Submit Search
Upload
screening for cancer cervix
•
11 likes
•
1,777 views
Aboubakr Elnashar
Follow
Aboubakr elnashar
Read less
Read more
Health & Medicine
Report
Share
Report
Share
1 of 29
Download now
Download to read offline
Recommended
Cervical cancer screening modalities
Cervical cancer screening modalities
chaimingcheng
Â
Cancer cervix screening
Cancer cervix screening
Amir Mahmoud
Â
CERVICAL CANCER & ITS PREVENTION
CERVICAL CANCER & ITS PREVENTION
O. E.Nyandi PhD
Â
Colposcopy Today Practical Approach !! Dr. Sharda Jain , Dr. Jyoti Agarwal dr...
Colposcopy Today Practical Approach !! Dr. Sharda Jain , Dr. Jyoti Agarwal dr...
Lifecare Centre
Â
Chapter 2.4 cancer screening
Chapter 2.4 cancer screening
Nilesh Kucha
Â
Screening for cervical cancer
Screening for cervical cancer
Aboubakr Elnashar
Â
Endometrial Cancer; Evidence Based Approach
Endometrial Cancer; Evidence Based Approach
Faculty of Medicine - Benha University
Â
Cervical intra epithelial neoplasia
Cervical intra epithelial neoplasia
Aboubakr Elnashar
Â
Recommended
Cervical cancer screening modalities
Cervical cancer screening modalities
chaimingcheng
Â
Cancer cervix screening
Cancer cervix screening
Amir Mahmoud
Â
CERVICAL CANCER & ITS PREVENTION
CERVICAL CANCER & ITS PREVENTION
O. E.Nyandi PhD
Â
Colposcopy Today Practical Approach !! Dr. Sharda Jain , Dr. Jyoti Agarwal dr...
Colposcopy Today Practical Approach !! Dr. Sharda Jain , Dr. Jyoti Agarwal dr...
Lifecare Centre
Â
Chapter 2.4 cancer screening
Chapter 2.4 cancer screening
Nilesh Kucha
Â
Screening for cervical cancer
Screening for cervical cancer
Aboubakr Elnashar
Â
Endometrial Cancer; Evidence Based Approach
Endometrial Cancer; Evidence Based Approach
Faculty of Medicine - Benha University
Â
Cervical intra epithelial neoplasia
Cervical intra epithelial neoplasia
Aboubakr Elnashar
Â
Cervical cancer screening and hpv vaccination
Cervical cancer screening and hpv vaccination
Sunita Yadav
Â
UPDATE HPV Vaccination IN Cervical Cancer Prevention Dr Sharda Jain
UPDATE HPV Vaccination IN Cervical Cancer Prevention Dr Sharda Jain
Lifecare Centre
Â
Prevention of Gynecologic Cancer
Prevention of Gynecologic Cancer
Aboubakr Elnashar
Â
fertililty sparing surgeries in gynecological cancers
fertililty sparing surgeries in gynecological cancers
Sreelasya Kakarla
Â
Cervical Cancer Screening
Cervical Cancer Screening
sarahmccorm
Â
Cervical cancer prevention Dr Sharda Jain
Cervical cancer prevention Dr Sharda Jain
Lifecare Centre
Â
Colposcopy2 1
Colposcopy2 1
Shruthi Shivdas
Â
Endometriosis associated infertility: ESHRE2022
Endometriosis associated infertility: ESHRE2022
Aboubakr Elnashar
Â
Management of cin
Management of cin
Sourav Chowdhury
Â
Breast cancer screening
Breast cancer screening
BIJAPUROBG
Â
EVIDENCE BASED PRACTICAL TIPS FOR OFFICE HYSTEROSCOPY BY DR SHASHWAT JANI
EVIDENCE BASED PRACTICAL TIPS FOR OFFICE HYSTEROSCOPY BY DR SHASHWAT JANI
DR SHASHWAT JANI
Â
Colposcopy
Colposcopy
drsubir
Â
Cervical Cancer
Cervical Cancer
Dr. Jyoti Malik
Â
Evidence Based Guide of Screening for Prevention of Cervical Cancer
Evidence Based Guide of Screening for Prevention of Cervical Cancer
Lifecare Centre
Â
Visual inspection of cervix
Visual inspection of cervix
Aboubakr Elnashar
Â
Why when where oophorectomy
Why when where oophorectomy
Kawita Bapat
Â
HPV Vaccination Update in 2021 Dr Sharda Jain
HPV Vaccination Update in 2021 Dr Sharda Jain
Lifecare Centre
Â
Screening in ovarian cancers
Screening in ovarian cancers
Ashutosh Mukherji
Â
Shoulder to Shoulder: Cervical Cancer Screening
Shoulder to Shoulder: Cervical Cancer Screening
shouldertoshoulder
Â
NIPT, Dr. Sharda Jain, Life Care centre
NIPT, Dr. Sharda Jain, Life Care centre
Lifecare Centre
Â
Radiologist Resume Updated
Radiologist Resume Updated
Ibraheem Sabry El Mogy
Â
Prof.Arshad Cheema
Prof.Arshad Cheema
Pk Doctors
Â
More Related Content
What's hot
Cervical cancer screening and hpv vaccination
Cervical cancer screening and hpv vaccination
Sunita Yadav
Â
UPDATE HPV Vaccination IN Cervical Cancer Prevention Dr Sharda Jain
UPDATE HPV Vaccination IN Cervical Cancer Prevention Dr Sharda Jain
Lifecare Centre
Â
Prevention of Gynecologic Cancer
Prevention of Gynecologic Cancer
Aboubakr Elnashar
Â
fertililty sparing surgeries in gynecological cancers
fertililty sparing surgeries in gynecological cancers
Sreelasya Kakarla
Â
Cervical Cancer Screening
Cervical Cancer Screening
sarahmccorm
Â
Cervical cancer prevention Dr Sharda Jain
Cervical cancer prevention Dr Sharda Jain
Lifecare Centre
Â
Colposcopy2 1
Colposcopy2 1
Shruthi Shivdas
Â
Endometriosis associated infertility: ESHRE2022
Endometriosis associated infertility: ESHRE2022
Aboubakr Elnashar
Â
Management of cin
Management of cin
Sourav Chowdhury
Â
Breast cancer screening
Breast cancer screening
BIJAPUROBG
Â
EVIDENCE BASED PRACTICAL TIPS FOR OFFICE HYSTEROSCOPY BY DR SHASHWAT JANI
EVIDENCE BASED PRACTICAL TIPS FOR OFFICE HYSTEROSCOPY BY DR SHASHWAT JANI
DR SHASHWAT JANI
Â
Colposcopy
Colposcopy
drsubir
Â
Cervical Cancer
Cervical Cancer
Dr. Jyoti Malik
Â
Evidence Based Guide of Screening for Prevention of Cervical Cancer
Evidence Based Guide of Screening for Prevention of Cervical Cancer
Lifecare Centre
Â
Visual inspection of cervix
Visual inspection of cervix
Aboubakr Elnashar
Â
Why when where oophorectomy
Why when where oophorectomy
Kawita Bapat
Â
HPV Vaccination Update in 2021 Dr Sharda Jain
HPV Vaccination Update in 2021 Dr Sharda Jain
Lifecare Centre
Â
Screening in ovarian cancers
Screening in ovarian cancers
Ashutosh Mukherji
Â
Shoulder to Shoulder: Cervical Cancer Screening
Shoulder to Shoulder: Cervical Cancer Screening
shouldertoshoulder
Â
NIPT, Dr. Sharda Jain, Life Care centre
NIPT, Dr. Sharda Jain, Life Care centre
Lifecare Centre
Â
What's hot
(20)
Cervical cancer screening and hpv vaccination
Cervical cancer screening and hpv vaccination
Â
UPDATE HPV Vaccination IN Cervical Cancer Prevention Dr Sharda Jain
UPDATE HPV Vaccination IN Cervical Cancer Prevention Dr Sharda Jain
Â
Prevention of Gynecologic Cancer
Prevention of Gynecologic Cancer
Â
fertililty sparing surgeries in gynecological cancers
fertililty sparing surgeries in gynecological cancers
Â
Cervical Cancer Screening
Cervical Cancer Screening
Â
Cervical cancer prevention Dr Sharda Jain
Cervical cancer prevention Dr Sharda Jain
Â
Colposcopy2 1
Colposcopy2 1
Â
Endometriosis associated infertility: ESHRE2022
Endometriosis associated infertility: ESHRE2022
Â
Management of cin
Management of cin
Â
Breast cancer screening
Breast cancer screening
Â
EVIDENCE BASED PRACTICAL TIPS FOR OFFICE HYSTEROSCOPY BY DR SHASHWAT JANI
EVIDENCE BASED PRACTICAL TIPS FOR OFFICE HYSTEROSCOPY BY DR SHASHWAT JANI
Â
Colposcopy
Colposcopy
Â
Cervical Cancer
Cervical Cancer
Â
Evidence Based Guide of Screening for Prevention of Cervical Cancer
Evidence Based Guide of Screening for Prevention of Cervical Cancer
Â
Visual inspection of cervix
Visual inspection of cervix
Â
Why when where oophorectomy
Why when where oophorectomy
Â
HPV Vaccination Update in 2021 Dr Sharda Jain
HPV Vaccination Update in 2021 Dr Sharda Jain
Â
Screening in ovarian cancers
Screening in ovarian cancers
Â
Shoulder to Shoulder: Cervical Cancer Screening
Shoulder to Shoulder: Cervical Cancer Screening
Â
NIPT, Dr. Sharda Jain, Life Care centre
NIPT, Dr. Sharda Jain, Life Care centre
Â
Similar to screening for cancer cervix
Radiologist Resume Updated
Radiologist Resume Updated
Ibraheem Sabry El Mogy
Â
Prof.Arshad Cheema
Prof.Arshad Cheema
Pk Doctors
Â
Radiologist Resume
Radiologist Resume
Ibraheem Sabry El Mogy
Â
Cervical Cancer in Sudan
Cervical Cancer in Sudan
Reproductive & Child Health Research Unit (RCRU)
Â
Management of breast cancer
Management of breast cancer
mostafa hegazy
Â
HCC in the Arab World Final
HCC in the Arab World Final
PAIRS WEB
Â
cervical cancer (1) ANSHIKA.pptx
cervical cancer (1) ANSHIKA.pptx
priyankasingh796838
Â
Dr nisreen anfnan cervical cancer in saudi arabia last version
Dr nisreen anfnan cervical cancer in saudi arabia last version
Tariq Mohammed
Â
Awareness about Mouth Cancer in Biotechnology Students_Crimson Publishers
Awareness about Mouth Cancer in Biotechnology Students_Crimson Publishers
CrimsonpublishersCancer
Â
Evaluation of Breast Cancer in Reference to Skin Changes
Evaluation of Breast Cancer in Reference to Skin Changes
QUESTJOURNAL
Â
gynaecology.Carcinoma of the endometrium.(dr.rojan)
gynaecology.Carcinoma of the endometrium.(dr.rojan)
student
Â
Cancer
Cancer
aasthasingh777
Â
Womans Cancer Foundation, Well Woman Clinic
Womans Cancer Foundation, Well Woman Clinic
MaheshShettyMD
Â
Woman's Cancer Foundation Well Woman Clinic Project design
Woman's Cancer Foundation Well Woman Clinic Project design
Woman's Cancer Foundation
Â
V. Kesic - Cervical cancer - State of the art
V. Kesic - Cervical cancer - State of the art
European School of Oncology
Â
CANCER PREVENTION & SCREENING IN INDIA.ppt
CANCER PREVENTION & SCREENING IN INDIA.ppt
DR. ANAND SINGH BHADORIYA (MBBS)
Â
Khartoum feb 2008
Khartoum feb 2008
Dr.Ahmed Elmahdi
Â
CANCER, LINKING CANCER WITH ITS RISK FACTORS, A STUDY CONDUCTED IN NRS MEDICA...
CANCER, LINKING CANCER WITH ITS RISK FACTORS, A STUDY CONDUCTED IN NRS MEDICA...
Naushad Alam
Â
Oral cancers
Oral cancers
Dr Qurat-ul-ain ayuob
Â
Epidemiological Aspects of Prostate Cancer at the Medical Oncology Service of...
Epidemiological Aspects of Prostate Cancer at the Medical Oncology Service of...
Healthcare and Medical Sciences
Â
Similar to screening for cancer cervix
(20)
Radiologist Resume Updated
Radiologist Resume Updated
Â
Prof.Arshad Cheema
Prof.Arshad Cheema
Â
Radiologist Resume
Radiologist Resume
Â
Cervical Cancer in Sudan
Cervical Cancer in Sudan
Â
Management of breast cancer
Management of breast cancer
Â
HCC in the Arab World Final
HCC in the Arab World Final
Â
cervical cancer (1) ANSHIKA.pptx
cervical cancer (1) ANSHIKA.pptx
Â
Dr nisreen anfnan cervical cancer in saudi arabia last version
Dr nisreen anfnan cervical cancer in saudi arabia last version
Â
Awareness about Mouth Cancer in Biotechnology Students_Crimson Publishers
Awareness about Mouth Cancer in Biotechnology Students_Crimson Publishers
Â
Evaluation of Breast Cancer in Reference to Skin Changes
Evaluation of Breast Cancer in Reference to Skin Changes
Â
gynaecology.Carcinoma of the endometrium.(dr.rojan)
gynaecology.Carcinoma of the endometrium.(dr.rojan)
Â
Cancer
Cancer
Â
Womans Cancer Foundation, Well Woman Clinic
Womans Cancer Foundation, Well Woman Clinic
Â
Woman's Cancer Foundation Well Woman Clinic Project design
Woman's Cancer Foundation Well Woman Clinic Project design
Â
V. Kesic - Cervical cancer - State of the art
V. Kesic - Cervical cancer - State of the art
Â
CANCER PREVENTION & SCREENING IN INDIA.ppt
CANCER PREVENTION & SCREENING IN INDIA.ppt
Â
Khartoum feb 2008
Khartoum feb 2008
Â
CANCER, LINKING CANCER WITH ITS RISK FACTORS, A STUDY CONDUCTED IN NRS MEDICA...
CANCER, LINKING CANCER WITH ITS RISK FACTORS, A STUDY CONDUCTED IN NRS MEDICA...
Â
Oral cancers
Oral cancers
Â
Epidemiological Aspects of Prostate Cancer at the Medical Oncology Service of...
Epidemiological Aspects of Prostate Cancer at the Medical Oncology Service of...
Â
More from Aboubakr Elnashar
WHAT IS NEW IN ESHRE 2022 AND FIGO 2022 FOR GENERAL GYNAECOLOGIST
WHAT IS NEW IN ESHRE 2022 AND FIGO 2022 FOR GENERAL GYNAECOLOGIST
Aboubakr Elnashar
Â
hepatitis B.pdf
hepatitis B.pdf
Aboubakr Elnashar
Â
hepatitis c2022.pdf
hepatitis c2022.pdf
Aboubakr Elnashar
Â
Adenomyosis associated infertility
Adenomyosis associated infertility
Aboubakr Elnashar
Â
Adenxal mass guidelines2020
Adenxal mass guidelines2020
Aboubakr Elnashar
Â
Aesthetic gynecology controversy
Aesthetic gynecology controversy
Aboubakr Elnashar
Â
Hormonal assay in clinical gyn
Hormonal assay in clinical gyn
Aboubakr Elnashar
Â
FIRST TRIMESTER ANC OF IVF
FIRST TRIMESTER ANC OF IVF
Aboubakr Elnashar
Â
Unnecessary investigations in reproductive medicine
Unnecessary investigations in reproductive medicine
Aboubakr Elnashar
Â
Infertility prevention
Infertility prevention
Aboubakr Elnashar
Â
Individualisation of controlled ovarian stimulation
Individualisation of controlled ovarian stimulation
Aboubakr Elnashar
Â
Female infertility
Female infertility
Aboubakr Elnashar
Â
Maternal near miss
Maternal near miss
Aboubakr Elnashar
Â
THE MANAGEMENT OF SEVERE PET/ECLAMPSIA
THE MANAGEMENT OF SEVERE PET/ECLAMPSIA
Aboubakr Elnashar
Â
cesarean birth: procedural aspects: NICE2021
cesarean birth: procedural aspects: NICE2021
Aboubakr Elnashar
Â
CAESAREAN SCAR DEFECT
CAESAREAN SCAR DEFECT
Aboubakr Elnashar
Â
Management of pregnancy of unknown location
Management of pregnancy of unknown location
Aboubakr Elnashar
Â
Aerobic Vaginitis
Aerobic Vaginitis
Aboubakr Elnashar
Â
COVID 19 infection and pregnancy RCOG2021
COVID 19 infection and pregnancy RCOG2021
Aboubakr Elnashar
Â
Imaging in pregnancy 2 in1
Imaging in pregnancy 2 in1
Aboubakr Elnashar
Â
More from Aboubakr Elnashar
(20)
WHAT IS NEW IN ESHRE 2022 AND FIGO 2022 FOR GENERAL GYNAECOLOGIST
WHAT IS NEW IN ESHRE 2022 AND FIGO 2022 FOR GENERAL GYNAECOLOGIST
Â
hepatitis B.pdf
hepatitis B.pdf
Â
hepatitis c2022.pdf
hepatitis c2022.pdf
Â
Adenomyosis associated infertility
Adenomyosis associated infertility
Â
Adenxal mass guidelines2020
Adenxal mass guidelines2020
Â
Aesthetic gynecology controversy
Aesthetic gynecology controversy
Â
Hormonal assay in clinical gyn
Hormonal assay in clinical gyn
Â
FIRST TRIMESTER ANC OF IVF
FIRST TRIMESTER ANC OF IVF
Â
Unnecessary investigations in reproductive medicine
Unnecessary investigations in reproductive medicine
Â
Infertility prevention
Infertility prevention
Â
Individualisation of controlled ovarian stimulation
Individualisation of controlled ovarian stimulation
Â
Female infertility
Female infertility
Â
Maternal near miss
Maternal near miss
Â
THE MANAGEMENT OF SEVERE PET/ECLAMPSIA
THE MANAGEMENT OF SEVERE PET/ECLAMPSIA
Â
cesarean birth: procedural aspects: NICE2021
cesarean birth: procedural aspects: NICE2021
Â
CAESAREAN SCAR DEFECT
CAESAREAN SCAR DEFECT
Â
Management of pregnancy of unknown location
Management of pregnancy of unknown location
Â
Aerobic Vaginitis
Aerobic Vaginitis
Â
COVID 19 infection and pregnancy RCOG2021
COVID 19 infection and pregnancy RCOG2021
Â
Imaging in pregnancy 2 in1
Imaging in pregnancy 2 in1
Â
Recently uploaded
Book Call Girls in Kasavanahalli - 7001305949 with real photos and phone numbers
Book Call Girls in Kasavanahalli - 7001305949 with real photos and phone numbers
narwatsonia7
Â
sauth delhi call girls in Bhajanpura 🔝 9953056974 🔝 escort Service
sauth delhi call girls in Bhajanpura 🔝 9953056974 🔝 escort Service
9953056974 Low Rate Call Girls In Saket, Delhi NCR
Â
Call Girls Hosur Just Call 7001305949 Top Class Call Girl Service Available
Call Girls Hosur Just Call 7001305949 Top Class Call Girl Service Available
narwatsonia7
Â
Call Girls Service in Bommanahalli - 7001305949 with real photos and phone nu...
Call Girls Service in Bommanahalli - 7001305949 with real photos and phone nu...
narwatsonia7
Â
Call Girl Bangalore Nandini 7001305949 Independent Escort Service Bangalore
Call Girl Bangalore Nandini 7001305949 Independent Escort Service Bangalore
narwatsonia7
Â
Call Girls Service In Shyam Nagar Whatsapp 8445551418 Independent Escort Service
Call Girls Service In Shyam Nagar Whatsapp 8445551418 Independent Escort Service
parulsinha
Â
Hemostasis Physiology and Clinical correlations by Dr Faiza.pdf
Hemostasis Physiology and Clinical correlations by Dr Faiza.pdf
MedicoseAcademics
Â
Call Girls Service Noida Maya 9711199012 Independent Escort Service Noida
Call Girls Service Noida Maya 9711199012 Independent Escort Service Noida
Pooja Gupta
Â
Call Girls Kanakapura Road Just Call 7001305949 Top Class Call Girl Service A...
Call Girls Kanakapura Road Just Call 7001305949 Top Class Call Girl Service A...
narwatsonia7
Â
Book Call Girls in Yelahanka - For 7001305949 Cheap & Best with original Photos
Book Call Girls in Yelahanka - For 7001305949 Cheap & Best with original Photos
narwatsonia7
Â
Call Girls ITPL Just Call 7001305949 Top Class Call Girl Service Available
Call Girls ITPL Just Call 7001305949 Top Class Call Girl Service Available
narwatsonia7
Â
Call Girls Whitefield Just Call 7001305949 Top Class Call Girl Service Available
Call Girls Whitefield Just Call 7001305949 Top Class Call Girl Service Available
narwatsonia7
Â
Housewife Call Girls Hsr Layout - Call 7001305949 Rs-3500 with A/C Room Cash ...
Housewife Call Girls Hsr Layout - Call 7001305949 Rs-3500 with A/C Room Cash ...
narwatsonia7
Â
Mumbai Call Girls Service 9910780858 Real Russian Girls Looking Models
Mumbai Call Girls Service 9910780858 Real Russian Girls Looking Models
sonalikaur4
Â
Housewife Call Girls Bangalore - Call 7001305949 Rs-3500 with A/C Room Cash o...
Housewife Call Girls Bangalore - Call 7001305949 Rs-3500 with A/C Room Cash o...
narwatsonia7
Â
High Profile Call Girls Jaipur Vani 8445551418 Independent Escort Service Jaipur
High Profile Call Girls Jaipur Vani 8445551418 Independent Escort Service Jaipur
parulsinha
Â
Call Girls In Andheri East Call 9920874524 Book Hot And Sexy Girls
Call Girls In Andheri East Call 9920874524 Book Hot And Sexy Girls
nehamumbai
Â
See the 2,456 pharmacies on the National E-Pharmacy Platform
See the 2,456 pharmacies on the National E-Pharmacy Platform
Kweku Zurek
Â
call girls in Connaught Place DELHI 🔝 >༒9540349809 🔝 genuine Escort Service ...
call girls in Connaught Place DELHI 🔝 >༒9540349809 🔝 genuine Escort Service ...
saminamagar
Â
Russian Call Girls in Pune Riya 9907093804 Short 1500 Night 6000 Best call gi...
Russian Call Girls in Pune Riya 9907093804 Short 1500 Night 6000 Best call gi...
Miss joya
Â
Recently uploaded
(20)
Book Call Girls in Kasavanahalli - 7001305949 with real photos and phone numbers
Book Call Girls in Kasavanahalli - 7001305949 with real photos and phone numbers
Â
sauth delhi call girls in Bhajanpura 🔝 9953056974 🔝 escort Service
sauth delhi call girls in Bhajanpura 🔝 9953056974 🔝 escort Service
Â
Call Girls Hosur Just Call 7001305949 Top Class Call Girl Service Available
Call Girls Hosur Just Call 7001305949 Top Class Call Girl Service Available
Â
Call Girls Service in Bommanahalli - 7001305949 with real photos and phone nu...
Call Girls Service in Bommanahalli - 7001305949 with real photos and phone nu...
Â
Call Girl Bangalore Nandini 7001305949 Independent Escort Service Bangalore
Call Girl Bangalore Nandini 7001305949 Independent Escort Service Bangalore
Â
Call Girls Service In Shyam Nagar Whatsapp 8445551418 Independent Escort Service
Call Girls Service In Shyam Nagar Whatsapp 8445551418 Independent Escort Service
Â
Hemostasis Physiology and Clinical correlations by Dr Faiza.pdf
Hemostasis Physiology and Clinical correlations by Dr Faiza.pdf
Â
Call Girls Service Noida Maya 9711199012 Independent Escort Service Noida
Call Girls Service Noida Maya 9711199012 Independent Escort Service Noida
Â
Call Girls Kanakapura Road Just Call 7001305949 Top Class Call Girl Service A...
Call Girls Kanakapura Road Just Call 7001305949 Top Class Call Girl Service A...
Â
Book Call Girls in Yelahanka - For 7001305949 Cheap & Best with original Photos
Book Call Girls in Yelahanka - For 7001305949 Cheap & Best with original Photos
Â
Call Girls ITPL Just Call 7001305949 Top Class Call Girl Service Available
Call Girls ITPL Just Call 7001305949 Top Class Call Girl Service Available
Â
Call Girls Whitefield Just Call 7001305949 Top Class Call Girl Service Available
Call Girls Whitefield Just Call 7001305949 Top Class Call Girl Service Available
Â
Housewife Call Girls Hsr Layout - Call 7001305949 Rs-3500 with A/C Room Cash ...
Housewife Call Girls Hsr Layout - Call 7001305949 Rs-3500 with A/C Room Cash ...
Â
Mumbai Call Girls Service 9910780858 Real Russian Girls Looking Models
Mumbai Call Girls Service 9910780858 Real Russian Girls Looking Models
Â
Housewife Call Girls Bangalore - Call 7001305949 Rs-3500 with A/C Room Cash o...
Housewife Call Girls Bangalore - Call 7001305949 Rs-3500 with A/C Room Cash o...
Â
High Profile Call Girls Jaipur Vani 8445551418 Independent Escort Service Jaipur
High Profile Call Girls Jaipur Vani 8445551418 Independent Escort Service Jaipur
Â
Call Girls In Andheri East Call 9920874524 Book Hot And Sexy Girls
Call Girls In Andheri East Call 9920874524 Book Hot And Sexy Girls
Â
See the 2,456 pharmacies on the National E-Pharmacy Platform
See the 2,456 pharmacies on the National E-Pharmacy Platform
Â
call girls in Connaught Place DELHI 🔝 >༒9540349809 🔝 genuine Escort Service ...
call girls in Connaught Place DELHI 🔝 >༒9540349809 🔝 genuine Escort Service ...
Â
Russian Call Girls in Pune Riya 9907093804 Short 1500 Night 6000 Best call gi...
Russian Call Girls in Pune Riya 9907093804 Short 1500 Night 6000 Best call gi...
Â
screening for cancer cervix
1.
SCREENING FOR CERVICAL CANCER Prof. Aboubakr Elnashar Benha university, Egypt Aboubakr Elnashar CONTENTS 1. MAGNITUDE OF THE PROBLEM 2. PREMALIGNANT STAGES 3. RISK FACTORS 4. SCREENING STRATEGY 5. METHODS OF SCREENING Aboubakr Elnashar
2.
1. MAGNITUDE OF THE PROBLEM â–ŞWorld wide: 3 rd most common female cancer â–Ş Developing countries: 80 % of all cases â–Ş Egypt: 2 nd most common female cancer â–Ş Developed countries: decrease since mid 1980 s Aboubakr Elnashar âť‘Incidence of Gynecologic Cancers in Egyptian Women 0 5 10 15 20 25 Breast Cancer Cervical Cancer Ovarian Cancer Uterine Cancer Percent Source: GLOBOCAN 2000. Aboubakr Elnashar
3.
CIN (%) N o Study University Year Author 1.07 4458 Hospital Cairo 1987 Hammad et al 3.1 5453 Community Suez canal 2007 Abd El All et al 3.1 25522 Hospital Ain Shams 2004- 2010 Shalakany (2012) 5.8 3600 Hospital Minia 2014 Sanad et al 1.3 6173 Alexandria 2015 Abdelhady et al 3.2 1600 Community Assuit 2017 Elmoselhy et al 3.00 46806 Total âť‘ Incidence â–Ş CIN in Egypt (Elnashar, 2019) Aboubakr Elnashar âť‘ Cx ca in Egypt: â–Ş 0.04% (AbdelAll et al, 2007) â–Ş 0.06% populations [Feraly et al, 2010) â–Ş 8th among the most common females' cancers (National Cancer Institute registry for the years 2002- 2004) â–Ş increasing incidence from 2002 to 2004 [Elattar, 2004) â–Ş increase by 34.0% from 2013 to 2050 [Ebrahim et al, 2014) Aboubakr Elnashar
4.
Incidence rates, crude rates, females, Egypt 2008–2011 National Population-Based Registry Program of Egypt. (2014) Crude rate % Breast 35.8 32 Ovary 4.6 4.1 Uterus unspecific 2.5 2.3 Cervix uteri 1.3 1.2 Corpus uteri 0.7 0.6 Vagina 0.2 0.14 Vulva 0.1 0.09 Other female genital 0.1 0.05 Aboubakr Elnashar Cervical Cancer in Egypt (Ibrahim AS et al. 2014) 0 5 10 15 20 25 30 35 < 45 years 45 - 59 years ≥ 60 years ASR Incidence/100,000 W Aboubakr Elnashar
5.
2. PREMALIGNANT STAGE âť‘ Cervical intraepithelial neoplasia (CIN): includes â–Ş Dysplasia & CIS â–Ş CIN 1 = Mild D. CIN 2= Moderate D. CIN 3= Severe D or CIS. Aboubakr Elnashar CIN I CIN II CINIII Aboubakr Elnashar
6.
âť‘Squamous intraepithelial lesion (SIL): includes â–Ş HPV & CIN. â–Ş Low grade SIL= CIN 1 or HPV. High grade SIL= CIN 2 or 3 Aboubakr Elnashar 3. RISK FACTORS I. Medical risk factors â–ŞCervical high-risk HPV infection: â–Ş99% of cervical cancer & high grade CIN are associated with HPV â–ŞTypes 16 and 18: responsible for 70% of all cervical cancers. â–ŞParity: â–ŞMultiparity â–Ş4 live births â–ŞEarly age of 1 st birth â–ŞImmunosuppression Aboubakr Elnashar
7.
II. Demographic risk factors â–ŞEthnicity (Latin American countries, U.S. minorities) â–ŞLow socioeconomic status â–ŞAge III. Behavioral risk factors â–ŞInfrequent or absent cancer screening Pap tests â–ŞEarly coitarche â–ŞMultiple sexual partners â–ŞMale partner who has had multiple sexual partners â–ŞTobacco smoking â–ŞDietary deficiencies: folic ac, vit A Aboubakr Elnashar HPV types Oncogenic potential HPV TYPES LOW 6, 11,14,43,44 INTERMEDIATE 31,33,35,51,52, HIGH 16,18, 45, 56 Aboubakr Elnashar
8.
âť‘13 high-risk HPV â–Ş 16, 18, â–Ş 31, 33, 35, 39 â–Ş 45, â–Ş 51, 52, 56, 58, 59, â–Ş 68. Aboubakr Elnashar âť–Cervical cancer is a preventable disease 1. Has a characteristic natural course with a slow progression through a premalignant stage 2. A premalignant stage can be detected by noninvasive means: Pap smear, VIA 3. An effective tt for the premalignant lesions Aboubakr Elnashar
9.
4. SCREENING STRATEGY âť‘Methods of Prevention â–Ş Primary: â–Ş Avoidance of the precipitating & risk factors â–Ş Counseling â–Ş Vaccination â–Ş Secondary: â–Ş Screening â–Ş Early detection â–Ş Tertiary: â–Ş Treatment or mitigation of damage Aboubakr Elnashar â–Ş Screening: â–Ş Definition â–Ş Systematic application of a test in â–Ş asymptomatic person â–Ş to identify pre clinical lesions. â–Ş Types : â–Ş Selective: Screening high risk groups â–Ş Mass: Screening all population Aboubakr Elnashar
10.
â–Ş In developing countries (lower and middle-income countries (LMICs) 1. Poor financial, human & technical resources 2. Higher incidence: 80% of cases 3. Higher mortality: 90% 4. Different risk factors 5. NO screening guidelines . 6. Decreased access to treatment 7. Inadequate follow up â–Ş Screening used in the developed world is inappropriate in developing countries Aboubakr Elnashar â–Ş In Higher -income counteries â–Ş have guidelines for screening women â–Ş These guidelines define not only the target population for screening, but also â–Ş screening methods, intervals, and â–Ş appropriate interventions depending on test results â–Ş The incidence of cervical cancer has decreased by approximately 80% Aboubakr Elnashar
11.
Choosing an appropriate screening modality â–Ş The three main modalities of screening in use â–Ş HPV testing â–Ş Cytology â–Ş VIA â–Ş Selection of method depends on existing resources rather than differences in efficacy â–Ş In good resource settings: â–Ş Validated primary HPV screening: The most effective method â–Ş In centers with an established cytology program with good quality control may continue with cytology. â–Ş In limited resource settings one may screen with VIA. Aboubakr Elnashar â–Ş Pap-only testing â–Ş performed every 3 y â–Ş Pap-HPV cotesting â–Ş Performed every 5 y in women older than 30 with past normal screening. â–Ş Until 2018, all 3 organizations recommended cotesting as the preferred screening algorithm for women ages 30 to 65. â–Ş Patients with a history of abnormal test results require more frequent testing as recommended by the ASCCP, 2012 Aboubakr Elnashar
12.
ASCCP, ACOG Aboubakr Elnashar â–Ş In L&MIC: WHO Aboubakr Elnashar
13.
▪ In HIC: Preventive Services Task Force, 2018 ▪ For average-risk women ▪ Age:21–29: cervical cytology alone every 3 years. ▪ 30–65 years, screening options include 1. Cytology alone every 3 years 2. High-risk HPV testing alone every 5 years, or 3. Cotesting every 5 years. ▪ Do not screen for cervical cancer. 1. Women younger than 21 y 2. women older than 65 years with adequate prior screening 3. women who have had a total hysterectomy Aboubakr Elnashar ▪ Risk Assessment ▪ All women aged 21 to 65 years are at risk for cervical cancer because of potential exposure to high-risk HPV types through sexual intercourse and should be screened. ▪ Certain risk factors further increase risk for cervical cancer 1. HIV infection 2. Compromised immune system 3. In utero exposure to diethylstilbestrol 4. Previous treatment of a high-grade precancerous lesion or cervical cancer. ▪ Women with these risk factors should receive individualized follow-up. Aboubakr Elnashar
14.
5. METHODS OF CERVICAL CANCER SCREENING A. Cytological 1. Conventional Pap. Smear 2. Liquid-based monolayers: LBC 3. Automated cytological screening B. HPV testing Aboubakr Elnashar C. Visual 1. Visual inspection of the cervix a. Unaided b. Visual inspection with acetic acid (VIA) c. Visual inspection with acetic acid and magnification (VIAM) d. Visual inspection with Lugol’s Iodine (VILI) Aboubakr Elnashar
15.
A. CYTOLOGY 1. Conventional Pap test ▪ used for ≥50 y all across the globe. ▪ widely used for in most developed countries ▪Meets all the requirements for mass screening:. ▪ Fairly tolerated by patients ▪Easy to administer ▪ Reasonable sensitivity & specificity. ▪Detection of endocervical lesions. Aboubakr Elnashar ❑Precautions: No ▪ Sexual intercourse ▪ Vaginal douche ▪ Medication ▪ Lubrication ▪ Powder ▪ Pelvic examination ▪ Acetic acid Aboubakr Elnashar
16.
â–Ş Instruments & materials: â–Ş Speculum â–Ş Spatula: â–Ş Cytobrush â–Ş cotton tipped swab for the endocervical canal â–Ş Ayre s spatula for the ectocervix â–Ş Fixative â–Ş Jar â–Ş Slide Aboubakr Elnashar âť‘Steps: 1. Taking the sample: â–Şfrom the ectocervix and endocervix â–Şwith a spatula or brush 2. Smearing: circular motion 3. Fixation: â–ŞEthyl alcohol â–ŞCoating spray 4. Staining: 5. Examination under a microscope by specially trained technologists and doctors. Aboubakr Elnashar
17.
Aboubakr Elnashar Aboubakr Elnashar
18.
Aboubakr Elnashar Aboubakr Elnashar
19.
❑Limitations ▪Requires: ▪Complex infrastructure: Complex laboratory test ▪Trained cytologist ▪Multiple visits ▪Continuous monitoring to maintain high-quality results ▪Results: ▪Moderate to low sensitivity:High rate of false-negative test results 20-40%: Women must be screened frequently ▪Rater dependent ▪Not immediately available ▪Less accurate among post-menopausal women ▪Impossible to locate the lesion. ▪Available: only in large cities in many countries Aboubakr Elnashar 2. Liquid-based monolayers (ThinPrep, CytoRich) ❑Steps: 1. Cells are collected using a brush instead of a spatula. 2. Head of the brush is vigorously shaken or broken off into a small pot of liquid containing preservative solution. 3. The sample is filtered or centrifuged to remove excess blood and debris. 4. The cells are then transferred to the slide in a “mono” layer. 5. Staining. Aboubakr Elnashar
20.
â–Ş LBC Vs Conventional Pap â–Ş More expensive â–Ş Repeat smear rates: 1 to 2% Vs 9% â–Ş Less false negative rate â–Ş No difference in the relative sensitivity. â–Ş No difference in the relative specificity, when H and L- GSIL were considered as cutoff. â–Ş Better in predicting CIN â–Ş It is the preferred tool for cervical cytology screening Aboubakr Elnashar Aboubakr Elnashar
21.
3. Automated Pap smears â–Ş To reduce errors by using computerized analysis to evaluate Pap smear slides. 1. Autocyte â–Ş Composed of an algorithmic & neural network scanner â–Ş Scans the slides & records images of 128 of the most abnormal fields found on the slide, with the most significant abnormality found in the center. â–Ş It reduces costs & shortens screening time. â–Ş Detects 97.2% of the abnormal tests (Koss et al,1994). Aboubakr Elnashar Aboubakr Elnashar
22.
2. AutoPap. ▪The material on the slide is reviewed and scored based on an algorithm, as to the likelihood of an abnormality being present. ▪Typically, it does not show the cytotechnologist which of the cells are likely to be abnormal. ▪Variety of visual characteristics, such as shape and optical density of the cells, are included in the algorithm. •It reviews all normal & satisfactory smears •As a primary screener, it removes 30 % of slides from the workload •97% sensitivity (Lee et al, 1997) Aboubakr Elnashar B. HPV TESTING ▪ Role of HPV as a causative agent of cervical cancer has been well established. ▪ However, most HPV infections in young women ▪ Regress rapidly, without causing clinically significant disease. ▪ infection is a marker of sexual activity than of cervical cancer risk. Aboubakr Elnashar
23.
â–Ş The most sensitive modality, suitable for screening in all resource settings. â–Ş Even a single round of HPV testing was shown to significantly reduce the incidence of cervical cancer â–Ş However, it is expensive and not widely available. â–Ş It is recommended for women aged over 30 years using validated tests. Aboubakr Elnashar â–Ş Validated tests â–Ş are those that have demonstrated efficacy in RCT or have shown test accuracy comparable to a validated test. â–Ş Reported as â–Ş Detected/not detected for a pool of 13 or 14 high-risk HPV genotypes â–Ş Some report individual genotypes for the most oncogenic types (HPV 16/18). â–Ş Examples: Hybrid Capture 2, careHPV, Cobas, Xpert, Cervista, APTIMA etc. Aboubakr Elnashar
24.
â–Ş The high-risk HPV-only test â–Ş utilizes real-time PCR to detect â–Ş HPV 16, â–Ş HPV 18, and â–Ş 12 other HPV genotypes. â–Ş Only 2 tests are approved by the FDA as stand-alone cervical cancer screening tests â–Ş Roche Cobas HPV test approved in 2014 â–Ş Becton Dickinson Onclarity HPV assay approved in 2018. â–Ş Other HPV tests that are used in a cotesting strategy â–Ş should not be used for high-risk HPV-only testing â–Ş because their performance characteristics may differ. Aboubakr Elnashar Aboubakr Elnashar
25.
Aboubakr Elnashar Aboubakr Elnashar
26.
C. Visual inspection with acetic acid (VIA) â–Ş Sensitivity comparable to cytology â–Ş Poor specificity: larger number of women will require further triage by colposcopy â–Ş Can be used in all resource settings by all levels of healthcare providers. â–Ş Currently it is the only test that can be used in low resource settings with considerable accuracy and safety but in future, the availability of affordable HPV testing may change this paradigm. Aboubakr Elnashar âť‘ Effects of acetic acid: â–ŞCoagulates the proteins of the nucleus & cytoplasm: protein opaque & white. â–ŞDehydrates the cells: cytoplasmic volume is reduced & the reflection is increased. âť‘Duration: â–Ş appears after 20 seconds â–Ş disappears after 2 minutes. Aboubakr Elnashar
27.
Category Clinical Findings Negative No acetowhite lesions or faint acetowhite lesions; polyp, cervicitis, inflammation, Nabothian cysts. Positive Sharp, distinct, well-defined, dense (opaque/dull or oyster white) acetowhite with or without raised margins touching SCJ; leukoplakia and warts. Suspicious for cancer ulcerative, cauliflower-like growth or ulcer; oozing and/or bleeding on touch. Visual inspection with acetic acid (VIA) Aboubakr Elnashar Normal NAAT Positive Suspicious for cancer Aboubakr Elnashar
28.
▪Visual inspection after application of Lugol’s iodine Test performance: (Sankaranarayanan et al., 2008). Specificity Sensitivity 85.5 76.8 VIA 85.4 91.7 VILI Aboubakr Elnashar ❑Categories for VILI test results: Category Clinical Findings Negative ▪Squamous epithelium turns brown ▪Columnar epithelium does not change color; or ▪Irregular, partial or non-iodine uptake areas. Positive ▪Well-defined, bright yellow iodine non- uptake areas touching SCJ or close to the os if SCJ is not seen. Suspicious for cancer ▪Ulcerative, cauliflower- like growth or ▪Ulcer; oozing and/or bleeding on touch. Aboubakr Elnashar
29.
• VILI: test-positive • Well-defined • bright yellow iodine non-uptake areas • touching the SCJ Aboubakr Elnashar
Download now