AU - Stehman, Frederick

AU - Steller, M. A.

AU - Tattersall, M. H N

AU - Thomas, G. M.

AU - Elliott, J. M.

AU - Epstein, A. H.

AU - Ferguson, J. H.

AU - Hall, W. H.

AU - Hitchcock, P. J.

AU - Hunter, C. P.

AU - Kramer, B. S.

AU - Lawson, H. W.

AU - Lunney, J. R.

AU - McNeil, C.

AU - Munoz, N.

AU - Nichols, C.

AU - Park, R. C.

AU - Pinn, V. W.

AU - Ruffin, J.

AU - Scherr, S.

PY - 1997

Y1 - 1997

N2 - Objective. To provide physicians and the general public with a responsible assessment of current screening, prevention, and treatment approaches to cervical cancer. Participants. The participants were a non- Federal, nonadvocate, 13-member panel representing the fields of obstetrics and gynecology, gynecologic oncology, radiation oncology, and epidemiology. In addition, 28 experts in obstetrics and gynecology, gynecologic oncology, radiation oncology, gynecologic surgery, and psychology presented data to the panel and a conference audience of 500. Evidence. The literature was searched through Medline and an extensive bibliography of references was provided to the panel and the conference audience. Experts prepared abstracts with relevant citations from the literature. Scientific evidence was given precedence over clinical anecdotal experience. Consensus process. The panel, answering predefined questions, developed their conclusions based on the scientific evidence presented in open forum and the scientific literature. The panel composed a draft statement that was read in its entirety and circulated to the experts and the audience for comment. Thereafter, the panel resolved conflicting recommendations and released a revised statement at the end of the conference. The panel finalized the revisions within a few weeks after the conference. Conclusions. Carcinoma of the cervix is causally related to infection with the human papillomavirus (HPV). Reducing the rate of HPV infection by changes in sexual behaviors in young people and/or through the development of an effective HPV vaccine would reduce the incidence of this disease. Pap smear screening remains the best available method of reducing the incidence and mortality of invasive cervical cancer. Persons with stage IA1 disease have a high cure rate with either simple hysterectomy or, where fertility preservation is an issue, by cone biopsy with clear margins. For patients with stage I and stage IIA disease, radical surgery and radiation are equally effective treatments. These patients should be carefully selected to receive one treatment or the other, but not both, as their combined use substantially increases the cost and morbidity of treatment. Women with more advanced, nonmetastatic disease should be treated with radiation. Recurrent cervical cancer confined to the pelvis should be treated with the modality not previously received. Radiation is recommended to palliate symptoms in patients with metastatic disease.

AB - Objective. To provide physicians and the general public with a responsible assessment of current screening, prevention, and treatment approaches to cervical cancer. Participants. The participants were a non- Federal, nonadvocate, 13-member panel representing the fields of obstetrics and gynecology, gynecologic oncology, radiation oncology, and epidemiology. In addition, 28 experts in obstetrics and gynecology, gynecologic oncology, radiation oncology, gynecologic surgery, and psychology presented data to the panel and a conference audience of 500. Evidence. The literature was searched through Medline and an extensive bibliography of references was provided to the panel and the conference audience. Experts prepared abstracts with relevant citations from the literature. Scientific evidence was given precedence over clinical anecdotal experience. Consensus process. The panel, answering predefined questions, developed their conclusions based on the scientific evidence presented in open forum and the scientific literature. The panel composed a draft statement that was read in its entirety and circulated to the experts and the audience for comment. Thereafter, the panel resolved conflicting recommendations and released a revised statement at the end of the conference. The panel finalized the revisions within a few weeks after the conference. Conclusions. Carcinoma of the cervix is causally related to infection with the human papillomavirus (HPV). Reducing the rate of HPV infection by changes in sexual behaviors in young people and/or through the development of an effective HPV vaccine would reduce the incidence of this disease. Pap smear screening remains the best available method of reducing the incidence and mortality of invasive cervical cancer. Persons with stage IA1 disease have a high cure rate with either simple hysterectomy or, where fertility preservation is an issue, by cone biopsy with clear margins. For patients with stage I and stage IIA disease, radical surgery and radiation are equally effective treatments. These patients should be carefully selected to receive one treatment or the other, but not both, as their combined use substantially increases the cost and morbidity of treatment. Women with more advanced, nonmetastatic disease should be treated with radiation. Recurrent cervical cancer confined to the pelvis should be treated with the modality not previously received. Radiation is recommended to palliate symptoms in patients with metastatic disease.

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