Three new guidelines make up the Genital Tract Cancers in Females series available to all physicians on www.bcguidelines.ca. They are Endometrial Cancer; Human Papillomavirus Related Cancers; and Ovarian, Fallopian Tube, and Primary Peritoneal Cancers.
The guidelines provide recommendations for the screening, diagnosis, and follow-up care of these cancers in women who are 19 years or older. Signs and symptoms for the different female genital tract cancers may overlap (e.g., abnormal uterine bleeding); therefore, these guidelines may need to be used in conjunction with each other when performing initial diagnostic investigations.
• Refer patients with suspected hereditary cancer syndrome to the BC Cancer Agency’s Hereditary Cancer Program.
• Investigate abnormal uterine bleeding, starting with a history and physical exam.
• Endometrial biopsy and transvaginal ultrasound are the recommended initial diagnostic investigations if other causes of abnormal uterine bleeding have been ruled out, and if endometrial cancer is suspected.
• Routine bloodwork, Pap smear, and imaging are not needed during follow-up visits posttreatment unless indicated by symptoms or signs on examination.
Human papillomavirus related cancers (cervical, vaginal, and vulvar)
• HPV immunization is recommended for the prevention of HPV infection, which is the major risk factor for cervical, vaginal, and vulvar cancers.
• Screening for cervical cancer in asymptomatic females should be offered following the BC Cancer Agency’s Cervical Cancer Screening Program.
• If cancer of the cervix is clinically suspected, proceed to biopsy or colposcopy, even in the case of a normal Pap smear result.
Ovarian, fallopian tube, and primary peritoneal cancers
• Maintain a high index of suspicion for ovarian cancer—symptoms are nonspecific and variable.
• Investigate immediately if abdominal mass or postmenopausal/abnormal bleeding is present since these symptoms have the highest positive predictive value.
• Refer patient immediately by telephone referral to gynecologic oncologist at the BC Cancer Agency’s Division of Gynecologic Oncology if epithelial ovarian cancer or germ cell ovarian tumor is suspected.
• Refer patient with suspected hereditary cancer syndrome to the BC Cancer Agency’s Hereditary Cancer Program.
• Routine tumor markers or imaging are not needed during follow-up visits, unless indicated by symptoms or signs on examination.
Above is the information needed to cite this article in your paper or presentation. The International Committee
of Medical Journal Editors (ICMJE) recommends the following citation style, which is the now nearly universally
accepted citation style for scientific papers:
Halpern SD, Ubel PA, Caplan AL, Marion DW, Palmer AM, Schiding JK, et al. Solid-organ transplantation in HIV-infected patients. N Engl J Med. 2002;347:284-7.
About the ICMJE and citation styles
The ICMJE is small group of editors of general medical journals who first met informally in Vancouver, British Columbia, in 1978 to establish guidelines for the format of manuscripts submitted to their journals. The group became known as the Vancouver Group. Its requirements for manuscripts, including formats for bibliographic references developed by the U.S. National Library of Medicine (NLM), were first published in 1979. The Vancouver Group expanded and evolved into the International Committee of Medical Journal Editors (ICMJE), which meets annually. The ICMJE created the Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly Work in Medical Journals to help authors and editors create and distribute accurate, clear, easily accessible reports of biomedical studies.
An alternate version of ICMJE style is to additionally list the month an issue number, but since most journals use continuous pagination, the shorter form provides sufficient information to locate the reference. The NLM now lists all authors.
BCMJ standard citation style is a slight modification of the ICMJE/NLM style, as follows:
- Only the first three authors are listed, followed by "et al."
- There is no period after the journal name.
- Page numbers are not abbreviated.
For more information on the ICMJE Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly Work in Medical Journals, visit www.icmje.org