EAGC course book on colposcopy PDF
Preview EAGC course book on colposcopy
Cover Page 1 EAGC Course Book on Colposcopy FIRST EDITION Page 2 “This book is dedicated to our wives, Ildikó and Gabrielle and to our children, Domonkos and Boldizsár Bősze and Alice and Megan Luesley, whose support and patience made this endeavor possible.” Page 3 European Academy of Gynaecological Cancer (EAGC) Book Series Founding Editor and EditorinChief Péter Bősze, Budapest, Hungary EAGC Course Book on Colposcopy PRIMEDX PRESS BUDAPEST Page 4 EDITED BY PÉTER BŐSZE, MD, PhD, DSc Professor of Obstetrics and Gynaecology Department of Obstetrics and Gynaecology Saint Stephan Hospital, Budapest, Hungary Chairman of the European Academy of Gynaecological Cancer, EAGC and DAVID M.LUESLEY, MA, MD, FRCOG Professor of Gynaecological Oncology Director, Department of Gynaecologic Oncology Birmingham Women’s Health Care, NHS Trust, Birmingham, UK with 33 additional contributors PRIMEDX PRESS BUDAPEST Published by PRIMEDX PRESS, Budapest, Hungary (1301 Budapest, P.O. Box 46, Fax: 36 1 4290318, Email: mail@primedX.hu) Managing Editor: Terézia Barabás, Presscon, Production Manager: Boldizsár Bősze, Design conception: Csaba Heltai. Layout: Gábor Kardos. Language editing: Liz Dollery, BSCCP Coordinator and Simon Thomas. Figures’ preparation: Lajos Megyeri Jr. Technical assistance: Domonkos Bősze, Printed: Visit Kft. Budapest, Hungary The emblem, designed by László Mátyássy, symbolizes a transition related to the female genital system, such as gynaecological cancer of unknown outcome. It is composed of an octogon and a mandorla. Octogon means eight, which is the number of transition (renewal, rebirth), the mandorla is an almondshape aureole representing the vulva. This edition published in the Taylor & Francis eLibrary, 2005. To purchase your own copy of this or any of Taylor & Francis or Routledge’s collection of thousands of eBooks please go to www.eBookstore.tandf.co.uk. Copyright © 2003 by PrimedX Press All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means—electronic, mechanical, photocopying, recording or otherwise—without the prior permission of the publisher, except for brief quotations embodied in critical articles and reviews. Great care has been taken to maintain the accuracy of information contained in this volume. However, neither the PrimedX Press nor the editors can be held responsible for errors or for any consequences arising from the use of information contained in this book. World Wide Web: http://www.cme.hu ISBN 0203005287 Master ebook ISBN ISBN 963 00 7356 0 (Print Edition) Page 5 Introduction to the European Academy of Gynaecological Cancer, EAGC, Book Series THE EUROPEAN ACADEMY OF GYNAECOLOGICAL CANCER, EAGC, is a European educational organization for comprehensive training and education in gynaecological oncology in Europe. For management and financial reasons, the EAGC has been established and is being managed by the European Academy of Gynaecological Cancer Foundation (EAGCF; officially registered in Budapest, Hungary). Due to this status, the EAGC is a nonprivate, nonprofit, nongovernmental and independent corporation without any financial commitment. Any financial resources, funds and assets in the context of EAGC shall be vested in the EAGCF. The EAGCF is a nonprivate, nonprofit, nongovernmental and independent foundation. A comprehensive training programme includes subspecialty training (equivalent to the fellowship program in USA) and continuing medical education/professional development (CME/CPD) in gynaecological oncology, which involves benign tumours and malignant diseases of the female genital tract and breasts. The EAGC is comprised of a permanent central administrative office, “the Headquarters,” and the accredited Training Centres throughout Europe called EAGC Training Centres. The EAGC has an Executive Board, an International Advisory Board and offices. One of the objectives of the EAGC missions is to launch a book series on educational and training materials in topics related to gynaecological oncology. This volume is the first edition of this series. It is the intention of EAGC to establish a European Certificate in Colposcopy. The European Federation for Colposcopy and Pathology of the Lower Genital Tract (EFC) has set up a competencebased Core Curriculum on Colposcopy, which serves as the basis of the European Certificate in Colposcopy. The present book provides detailed knowledge for this endeavour and can be used for courses and individual education in the field. We trust that this edition will be useful for those who are interested not only in colposcopy but in the diseases of the female genital tract. We do hope the joint efforts of the 35 authors will contribute to improve Women’s Health Care. Peter Bősze David M.Luesley Page 6 Page 7 Foreward Worldwide, cancer of the cervix is one of the most common causes of death in women. Each death is a tragedy, not only because usually the women are young, but because they leave behind young families. It is a further tragedy that, although cancer of the cervix is a disease which has almost been eradicated in countries which have introduced screening programmes, it remains the second or third most common cause of death in women in developing countries. As gynaecologists, it is our responsibility to give the best possible care to women and to that end we have a responsibility to reduce deaths from cervical cancer. We can sympathise with colleagues who work in countries where there are too few doctors for too many patients, and where the national budget for healthcare is limited. On the other hand, prevention of cervical cancer will, in the longterm, prove much cheaper and more beneficial than trying to treat cancer once it is already established. Whatever type of screening programme is adopted, such as cervical cytology or visual inspection with acetic acid, or a combination of both (or in the future electronic realtime devices or possibly HPV screening), colposcopy is the key to eradicating this largely preventable disease. Basic colposcopy can be learned fairly easily provided the clinician has a good basic training, which includes an understanding not only of colposcopy, but cytology and histopathology. The relationship between the various disciplines is a symbiotic relationship in as much as each is interdependent upon the other. The role of colposcopy is simple—it should identify areas of premalignant disease, which if removed completely, will more or less guarantee that the woman will not die from cervical cancer. Ideally the colposcopist should be seeing patients who are known to have an abnormal screening test or who have a clinically suspicious cervix, but in some countries colposcopy will be used as the primary screening procedure. However it is used, the colposcopist should bear in mind that the objective of every gynaecologist is to give the best possible quality of care available. To do this the colposcopist needs to identify how the highest quality service can be given, and then to deliver that service, but to remember that the third stage in providing a quality service is to be able to prove that the service given is, in fact, of the highest quality. To that end, audit of one’s own practice is vital. This book, edited by Peter Bősze and David Luesley, is a valuable training manual. Each author has been carefully chosen because of their special skills in their particular field and the book covers thoroughly everything which a trainee colposcopist needs to know and everything that a trained colposcopist needs to remember. Cancer of the cervix can be beaten—if each of us waits for someone else to find a way then the battle will never be won!! It is the personal responsibility of all of us as gynaecologists to ensure that a skilled colposcopy service is available to all those women who need it. J A Jordan President, European Federation for Colposcopy Page 8 Contributors PÉTER BŐSZE, MD, PhD, DSc Professor of Obstetrics and Gynaecology Department of Obstetrics and Gynaecology Saint Stephan Hospital, Budapest, Hungary KAREN CANFELL, BE (Hons) European Clinical and Scientific Director Polartechnics (UK) Limited, Oxford, UK. MONTSE CARARACH, MD Assistant Professor of Gynaecology and Obstetrics Department of Gynaecology and Obstetrics Institut Universitari Dexeus, Barcelona, Spain SWEE CHONG QUEK, MRCOG Obstetrician & Gynaecologist Gynaecologic Oncology Unit KK Women’s & Children’s Hospital Singapore CARL CHOW, BSc MRCOG Clinical Research Fellow Department of Gynaecologic Oncology Whittington Hospital, London, UK MAGGIE CRUICKSHANK, MBChB, MRCOG, MD Senior Lecturer in Gynaecology Oncology Department of Gynaecology and Obstetrics Aberdeen Royal Infirmary, Aberdeen, Scotland MARIA TERESA CUSIDÓ, MD Assistant Professor of Gynaecology and Obstetrics Department of Gynaecology and Obstetrics Institut Universitari Dexeus, Barcelona, Spain MARIA JOSE DE CAMARGO, MD Professor of Gynaecology and Colposcopy Fundacao Oswaldo Cruz Gynaecology Department of Instituto Fernandes Figueira Rio de Janeiro, Brazil GIUSEPPE DE PALO, MD Professor of Gynaecology Director, Division of Preventive Medicine Istituto Nazionale Tumori, Milan, Italy SANTIAGO DEXEUS, MD Professor of Gynaecology and Obstetrics Director, Department of Gynaecology and Obstetrics Institut Universitari Dexeus, Barcelona, Spain IAN D.DUNCAN, MB, ChB, FRCOG Reader in Gynaecology University of Dundee, Dundee, Scotland IAN J.ETHERINGTON, MD, MRCOG Consultant Obstetrician and Gynaecologist Academic Department of Obstetrics and Gynaecology City Hospital NHS Trust, Birmingham, UK THERESA FREEMANWANG, MRCOG Consultant Gynaecologist and Honorary Senior Lecturer Department of Women’s Health Whittington Hospital, London, UK VALERIE HARPER, MD Consultant Gynaecologist Department of Gynaecology Monklands Hospital, Lanarkshire, UK Page 9 THEO J.M.HELMERHORST, MD Professor of Obstetrics and Gynaecology Director, Department of Obstetrics and Gynaecology University Hospital Rotterdam, Rotterdam, The Netherlands ELLEN H.HOPMAN, MD Assistant Professor of Gynaecology and Obstetrics Department of Obstetrics and Gynaecology University Hospital Rotterdam, Rotterdam, The Netherlands JOE JORDAN, MD, FRCOG President, European Federation of Colposcopy Medical Director, Birmingham Women’s Hospital Birmingham, UK VESNA KESIC, MD, PhD Associate Professor of Gynaecology and Obstetrics Department of Obstetrics and Gynaecology University Clinical Centre, Beograd, Yugoslavia HENRY C.KITCHENER, MD FRCS(Glas) FRCOG Professor of Gynaecological Oncology Academic Unit of Obstetrics and Gynaecology St. Mary’s Hospital, Manchester, UK ALBERTO DE BARROS LOPES, MRCOG Consultant Gynaecological Oncologist Northem Gynaecological Oncology Centre Queen Elizabeth Hospital, Gateshead, UK DAVID M.LUESLEY, MA, MD, FRCOG Professor of Gynaecological Oncology Department of Gynaecologic Oncology Birmingham Women’s Health Care, NHS Trust, Birmingham, UK JOHN M.MONAGHAN, MB, FRCS (Ed), FRCOG Senior Lecturer in Gynaecological Oncology Northem Gynaecological Oncology Centre Queen Elizabeth Hospital, Gateshead, UK SALONEY NAZEER, MD Médecin Consultant, Chargée d’Enseignement WHO Collaborating Centre for Research in Human Reproduction University Hospital of Geneva, Geneva, Switzerland HELLMUTH PICKEL, MD, MIAC Professor, Department of Obstetrics and Gyanecology Division of Conservative Gynecological Oncology University of Graz, Graz, Austria WALTER PRENDIVILLE, MAO FRCOG FRACOG Associate Professor, Royal College of Surgeons in Ireland Department of Gynaecology Coombe Women’s Hospital, Dublin, Ireland CHARLES W.E.REDMAN, MD, FRCS(Ed), FRCOG Consultant in Gynaecology Department of Obstetrics and Gynaecology North Staffordshire Hospital, StokeonTrent, UK ANDREA SAS, MD Assistant Professor of Gynaecology and Obstetrics Department of Gynaecology and Obstetrics Institut Universitari Dexeus, Barcelona Spain MAHMOOD I.SHAFI, MD, DA, MRCOG Consultant Gynaecological Surgeon and Oncologist Department of Gynaecology Birmingham Women’s Hospital, Birmingham, UK
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