Preventing Malignancies Of The Reproductive Tract, An Issue Of Obstetrics And Gynecology Clinics (the Clinics: Internal Medicine)

Obstet Gynecol Clin N Am 34 (2007) xiii–xiv Foreword William F. Rayburn, MD Consulting Editor Cancer is the second leading cause of death among women. Ideally, it is desirable to prevent or at least to detect cancer in the precancerous stage. Early detection is possible by using Papanicolaou’s (Pap) test for cervical cancer, biopsies for endometrial cancer, and mammography for breast cancer. History plays a more major role in the detection of colorectal cancer, because having first-degree relatives with colon cancer; a history of colorectal, breast, endometrial, or ovarian cancer; and a history of adenomatous polyps or ulcerative colitis are identified risk factors. For many women, obstetrician-gynecologists are physicians who provide their primary or preventive health care. Many reproductive tract malignancies are preventable. An obstetrician-gynecologist is, therefore, in an excellent position to provide select screening for reproductive tract malignancies. Evaluation of risk for cancer includes questions about high-risk habits, assessment of family history for cancer, and review of symptoms pertinent to each organ system. Counseling focuses on risk factors and early warning signs, prevention strategies, and routine or selective testing. The obstetrician-gynecologist plays an important role in counseling patients on lifestyle factors that can reduce or increase the risk of cancer. Informed patients can make better choices by implementing certain behavior modifications. Patients should be encouraged to reduce the risk of cancer by not smoking, eating high-fiber foods, restricting fat intake, exercising daily, restricting exposure to the sun, paying attention to certain body changes, and getting regular health checkups for diagnostic evaluations (Pap test, mammography, sigmoidoscopy) and preventive therapy (vaccination). 0889-8545/07/$ - see front matter Ó 2007 Elsevier Inc. All rights reserved. doi:10.1016/j.ogc.2007.10.002 obgyn.theclinics.com xiv FOREWORD This issue of Obstetrics and Gynecologic Clinics of North America, guest edited by Carolyn Muller, MD, directs the reader to fundamental cancer prevention and screening for a better understanding of the conflicting outcomes from many studies designed to evaluate risk factors and interventions. State-of-the-art prevention strategies are presented by a distinguished group of authors who have dedicated their professional careers to the study of each of the major reproductive tract malignancies. Current clinical trials are highlighted that inform the practicing obstetrician-gynecologist about future directions into tomorrow’s preventive care. William F. Rayburn, MD Department of Obstetrics and Gynecology University of New Me