5th International Multidisciplinary Congress

Paris, France, April 13-16, 2003




This volume covers the outstanding research developments in Human Papillomavirus Infection and Cervical Neoplasia Prevention presented during the Eurogin 2003 International Congress on the Global Challenge of Cervical Cancer Prevention, held in Paris on April 13-16, 2003. The programme of the congress was devised to provide valuable information to delegates, thanks to the participation of internationally renowned specialists.

During the conference, emphasis was put on the importance of integrating basic and clinical research into cervical cancer screening and prevention and on the need for international collaboration and epidemiological studies.

The strateggering pace of new technology has enabled investigators in both academia and industry to develop innovative approaches to solving many of the problems that have bedevilled gynecologists and pathologists for years. HPV DNA detection technology has improved by orders of magnitude and may be useful for primary screening: computers can screen Paps better than cytotechnologists; probes that can be used in the office promise real time cervical neoplasia detection opportunities; Pap smears using fluid-based systems have significantly improved sensitivity; and probes for mitosis-associated proteins and other molecular tests are being evaluated for potential use in detecting HPV related lesions. Even the holy grail of prevention rather than treatment of HPV caused diseases may become a reality through HPV vaccination. At the same time, new treatment modalities are being evaluated and are likely to lead to new management algorithms. Immune modulators and new topical cytostatic formulations may make medical rather than ablative or excisional procedures a reality.

While this fantastic technology is being pursued in the developed countries, women in low resource settings continue to die from genital tract cancers at an alarming rate. The problems relating to money, infrastructure, competing needs, a political indifference frequently seem insurmountable. But investigators in a dozen countries are systematically exploring better, easier, and less expensive ways to screen underserved women for cervical neoplasia and to treat their disease when it is detected. These studies mesh well with advances in service delivery, and they may all come together in the near future to provide at least partial solutions to what was thought to be intractable problems.

We trust that the latest technological and pharmaceutical advances presented in the scientific programme will enable participants to identify current-day problems and provide them with the opportunity of developing a practical policy.

The international and multidisciplinary participation of delegates was a particularly stimulating feature. We would like to extend grateful thanks to the contributors and exhibitors for their generous support as well as to the organizing committee for their devoted efforts and to Monduzzi Editions for publishing these proceedings.

Joseph Monsonego
Chairman of the Scientific Committee




Invited Lectures

Natural History of HPV Infections: Recent Developments
K.J. Syrjänen

The Natural History of Vulval Intraepithelial Neoplasia (VIN)
R.W. Jones

Renewing the Organised Screening Programme For Cervical Cancer in Finland: First Results on Randomised Comparison of Primary Screening with Traditional Pap-Smear and Automation-Assisted Screening
P. Nieminen, A. Anttila and M. Hakama

Cervical Screening: The Challenge For the Future
J. Patnick

HPV Transmission in Families
S. Syrjänen, Marjut Rintala and Seija Grenman

Geographic Variation in HPV Infection
S. Franceschi, G.M. Clifford, S. Vaccarella, H.R. Shin, S. Sukvirach, P.T.H. Anh, E. Matos, M. Molano, J. Thomas and R. Herrero

The Story of Human Papillomavirus Infection: EMERGENCE
A. Meisels

HPV Testing in Primary Cervical Cancer Screening: A Canadian Experience
S. Ratnam and E. Franco

Human Papillomavirus Testing in Primary Screening of High-Grade Cervical Lesions: A Study of 12538 Women
C. Clavel, J. Cucherousset, J.P. Bory, R. Gabriel, C. Quereux and P. Birembaut

Testing Optional Screening Tools For Cervical Cancer in the New Independent States (NIS) Of The Former Soviet Union
K.J. Syrjänen, I.P. Shabalova, N. Petrovichev, V.P. Kozachenko, A. Pajanidi, J.I. Podistov, G. Chemeris, L.G. Sozaeva, Zakharova, E.V. Lipova, I. Tsidaeva, O.G. Ivanchenko, A.A. Pshepurko, S. Zakharenko, R. Nerovjna, L.B. Kljukina, O.A. Erokhina, M.F. Branovskaja, M. Nikitina, A. Griunberg, V. Griunberga, A. Juschenko, P. Tosi, M. Cintorino, R. Santopietro and S. Syrjänen

Comparing Pap Smear Cytology, Aided Visual Inspection (VIA), Screening Colposcopy, Cervico- Graphy and HPV Testing By HCII (Normal and Self-Sampling) As Optional Screening Tools in Latin America. Experience From the LAMS Study
K. Syrjänen, P. Naud, S.M. Derchain, C. Roteli-Martins, A. Longatto-Filho, S. Tatti, M. Branca, M. Erzen, L. Serpa-Hammes, R. Gontijo, T.P. Lima, M.Y.S. Maeda, A. Lorincz, G.B. Dores, S. Costa and S. Syrjänen

Cervical Cancer Screening: The Role of PAP Smear, Hybrid Capture and Visual Inspection in the Diagnosis of Premalignant and Cervical Cancer Lesions
P. Naud, J. Matos, L. Hammes, A. Lorincz, G. Dores, V. Magno, J. Stuczinski, P. Crussius, C. Campos, M. Barcellos, C. Browers, M. Osanai, L. Zubaran, A. Ávila, E. Capp and J.C. Prola

Fluorescence-based Spectroscopy for Detecting High-grade Intraepithelial Neoplasia (CIN) of the Cervix
A.K. Dattamajumdar, A. Ferenczy, M. Tuggy, M. Rosing, J. Waldman, V. Hunter, J. Villella, D. Wells, J.T. Lewis and D. Ganguly

Multimodal Spectroscopic Imaging of the Human Uterine Cervix for Triage of Patients with Indeterminate Cervical Cytology
T. De Santis, N. Chacktoura, D. Ferris, L. Twiggs, L. Flowers, M. Lashgari, E. Wilkinson, S. Bambot, A. Agrawal and D. Mongin

Human Papillomavirus (HPV) Type Distribution in HIV-Seropositive and -Seronegative Italian Women
M.L. Tornesello, M.L. Duraturo, L. Buonaguro, M. Sansone, M. Di Stefano, R. Piccoli and F.M. Buonaguro

The Role of HPV in VIN
M. van Seters and M. van Beurden

Grading Colposcopic Features
S. Dexeus, D. Dexeus and M. Cararach

Diagnosis of intraepithelial Lesions of the Cervix: Which Is the Gold Standard?
X. Cortes-Bordoy, S. Crespi and J. Vinimelis

Management of CIN in Pregnancy
J.-J. Baldauf, D. Hamid and A. Minetti

Is Destructive Treatment of Cervical Preinvasive Disease Obsolete? A 13-Year Experience with Cryotherapy and Laser
F.B. Guijon

European Federation for Colposcopy (EFC)
J. Jordan, C. Redman, E. Dollery and E. Diakomanolis

Correlation of Viral Integration and Viral Load Among HPV 16-Infected Women
S.-M. Kulmala, B. Johansson, P. Peitsaro, M. Ruutu and S.M. Syrjänen

Does Telomerase Activation Have a Role in HPV-Induced Carcinogenesis?
B. Johansson, P. Peitsaro, M. Ruutu and S.M. Syrjänen

Recent Progress On Fertility Preserving Treatment of Infiltrative Cervical Cancer
A. Onnis

Early Invasion in Cervical Cancer
E. Diakomanolis

Clinician Panel: Translating Immunology Into the Practice
I. Bourgault Villada

A Randomized, Placebo-Controlled Study of ZYC101a for the Treatment of High Grade Intraepithelial Neoplasia
K.U. Petry, F. Garcia, M.A. Gold, L. Muderspach, P. Braly, C.P. Crum, R.G. Urban, M.L. Hedley and K. Beach

Combi-therapy for EGW´s – Which Options?
G. von Krogh

Hysteroscopic Treatment of Uterine Synechias
L. Montevecchi

Office Gynecological Procedures: Treatment of Vaginal Disease
E. Paraskevaidis and A. Sotiriadis

Ductal Lavage in Women at High Risk for Breast Cancer
V. Vogel

Current Issues in Diagnostic Testing of STIs
R.W. Peeling

Other STDs Issues
J.H.F. Smith

Rapid and Sensitive Detection of HSV in Pregnant Women During Pregnancy and Before Labor By Direct Fluorescent Assay (DFA) with Monoclonal Antibodies
M. Askienazy-Elbhar and M. Azoulay

Steps toward Reliable Online Health Information: the HONcode
C. Boyer

HPV Prevalence in South of Brazil
P. Naud, J. Matos, L. Hammes, J. Stuckzinski, K. Brouwers, V. Magno, P. Crussius, A. D’Avila, C. Campos, C. Marc, M. Hoblik and L. Oliveira

Improving Health Systems Towards Equality-based Control of Cervical Cancer in Latin America. Comparing Pap Smear Cytology, Aided Visual Inspection, Cervicography and Human Papillomavirus (HPV) Testing as Optional Screening Tools in Brazil and Argentina. Multicentric Study – Description of data from Porto Alegre - Brazil
P. Naud, K. Syrjänen, L. Hammes, J.C. Matos, M.C. Barcelos, C. Campos, E. Dias, V.A. Magno, C.E. Niederauer, C. Pereira, R. Prati, J. Stuczinski, A. Rose, A.C. Pütten, P. Ferreira, E. Campos, M. Branca, M. Erzen, A. Lorincz, G. Dores, O. Artigalas, F. Costa, G. Fontana, M. Höblick, M.C. Mano, C. Marques Pereira, I. Moreira, J.G. Olijnyk, E. Piccoli and J.G. Thome


Free Papers

Optical Detection of Cervical Neoplasia: Effect of Biological and Procedural Variables
R. Cestero, R. Alvarez, W. Huh, F. Garcia, M. Gold, R. Guido, K. McIntyre-Seltman, D. Harper, V. Soto-Wright and L. Burke

Detection of HPV and Subtyping of HPV in Papspin Medium Collected Cervical Cells
M. Ramael and H. Van Steelandt

Detection of Cervical Neoplasia Using Non-Invasive Fibre-Optic Confocal Microscopy
W. McLaren, J. Tan and M. Quinn

Study of Cervical Intraepithelial Neoplasia By Calibrated Fluorescence Imaging Technique

T.H. Cheung, Tao Wu, W.K. Lo, M.Y. Yu and Jianan Qu

Optical Coherence Tomography in Diagnosis of Cervical Neoplasia
N. Shakhova, I. Kuznetzova, T. Kachalina, N. Gladkova, V. Gelikonov, V. Kamensky and F. Feldchtein

Evaluation of Pap Test Thin Prep (TP) Results in Clinical Practice
H. Margari, M. Stamataki, H. Arbaniti, Sm. Divani, M. Gavriil, N. Margari, St. Kanakakis and E. Kada

Organization and Implementation of Cervical Screening Pilot Program in County of Cluj, Transilvania
O. Suteu, L. Lazar, A. Irimie, F. Nicula, D. Coza, M. Duma, R. Pais and L. Neamtiu

Management of ASCUS in Postmenopausal Women
P. Cristiani, A. Abbruzzese, M. Benedetti, G. Cama, A. Campana, S. Costa, M. De Nuzzo, A. Galletti, P. Garutti, P. Greci, L. Lombardozzi, P. Terzano, M. Tiboni and C. Veronesi

Coexistence of VIN and Vulvar Cancer with Intraepithelial Or Invasive Changes within Uterine Cervix and Vagina in Young Women As a Clinical Problem
K. Adamek and A. Basta

Detection of High Risk Oncogenic Human Papillomavirus in Women Patient with CIN 3 Lesions
G. Dinca, V. Tarlea, R. Mociulschi, M. Ionescu and N. Coman

A Simple Procedural Modification For the Hybrid Capture 2 HPV DNA Test That Strengthens Accuracy
A. Cullen, K. Modarress, S. Shults, C. Collier and A. Lorincz

Development of a PCR Chemiluminescent Enzyme Immunoassay (CLEIA) For Typing HPV DNAS in a Novel Microtiter Format
S. Venturoli, M. Cricca, F. Bonvicini, G. Gallinella, E. Manaresi, M. Mirasoli, A. Roda, M. Zerbini and M. Musiani

An Audit on the Follow-up After the Treatment of Cervical Intraepithelial Neoplasia
P. Ramanathan and V. Kaul

Modelling Colposcopy Services in the UK: Implications of Proposed Guideline Change with Respect to a Single Mildly Dyskaryotic Smear and Modification with HPV Testing
R.J. Hadwin and P.G. Walker

The Loop Radiofrequence Electrosurgical Excision Procedure (LEEP) in Preinvasive Squamous Cervical Lesions: Our Experience
G. Perrini, C. Cordero di Montezemolo, S. Mazzola, A. Ferrero and P. Sismondi

Laser Peeling For Extensive Genital HPV Infection-Technique and Results
M. Waligora

Quantitative Histopathology of Cervical Intra-Epithelial Neoplasia
M. Guillaud, D Cox, K Aldler-Sthorz, A. Malpica, G. Staerkel, J. Matisic, D. Van Niekerk, N. Poulin1 M. Follen and C. MacAulay

Cost-Effectiveness of New Cervical Cancer Screening Technologies: A German Health Technology Assessment and Decision Analysis
U. Siebert, G. Sroczynski, P. Hillemanns, B. Gibis, K. Voigt, P. Aidelsburger, J. Wasem, J. Engel, D. Hölzel and S. Goldie

Comparative Evaluation of the Conventional Pap Test and the Residual Material Left On the Pap Test Brush in Thin Prep Liquid Cytology
H. Margari, M. Stamataki, K. Kampitsis, Ch. Stavridis, S. Boutou, M. Gavriil, N. Margari and P. Karakitsos

A Novel Function of HPV16 E6 Oncoprotein: Increase of Cell Adhesion
A. Epshtein, P. Gonen and L. Sherman

Clinical Significance of Genetic Alterations of Chromosome 3, 7, X and EGFR Gene in Uterine Cervical Cancer Progression
AM. Cianciulli, G. Corrado, R. Merola, E. Vizza, R. Marzano, F. de la Iglesia Lopez, C. Vincenzoni, G.M. Galati and C. Sbiroli

Effects of Estrogens and Phyto-estrogens on EGF Receptor Expression
L. Salvatori, E. Petrangeli, L. Ravenna, P. Chinzari, S. Marchionni, S. Costa, L. Frati and M.A. Russo

Carcinogenesis in Cervical Polyps
M. Osuna-Pedroza

Overexpression of p16INK4a in HPV Positive and Negative Infiltrating Cervical Adenocarcinomas
J. Velasco, R. Hernández, C.L. Menéndez, C. Macías, A. Astudillo, E. Serra, A. Alba, F. Domínguez, J. Pinto and A. Tardón

HPV Genotyping by SPF10 PCR LiPA in Combination with Complementary Sequence Analysis
A.C. Molijn, B. Kleter, W.G.V. Quint and L.J. van Doorn

An outbreak of Cervical Cancer in San Luis Potosí, Mexico
L. Rosales-Ortuño, M.T. Rodríguez-Nieto and R. López-Revilla

Human Papillomaviruses and Other Sexually Transmitted Diseases in Croatia – Current Status
G. Grubisic and M. Grce

Evaluation of the APTIMA COMBO GEN-PROBE Technique in the Diagnosis of Chlamydia Trachomatis Infections and Interest of Systematic Screening For Neisseria Gonorrhoeae
J.M. Sueur, J. Orfila, F. Betsou and F. Anarratone

Genital Chlamydial Infection: Epidemiology and Clinical Manifestations in Female Patients
M. Malinova and T. Kamenov

Bone Mineral Density Can Be Predicted From Pap Smears
A. Repše-Fokter, S.K. Fokter, R. Komadina and D. Štiblar-Martinèiè


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