Cancer detection in gynecology

Early cancer detection is one of the major tasks in the daily work of the g ynecologist. In 1971, the directory for a public early cancer detection pro gram was defined. Organ systems examined include the external and internal genitalia,the breasts,the skin,the rectum,and the colon. Methods applied in clude detailed anamneses, body exam,training for breast self-examination, P ap smear, and stool testing for blood. The use of mammography is restricted to women from families with multiple breast cancer cases or with previous breast alterations. In 2000,the knowledge about breast cancer incidence, morbidity and mortalit y, risk modulators and determinators, the definition of high risk groups, n ew detection methods, changes in therapies, and the focussing on quality of life with and without breast cancer have changed. Therefore,the focus and demand on the public early cancer detection program have to be adapted. At the same time,the health system's reduced finances direct towards maximum e fficiency of the applied methods,the groups screened,and efforts for increa sing compliance of women from high risk groups. Global screening does not s eem to be applicable. Integration of risk assessment, information about pre vention and prophylaxes, as well as motivation for participation could modi fy the established public early cancer detection program towards an individ ualized cancer care program.