**Author details**

Doris Barboza1 \* and Esther Arbona2

\*Address all correspondence to: dorisbarbozad@gmail.com

1 Medical Institute La Floresta, Oncological Radiotherapy Service, Group GURVE, Caracas, Venezuela

2 Internal Medicine Infectious Disease Department, Dana–Farber Cancer Institute, Boston, USA

### **References**


[6] Sankaranarayanam R, Nene BM, Shastri SS. HPV screening for cervical cancer in rural Indian. England Journal of Medicine. 2009;**360**(14):385-1394

• Start screening no sooner than age 21, regardless of the age of onset of sexual activity or other risk factors. Between 21 and 29 years of age, PAP smear must be done every 3 years. Between 30 and 65 years, co-testing (cytology more than an HPV test) every 5 years is preferable; if not possible, single cytology every 3 years is acceptable. After the age of 65 years, screening can be discontinued if previous screening has been done and found negative and

40 Cervical Cancer - Screening, Treatment and Prevention - Universal Protocols for Ultimate Control

• Screening can be discontinued if there is total hysterectomy (with removal of cervix) and a

These suggestions are valid for developed countries that allow the implementation of adequate screening campaigns with all the resources available. However, for developing countries with limited resources, cytology and direct visualization of the cervix with VIN are valid

1 Medical Institute La Floresta, Oncological Radiotherapy Service, Group GURVE, Caracas,

2 Internal Medicine Infectious Disease Department, Dana–Farber Cancer Institute, Boston,

[1] Wrigt TC Jr, Blumenthal P, Bradley J, Denny L, Esmuy PD, Jayant K, Jayant K, Nene BM, Rajkumar R, Sankaranrayaanan R, Sellor JLD, Shastri SS, Serris J. Diagnostic Cytopa-

[2] Jemal A, Bray F, Center MM, et al. Global cáncer statistics CA. Cáncer Journal of

[3] Kahn JA. HPV vaccination for the prevention of cervical intraepithelial neoplasia. New

[4] Mathew A, George PS. Trends in incidence and mortality rate of squamous cell carcinoma and Adenocarcinoma of cérvix-Worlwide Asia Pac. Journal of Cancer Prevention.

[5] Vizcaino AP, Moreno V, Bosch FX, et al. International trends in incidence of cervical cancer II. Squamous cell Carcinoma. International Journal of Cancer. 2000;**86**:429-435ia

not CIN 2 (+) during the previous 20 years.

\* and Esther Arbona2

thology. 2007 Dec;**35**(12):845

England Journal of Medicien. 2009;**361**:271

Clinicians. 2011;**61**:69

2009;**10**:645-650

\*Address all correspondence to: dorisbarbozad@gmail.com

history of CIN 2 (+).

methods.

**Author details**

Doris Barboza1

Venezuela

**References**

USA


[20] Siegel R, Ward E, Brawley O, Jemal A. Cancer statistics, 2011: Impact of eliminating socioeconomic and racial disparities on premature cancer deaths. CA Cancer Journal of Clinicians. 2011;**61**:212

[34] Lee D, Kin HZ, Jeong KW, Shim YS, Horikawa L, Barret JC, et al. Human papillomavirus E2 down-regulates the human telomerase reverse transcriptase promoter. Biological

Uterine Cervical Cancer Screening

43

http://dx.doi.org/10.5772/intechopen.72606

[35] Duensing S,Duensing A, Crum CP, Mûnger K. Human papillomavirus type 16 E7 oncoprotein- induced abnormal centrosome synthesis is an early event in the evolving malig-

[36] Zhang A, Mâner S, Betz R, Angstrôm T, Stendhal U, et al. Genetic alterations in cervical carcinomas: frequent low-level amplifications of oncogenes are associated with human

[37] Schiffman Castle PE, Jeronimo J, et al. Human papillomavirus and cervical cancer.

[38] Suarez CM, Briñez A, Castillo L, Briceño JM, et al. Identify and typify Human papilloma virus in patients with Cancer Uterine Cervix in Venezuela. Revista Venezolana de

[39] Shastri SS, Mittra I, Misha G, Dikshit SGR, Badwer R. Journal of Clincal Oncology. 2013

[40] Nanda K, McCrroy DC, Myers ER, et al. Accuracy of the Papanicolau test screening for and up cervical cytology abnormalities: A systematic review. Annals of Internal

[41] Vesco KK, Whitlock EP, Eder M, et al. Risk factors and other epidemiologic considerations for cervical cancer screening: a narrative review for the U.S. Preventive Services

[42] Gibb RK, Martens MG. The impact of liquid-based cytology in decreasing the incidence

[43] Jama L, Saftlas A, Wang W, Exerter M, Whittaker J. Mccowam Treatment for cervical intraepithelial neoplasia and risk of preterm delivery. Jama. 2004 May 5;**291**(17):2100-2106

[44] Bell S, Porter M, Kitchener H, et al. Psychological response to cervical screening. Pre-

[45] Gray NM, Sharp L, Cotton SC, et al. Psychological effects of a low-grade abnormal cervical smear test result: Anxiety and associated factors. British Journal of General Practice.

[46] American College of Obstetricians and Gynecologists. ACOG. Committee Opinion No 463: Cervical cancer in adolescents: screening, evaluation, and management. Obstetrics

[47] Mount SL, Papillo JL. A study of 10.296 pediatric and adolescent Papanicolaou smear

[48] Moyer VA, U.S. Preventive Services Task Force. Screening for cervical cancer; U.S Preventive Service Task Force recommendation statement. Annals of Internal Medicine. 2012;**156**:880

diagnoses in northern New England. Pediatrics. 1999;**103**:539

of cervical cancer. Reviews in Obstetrics and Gynecology. 2011;**4**:S2

papillomavirus infection. International Journal of Cancer. 2002;**101**:427-433

Chemistry. 2002:27748-27745

Lancet. 2007;**370**(390)

Oncologia. 2006;**18**:221-225

Medicine. 2000;**132**:810

ventive Medicine. 1995;**24**:610

Gynecology. 2010;**116**:469

1999;**49**:348

nant phenotype. Cancer Research. 2001;**61**:2356-2360

31.18 supple.2. Plenary session ASCO JUN 2,2013

Task Force. Annals of Internal Medicine. 2011;**155**:698


[34] Lee D, Kin HZ, Jeong KW, Shim YS, Horikawa L, Barret JC, et al. Human papillomavirus E2 down-regulates the human telomerase reverse transcriptase promoter. Biological Chemistry. 2002:27748-27745

[20] Siegel R, Ward E, Brawley O, Jemal A. Cancer statistics, 2011: Impact of eliminating socioeconomic and racial disparities on premature cancer deaths. CA Cancer Journal of

[21] Liu L, Yang X, Chen X, et al. Association between TNF polymorphisms and cervical can-

[22] Wang Q, Zhang C, Walay S, et al. Association between cytokine gene polymorphisms and cervical cancer in a Chinese population. European Journal of Obstetrics and Gynecology

[23] Craveiro R, Bravo I, Catarino R, et al. The role of p73 G4C 14 polymorphism in the sus-

[24] Whang K, Zhou B, Zhang J, et al. Association signal of signal transducer and activator of transcription 3 gene polymorphisms with cervical cancer in Chinese women. DNA and

[25] Jemal A, Simard EP, Dorell C, et al. Annual Report to the Nation on the Status of Cancer, 1975-2009, featuring the burden and trends in hu infman papillovirus (HPV)-associated cancers and HPV vaccination coverage levels. Journal of National Cancer Institute.

[26] Koutsky LA, Holmes KK, Critchlow CW, Stevens CE, Paavone J, Beckmann AM, et al. A cohort study of the risk of cervical intraephitelial grade 2 or 3 in relation to papillomavi-

[27] Kjaer SK, Van der Brule AJ, Paul IG, Svare EI, Sherman ME, Thomsem BL, et al. Type specific persistent of high risk human papillovirus (HPV) as indicator of high grade cervical squamous intraepithelial lesions in young women: Population based prospective

[28] Bosch FX, Muñoz N, De Sanjose, Navarro C, Moreo P, Ascunce N, Gonzalez LC, Tafur L, Gili M, Larrañaga I, et al. Human pavillomavirus and cervical intraepithelial neoplastic grado III/carcinoma in situ: A case control study in Spain and Colombia. Cancer

[30] Werness Ba, Levine AJ, Howley PM. Association of human papillomavirus types 16 and

[31] Vogelstein B, Kinzler K.The multistep nature of cancer. Trends in Genetics. 1993;**9**:138-141 [32] Hu G, Lui Mendelsohn J, Ellis LM, Radinsky R, Andreeff M, et al. Expression of epidermal growth factor receptor and papillomavirus E6/E7 proteins in cervical carcinoma

[33] Sizemore N, Rorke E. Human papillomavirus16 immortalization of normal human ectocervical epithelial cells alters retinoic acid regulation of cell growth and epidermal

cer risk: a meta- analysis. Molecular Biology Reports. 2012;**39**:2683

42 Cervical Cancer - Screening, Treatment and Prevention - Universal Protocols for Ultimate Control

ceptibility to cervical cancer. DNA and Cell Biology. 2012;**31**:224

rus infection. England Journal of Medicine. 1992;**327**:1272-1278

Epidemiology Biomarkers Prevention. 1993 Sep-Oct;**2**(5):415-422

[29] Muñoz N, Bravo LE. Colombia Medica. 2012 Oct-Dec;**43**:296-304

cells. Journal of National Cancer Institute. 1997;**89**:1271-1276

growth factor receptor expression. Cancer Research. 1993;**53**:4511-4517

18 E6 proteins with p53. Science. 1990;**248**:76-79

Clinicians. 2011;**61**:212

and Reproductive Biology. 2011;**158**:330

Cell Biology. 2011;**30**(11):931

follow up study. BMJ. 2002;**325**(7364)

2013;**105**:175


[49] Huh WK, Ault KA, Chelmow D, et al. Use of primary high-risk human papillomavirus testing for cervical cancer screening: Interim clinical guidance. Obstetrics Gynecology. 2015;**125**:330

**Chapter 4**

**Provisional chapter**

**Great Role in Gynecological Cancer Prophylaxis of a**

In Japan, there are unique facilities (namely Ningen Dock) for health check-up that provide asymptomatic participants with a health examination, including cancer screening activities, at their own expense. The most advanced examination equipment and examinations do not only provide high accuracy, but they also reduce stress on the body of the client. Usage of the medical equipment and diagnostic techniques allows us for successful detection of many diseases in their early stages of development. This early detection leads to quicker response for the disease. On the other hand, gynecological cancer screening is a relatively simple, low cost, and noninvasive method. In this chapter, we introduce a major role of Ningen Dock in gynecological malignancy prophylaxis. Ningen Dock attendances are associated with extremely low positive gynecology cancer screening incidence (0.03%). The level of knowledge and attitude toward screening may be related to multiple factors such as ethnicity, place of residence, income, and social-economic status. Not paying attention to cancer screening may be the risk factors for non-attendance to health check-up. These findings are of importance for improving the gynecological can-

cer screening practices of the lower screening attendance in Japan.

screening, cancer screening, cervical cancer

**Keywords:** health check-up, Ningen Dock, gynecological cancer, attitude toward

**Unique Health Check-Up Institute, Ningen Dock in** 

**Great Role in Gynecological Cancer Prophylaxis of a** 

DOI: 10.5772/intechopen.72142

© 2016 The Author(s). Licensee InTech. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution,

© 2018 The Author(s). Licensee IntechOpen. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use,

distribution, and reproduction in any medium, provided the original work is properly cited.

and reproduction in any medium, provided the original work is properly cited.

Health and medical check-ups aim to discover problems that may be harmful to the future health of the examinees, providing proposals for health promotion support solutions. Health

**Unique Health Check-Up Institute, Ningen Dock in**

Atsushi Imai, Hiroyuki Kajikawa, Chinatsu Koiwai,

Atsushi Imai, Hiroyuki Kajikawa, Chinatsu Koiwai,

Additional information is available at the end of the chapter

Additional information is available at the end of the chapter

Satsoshi Ichigo and Hiroshi Takagi

Satsoshi Ichigo and Hiroshi Takagi

http://dx.doi.org/10.5772/intechopen.72142

**Japan (Review)**

**Abstract**

**1. Introduction**

**Japan (Review)**


**Provisional chapter**

#### **Great Role in Gynecological Cancer Prophylaxis of a Unique Health Check-Up Institute, Ningen Dock in Japan (Review) Unique Health Check-Up Institute, Ningen Dock in Japan (Review)**

**Great Role in Gynecological Cancer Prophylaxis of a** 

DOI: 10.5772/intechopen.72142

Atsushi Imai, Hiroyuki Kajikawa, Chinatsu Koiwai, Satsoshi Ichigo and Hiroshi Takagi Satsoshi Ichigo and Hiroshi Takagi Additional information is available at the end of the chapter

Atsushi Imai, Hiroyuki Kajikawa, Chinatsu Koiwai,

Additional information is available at the end of the chapter

http://dx.doi.org/10.5772/intechopen.72142

#### **Abstract**

[49] Huh WK, Ault KA, Chelmow D, et al. Use of primary high-risk human papillomavirus testing for cervical cancer screening: Interim clinical guidance. Obstetrics Gynecology.

[50] Committee on Practice Bulletins-Gynecology. Practice Bulletin No 168: Cervical Cancer

[51] Saslow D, Solomon D, Lawson HW, et al. American Cancer Society for Colposcopy and Cervical Pathology, and American Society for Clinical Pathology screening guidelines for the prevention and early detection of cervical cancer. CA Cancer Journal of

[52] Sawaya GF, Kerlikowske K, Lee NC, et al. Frequency of cervical smear abnormalities

[53] Sawaya GF, Grady D, Kerlikowske K, et al. The positive predictive value of cervical smears in previously screened postmenopausal women: The Heart and Estrogen/pro-

[54] Saad RS, Dabbs DJ, Kordunsky L, et al. Clinical significance of cytology diagnosis of atypical squamous cells, cannot exclude high grade, in perimenopausal and postmeno-

[55] Wright TC Jr, Ellerbrock TV, Chiasson MA, et al. Cervical intraepithelial neoplasia in women infected with human immudeficienciency virus: Prevalence, risk factors, and validity of Papanicolau smears. New York Cervical Disease Study. Obstetrics

[56] Nath R, Mant C, Luxton J, et al. High risk of human papillomavirus type 16 infections and of development of cervical squamous intraepithelial lesions in systemic lupus ery-

[57] Klumb EM, Pinto AC, Jesus GR, et al. Are women with lupus at higher risk of Hpv infec-

[58] Rositch AF, Nowak RG, Gravitt PE. Increased age and race- specific incidence of cervical cancer after correction for hysterectomy prevalence in the United States from 2000 to

[59] Fetters MD, Fischer G, Reed BD. Effectiveness of vaginal Papanicolaou smear screening

[60] Committee on Practice Bulletins Gynecology. ACOG Practice Bulletin Number 131:

within 3 years of normal cytology. Obstetrics Gynecology. 2000;**96**:219-223

gestin Replacement Study (HERS). Annals of Internal Medicine. 2000;**133**:942

pausal women. American Journal of Clinical Pathology. 2006;**126**:381

thematosus patients. Arthritis and Rheumatology. 2007;**57**:619

after total hysterectomy for benign disease. JAMA. 1996;**275**:940

Screening for cervical cancer. Obstetrics Gynecology. 2012;**120**:1222

Screening and Prevention Obstetrics Gynecology. 2016;**128**:e111

44 Cervical Cancer - Screening, Treatment and Prevention - Universal Protocols for Ultimate Control

2015;**125**:330

Clinicians. 2012;**62**:147

Gynecology. 1994;**84**:591

tion? Lupus. 2010;**19**:1485

2009. Cancer. 2014;**120**:2032

[61] ACOG. Clinical. Guidelines. 2012

In Japan, there are unique facilities (namely Ningen Dock) for health check-up that provide asymptomatic participants with a health examination, including cancer screening activities, at their own expense. The most advanced examination equipment and examinations do not only provide high accuracy, but they also reduce stress on the body of the client. Usage of the medical equipment and diagnostic techniques allows us for successful detection of many diseases in their early stages of development. This early detection leads to quicker response for the disease. On the other hand, gynecological cancer screening is a relatively simple, low cost, and noninvasive method. In this chapter, we introduce a major role of Ningen Dock in gynecological malignancy prophylaxis. Ningen Dock attendances are associated with extremely low positive gynecology cancer screening incidence (0.03%). The level of knowledge and attitude toward screening may be related to multiple factors such as ethnicity, place of residence, income, and social-economic status. Not paying attention to cancer screening may be the risk factors for non-attendance to health check-up. These findings are of importance for improving the gynecological cancer screening practices of the lower screening attendance in Japan.

**Keywords:** health check-up, Ningen Dock, gynecological cancer, attitude toward screening, cancer screening, cervical cancer

#### **1. Introduction**

Health and medical check-ups aim to discover problems that may be harmful to the future health of the examinees, providing proposals for health promotion support solutions. Health

Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. © 2018 The Author(s). Licensee IntechOpen. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

© 2016 The Author(s). Licensee InTech. This chapter is distributed under the terms of the Creative Commons

check-ups focus on comprehensive assessments regarding the whole body even without disorders, while medical examinations include a specific disease or organ. In many countries, including Japan, a series of systemic routine health examinations and preventive medicine development in response to client needs undergo on a voluntary basis.

In Japan, there are unique facilities (namely Ningen Dock) for health check-up that provide asymptomatic participants with a health examination, including cancer screening activities, at their own expense [1]. Japan is indeed a country in the world with the most advanced medical devices. For example, about half of the CT scans and about one-third of the MRI scans are owned by medical facilities in Japan [2]. The most advanced examination equipment and examinations do not only provide high accuracy, but they also reduce stress on the body of the client. Usage of the medical equipment and diagnostic techniques allows us for successful detection of many diseases in their early stages of development. This early detection leads to quicker response for the disease.

The "OMOTENASHI" services provided by staffs, including nurses, technologists, and doctors, is supporting the popularity. With the careful client support underpinned by the Japanese culture of hospitality, the Ningen Dock in Japan is popular in neighboring countries. The number of people from another country is rapidly increasing, to visit Japan, to receive the medical services of Ningen Dock. These situations prompted us to introduce a major role of Ningen Dock in gynecological malignancy prophylaxis.
