The diagnosis of gynecologic cancer

Malignant tumors of the female reproductive tract may be divided into the accessible and the inaccessible. Cancer of the vulva, cervix, and endometrium fall into the accessible group and they are characterized by knowledge of their precursor lesions and efficient screening or detection methods. Although we have not achieved total surveillance of our adult female population, we can expect to achieve prevention or early diagnosis of these tumors as we educate the public to the possibility of prevention and control. In the case of the inaccessible tumors, such as in ovarian cancer, we are still dependent upon physical examination and its adjuvants, for symptoms are late and no screening measure has been found effective to this date. Research into possible tumor markers, biochemical or immunological, are being investigated for the earlier diagnosis of this disease. Abnormal uterine bleeding requires tissue diagnosis before institution of any treatment. The primary physician's office is the most important site for cancer screening and it is the physician's responsibility to stay abreast of new information available in the oncologic disciplines, since cancer is the second most common cause of death in our country.