Look / Heggenhougen / Quah Sexual and Reproductive Health

A Public Health Perspective
1. Auflage 2011
ISBN: 978-0-12-385010-2
Verlag: Elsevier Science & Techn.
Format: PDF
Kopierschutz: 1 - PDF Watermark

E-Book, Englisch, 348 Seiten, Web PDF

This volume brings together two areas of health that are among the foci of current development efforts, as articulated by the Millennium Development Goals (MDGs), namely sexual and reproductive health (MDG 5: improve maternal health, target 2: achieve, by 2015, universal access to reproductive health); and Gender (MDG 3: promote gender equality and empower women). Few, if any, published books have dealt in a comprehensive way with public health aspects of these two strongly interrelated areas of health. Most published volumes devoted to sexual and reproductive health have a strong clinical focus, whereas books on gender tend to concentrate primarily on the socio-cultural and anthropological aspects of the subject. - Focuses on the relationship between sexual and reproductive behaviors and the resulting impact on populations and societies as a group - Provides a science-based approach to identifying appropriate response plans, adaptations, and mitigation steps for related behaviors - Explores the financial and societal impact of behavioral choices - Includes new preface specifically for this audience

Autoren/Hrsg.

Look, Paul van

Heggenhougen, Kristian

Quah, Stella R.

Inhaltsverzeichnis

1;Cover Page;1
2;Sexual and Reproductive Health: A Public Health Perspective;4
3;Copyright Page;5
4;Contents;6
5;Contributors;8
6;Preface;10
7;Section 1: Physiology, General Epidemiology and Demography;12
7.1;Female Reproductive Function;13
7.1.1;Introduction;13
7.1.2;Menstruation and the Menstrual Cycle;13
7.1.3;The Ovarian Cycle;14
7.1.4;The Endometrial Cycle;18
7.1.5;The Conceptional Cycle;18
7.1.5.1;Gamete Encounter and Fertilization;18
7.1.5.2;Development and Transport of the Zygote to the Site of Implantation;20
7.1.5.3;Implantation;20
7.1.6;Regulation of the Hypothalamic-Pituitary- Ovarian Axis;21
7.1.7;Conclusion;22
7.1.8;Citations;22
7.1.9;Further Reading;22
7.1.10;Relevant Websites;22
7.2;Male Reproductive Function;23
7.2.1;Introduction;23
7.2.2;The Testis;23
7.2.2.1;Hormonal Regulation of Testicular Function;23
7.2.2.1.1;Gonadotropin-releasing hormone (GnRH);23
7.2.2.1.2;Gonadotropins;25
7.2.2.2;Endocrine Function: Testosterone Production;26
7.2.2.2.1;Hypogonadism;26
7.2.2.3;Exocrine Function: Spermatogenesis;28
7.2.3;Seminal Ducts;28
7.2.3.1;Epididymis;28
7.2.3.2;Deferent Duct and Seminal Vesicle;28
7.2.3.3;Prostate;29
7.2.3.4;Penis;29
7.2.4;Infertility;29
7.2.5;Conclusion;30
7.2.6;Citations;30
7.2.7;Further Reading;31
7.2.8;Relevant Websites;31
7.3;Puberty;31
7.3.1;Definition;31
7.3.2;Physiological Changes;32
7.3.3;Secular Trends;33
7.3.4;Variation Within the Normal Range;34
7.3.5;Abnormal Pubertal Development;34
7.3.6;Disorders of Sexual Development;35
7.3.7;Conclusions;36
7.3.8;Citations;36
7.3.9;Further Reading;36
7.4;Menopause;37
7.4.1;Introduction;37
7.4.2;Types of Menopause;37
7.4.2.1;Premature;37
7.4.2.2;Surgical;37
7.4.2.3;Natural;37
7.4.3;Effects of Menopause;38
7.4.4;Symptoms;38
7.4.4.1;The Hot Flush;38
7.4.4.2;Other Symptoms;39
7.4.4.3;Libido;40
7.4.5;Physical Effects;40
7.4.5.1;Urogenital Tract;40
7.4.5.2;Bone;41
7.4.5.3;Cardiovascular Disease;42
7.4.5.4;Dementia;43
7.4.5.5;Skin and Hair;43
7.4.6;Treatments;43
7.4.6.1;Hormone Replacement Therapy;43
7.4.6.2;Alternative Treatments;44
7.4.7;Conclusion;44
7.4.8;Citations;44
7.4.9;Further Reading;44
7.4.10;Relevant Websites;44
7.5;Sexual and Reproductive Health: Overview;45
7.5.1;Introduction;45
7.5.2;Sexual and Reproductive Health: Concepts and Dimensions;45
7.5.2.1;Reproductive Health;45
7.5.2.1.1;Definition of reproductive health;45
7.5.2.2;Sexual Health;46
7.5.2.3;The Human Rights Dimension;46
7.5.2.4;The Development Dimension;46
7.5.3;The Burden of Sexual and Reproductive Ill-Health;46
7.5.3.1;Global Situation of Sexual and Reproductive Health;46
7.5.3.2;Pregnancy, Childbirth, and Health of Newborns;47
7.5.3.3;Family Planning;47
7.5.3.4;Unsafe Abortion;47
7.5.3.5;Sexually Transmitted Infections, including HIV and Reproductive Tract Infections;47
7.5.3.6;The Unfair Burden on Women;48
7.5.3.7;Sexual and Reproductive Health Indicators;48
7.5.3.8;Inequity in Sexual and Reproductive Health;49
7.5.3.9;Determinants of Sexual and Reproductive Health;49
7.5.3.10;Behavioral Determinants;49
7.5.4;Economic and Social Determinants;50
7.5.5;Health System Determinants;50
7.5.6;The Sexual and Reproductive Health Package;51
7.5.6.1;The Five Core Aspects of Sexual and Reproductive Health;51
7.5.6.2;Sexual and Reproductive Health: An Integrated Package;51
7.5.6.3;Family Planning;51
7.5.6.4;Integration of Sexual and Reproductive Health Services;51
7.5.6.5;Implementation of the Sexual and Reproductive Health Package;52
7.5.7;Special Considerations of Sexual and Reproductive Health Care;52
7.5.8;Dealing with Healthy People;52
7.5.9;Dealing with More than One Client;53
7.5.10;Dealing Mostly with Women;53
7.5.11;Dealing with Society;53
7.5.12;International Commitment to Sexual and Reproductive Health;53
7.5.12.1;Sexual and Reproductive Health and the Millennium Development Goals (MDGs);53
7.5.12.2;WHO Reproductive Health Strategy to Accelerate Progress Toward the Attainment of MDGs;53
7.5.13;Conclusion;54
7.5.14;Citations;54
7.5.15;Further Reading;54
7.5.16;Relevant Websites;54
7.6;Sexual Health;55
7.6.1;Introduction;55
7.6.1.1;Defining the Area of Sexual Health;55
7.6.1.2;Barriers to the Achievement of Sexual Health;55
7.6.2;The Public Health Burden;55
7.6.3;Risk Behaviors;56
7.6.3.1;Trends and Patterns;56
7.6.3.2;Risk Factors and Risk Groups;56
7.6.3.3;Social and Environmental Factors;57
7.6.4;Effective Public Health Strategies;57
7.6.4.1;Interventions Aimed at Individual Behavior Change;57
7.6.4.2;Intervention at the Level of the Social Context;59
7.6.5;Conclusion;61
7.6.6;Citations;61
7.6.7;Further Reading;62
7.6.8;Relevant Websites;62
7.7;Population Growth;62
7.7.1;Dynamics of Population Growth;62
7.7.1.1;Population Projections;63
7.7.1.2;The Demographic Transition;63
7.7.1.3;Fertility Rates;63
7.7.1.4;Population Aging;65
7.7.2;Factors That Influence Population Growth;65
7.7.2.1;Contraceptive Prevalence;65
7.7.2.2;Mortality from HIV/AIDS and Other Infectious Diseases;66
7.7.2.3;Gender Equity;67
7.7.2.4;Migration;67
7.7.2.5;Government Policies;68
7.7.3;Impacts of Population Growth;68
7.7.3.1;Health;68
7.7.3.2;Poverty;68
7.7.3.3;Natural Resources;69
7.7.3.4;Conflict and Security;70
7.7.4;Conclusion;70
7.7.5;Citations;70
7.7.6;Further Reading;71
7.7.7;Relevant Websites;71
7.8;Trends in Human Fertility;71
7.8.1;Introduction;71
7.8.2;Trends in Industrialized Countries;73
7.8.3;Trends in Developing Regions;74
7.8.4;Conclusions;76
7.8.5;Citations;78
7.8.6;Further Reading;78
7.8.7;Relevant Websites;78
7.9;Perinatal Epidemiology;78
7.9.1;Introduction;78
7.9.2;Definitions and Definitional Pitfalls;79
7.9.3;Perinatal Mortality;79
7.9.4;Causes of Perinatal Death;80
7.9.5;Perinatal Morbidity;81
7.9.6;Perinatal Audit;82
7.9.7;Perinatal Risk Factors;82
7.9.8;Analytical Studies;83
7.9.9;Recurrence Risk;84
7.9.10;Generational Studies;85
7.9.11;Record Linkage to Registries Outside Medical Birth Registries;85
7.9.12;Maternal and Child Cohorts;86
7.9.13;Citations;86
8;Section 2: Core Elements;88
8.1;Family Planning/Contraception;89
8.1.1;Introduction;89
8.1.2;Combined Hormonal Contraception;90
8.1.2.1;Mode of Action;90
8.1.2.2;Combined Oral Contraceptives;90
8.1.2.2.1;Contraindications;91
8.1.2.2.2;Side effects and risks;91
8.1.2.2.3;Noncontraceptive benefits;92
8.1.2.3;Combined Hormonal Patches, Injectables, and Rings;92
8.1.3;Progestogen-Only Contraception;92
8.1.3.1;Mode of Action;93
8.1.3.2;Progestogen-only pills;93
8.1.3.3;Injectables;93
8.1.3.4;Implants;93
8.1.4;Intrauterine Devices and Systems;94
8.1.4.1;Mode of Action;94
8.1.4.2;Side Effects and Risks;94
8.1.4.3;Intrauterine System;94
8.1.5;Barrier Methods;94
8.1.5.1;Male Condom;94
8.1.5.2;Female Condom;95
8.1.5.3;Diaphragms;95
8.1.5.4;Cervical Caps;95
8.1.5.5;Spermicides;95
8.1.6;Fertility Awareness Methods;96
8.1.7;Lactational Amenorrhea Method;96
8.1.8;Withdrawal;96
8.1.9;Sterilization Procedures;96
8.1.9.1;Female Sterilization;96
8.1.9.1.1;Timing of the procedure;97
8.1.9.1.2;Techniques;97
8.1.9.1.3;Clinical management;97
8.1.9.2;Male Sterilization;97
8.1.9.2.1;Technique;97
8.1.9.2.2;Clinical management;97
8.1.10;Emergency Contraception;98
8.1.10.1;Hormonal Emergency Contraception;98
8.1.10.2;Postcoital Intrauterine Device;98
8.1.11;Conclusion;98
8.1.12;Citations;98
8.1.13;Further Reading;99
8.1.14;Relevant Websites;99
8.2;Gynecological Morbidity;99
8.2.1;Introduction;99
8.2.2;Amenorrhea;99
8.2.3;Polycystic Ovarian Syndrome (PCOS);101
8.2.4;Heavy Menstrual Bleeding (Menorrhagia)/Dysfunctional Uterine Bleeding;101
8.2.4.1;Medical Treatments;102
8.2.4.2;Surgical Treatments;102
8.2.5;Benign Gynecological Tumors;103
8.2.5.1;Endometrial Polyps;103
8.2.5.2;Cervical Polyps;103
8.2.5.3;Fibroids (Uterine Leiomyomata);103
8.2.6;Adenomyosis;104
8.2.7;Endometriosis;104
8.2.8;Adnexal Pathologies;105
8.2.8.1;Adnexal Masses;105
8.2.8.2;Adnexal Torsion;105
8.2.9;Bartholin Gland Cyst/Abscess;106
8.2.10;Chronic Pelvic Pain (CPP);106
8.2.11;Premenstrual Syndrome;107
8.2.12;Diethylstilbestrol (DES) Exposure;107
8.2.13;Pelvic Organ Prolapse;107
8.2.14;Urinary and Fecal Incontinence;108
8.2.14.1;Urinary Incontinence;108
8.2.14.2;Fecal Incontinence;109
8.2.15;Female Genital Tract Fistulae;109
8.2.16;Female Genital Mutilation (FGM);110
8.2.17;Citations;111
8.2.18;Further Reading;111
8.2.19;Relevant Websites;112
8.3;Sexually Transmitted Infections: Overview;112
8.3.1;Introduction;112
8.3.2;History and Epidemiology of STIs;113
8.3.3;Transmission Dynamics of STIs;113
8.3.4;Classification of STI Pathogens;114
8.3.4.1;Syphilis;114
8.3.4.2;Gonorrhea;116
8.3.4.3;Chlamydia;116
8.3.4.4;Chancroid;117
8.3.4.5;Genital Herpes;117
8.3.4.6;Human Papillomavirus (HPV) Infection;118
8.3.4.7;Trichomoniasis;119
8.3.5;Consequences of STIs;119
8.3.6;STI Control and Prevention;120
8.3.6.1;Partner Notification and Referral;120
8.3.7;The Future of STIs;121
8.3.8;Conclusion;121
8.3.9;Citations;122
8.3.10;Further Reading;122
8.3.11;Relevant Websites;122
8.4;AIDS: Epidemiology and Surveillance;122
8.4.1;Introduction;122
8.4.2;Overall Prevalence of HIV;123
8.4.3;Distinctions between HIV Types 1 and 2;123
8.4.4;HIV-1 Groups and Subtypes;124
8.4.5;Modes of HIV Transmission: Rates and Risk Factors;126
8.4.5.1;Sexual Transmission;126
8.4.5.2;Transmission via Injection Drug Use (IDU);128
8.4.5.3;Mother-to-Child Transmission;129
8.4.5.4;Transmission via Exposure to Blood Products;130
8.4.5.5;Occupational Exposure and HIV Transmission Risk;130
8.4.6;Regional HIV Surveillance Data;130
8.4.6.1;Sub-Saharan Africa: Overview;131
8.4.6.1.1;Southern Africa;131
8.4.6.1.2;East Africa;131
8.4.6.1.3;West and Central Africa;131
8.4.6.2;Asia: Overview;131
8.4.6.2.1;South-East Asia;131
8.4.6.2.2;People's Republic of China;132
8.4.6.2.3;India;132
8.4.6.3;Eastern Europe and Central Asia;132
8.4.6.4;Latin America and the Caribbean;132
8.4.6.5;North America, Western, and Central Europe;133
8.4.6.6;Middle and North Africa;133
8.4.6.7;Oceania;133
8.4.7;Citations;133
8.4.8;Relevant Websites;136
8.5;Mother-to-Child Transmission of HIV;136
8.5.1;Introduction;136
8.5.2;Prevention of Transmission of HIV from HIV-Positive Mothers to Their Infants;137
8.5.2.1;Prevention of Mother-to-Child Transmission (pMTCT);137
8.5.2.2;ART in Pregnant Women;137
8.5.2.2.1;Recommended ART regimens for pMTCT;138
8.5.2.2.2;ART toxicity during pregnancy;138
8.5.2.3;Mode of Delivery;138
8.5.2.4;Breastfeeding and MTCT Risk;140
8.5.3;The Care of HIV-Exposed Infants;141
8.5.4;Diagnosing HIV Infection in Infants;141
8.5.5;HIV Prevention and the Adolescent;143
8.5.6;Pediatric HIV Infection;143
8.5.6.1;Care of the Child with HIV;143
8.5.6.2;Starting ART in Infants and Children;143
8.5.7;Conclusions;146
8.5.8;Citations;146
8.5.9;Further Reading;147
8.6;Infertility;149
8.6.1;Introduction;150
8.6.2;Definitions;150
8.6.3;Prevalence of Infertility;151
8.6.4;Consequences of Infertility for Individuals and the Family;152
8.6.5;Etiology;153
8.6.6;Overview of Infertility Evaluation and Treatment Alternatives;153
8.6.6.1;Infertility Evaluation of the Female Partner;154
8.6.6.1.1;Evaluation of ovarian reserve;154
8.6.6.1.2;Assessment and characterization of the ovulatory cycle;154
8.6.6.1.3;Assessment of uterine cavity and evaluation of tubal indemnity and pelvic integrity;155
8.6.6.1.4;Endometriosis;155
8.6.6.2;Infertility Evaluation of the Male Partner;156
8.6.6.3;Unexplained Infertility;156
8.6.6.4;Overview of Assisted Reproductive Technology;156
8.6.7;Inequality in Access to Fertility Treatments/ART;157
8.6.8;Citations;159
8.6.9;Further Reading;159
8.7;Abortion;160
8.7.1;Introduction;160
8.7.2;Defining Abortion;160
8.7.3;The Magnitude of Induced Abortion;160
8.7.3.1;Regional Differences in Induced Abortion;160
8.7.3.2;Regional Differences in Occurrence of Unsafe Abortion;161
8.7.4;Methods of Pregnancy Termination;161
8.7.4.1;Surgical Abortion;161
8.7.4.2;Pharmacological Abortion;162
8.7.4.3;Methods of Unsafe Abortion;163
8.7.5;Complications and Consequences of Unsafe Abortion;163
8.7.5.1;Acute Complications;163
8.7.5.2;Long-Term Sequelae;163
8.7.5.3;Maternal Mortality;163
8.7.5.4;Psychological Consequences;163
8.7.5.5;Economic Consequences;164
8.7.6;Association Between Legal Status and the Consequences of Abortion;164
8.7.6.1;Legal Status of Abortion in the World;164
8.7.6.2;Legal Status and Abortion Rate;165
8.7.6.3;Abortion Law and Maternal Mortality;165
8.7.7;Determinants of Induced Abortion;165
8.7.7.1;Knowledge of Contraception;165
8.7.7.2;Access to Contraception;166
8.7.7.3;Effectiveness of Contraceptive Methods;166
8.7.7.4;Gender Power Imbalance;166
8.7.8;Interventions to Reduce Induced Abortions;167
8.7.8.1;Family Planning;167
8.7.8.2;Sex Education;168
8.7.8.3;Other Interventions;168
8.7.9;Interventions to Reduce Unsafe Abortions and Their Consequences;168
8.7.9.1;Decriminalizing or Extending Legal Grounds for Abortion;168
8.7.9.2;Improving Access to Legal Abortion;169
8.7.9.3;Access to Postabortion Care;169
8.7.10;Conclusions;169
8.7.11;Citations;170
8.7.12;Further Reading;170
8.8;Maternal Mortality and Morbidity;171
8.8.1;Introduction;171
8.8.2;Concepts and Definitions;171
8.8.2.1;Maternal Death;171
8.8.2.2;Maternal Morbidity;172
8.8.3;Maternal Death;173
8.8.3.1;Measurement;173
8.8.3.1.1;Measures of maternal mortality;173
8.8.3.1.2;Data sources and collection methods;173
8.8.3.2;Global Levels and Determinants;174
8.8.3.3;Causes of Maternal Deaths;174
8.8.4;Maternal (Obstetric) Morbidity;177
8.8.4.1;Severe Acute Maternal Morbidity (Near Miss);177
8.8.4.2;Major Morbidities;179
8.8.4.2.1;Obstetric hemorrhage;179
8.8.4.2.2;Hypertensive disorders of pregnancy (preeclampsia/eclampsia);180
8.8.4.2.3;Sepsis;181
8.8.4.2.4;Obstructed labor;181
8.8.4.2.5;Venous thromboembolism;182
8.8.4.2.6;Other major morbidities;182
8.8.4.2.6.1;The effect of AIDS;182
8.8.4.2.6.2;The effect of malaria;182
8.8.4.3;Minor Morbidities;183
8.8.4.3.1;Obstetric trauma;183
8.8.4.3.2;Psychological/psychiatric problems;184
8.8.5;Conclusion;184
8.8.6;Disclaimer;184
8.8.7;Citations;184
8.8.8;Further Reading;185
8.9;Sexual Violence;185
8.9.1;Introduction;185
8.9.2;Sexual Violence: Definition;185
8.9.3;Prevalence of Sexual Violence;186
8.9.3.1;Sexual Assault;186
8.9.3.2;Sexual Trafficking;188
8.9.3.3;Harmful Traditional Practices;188
8.9.3.4;Sexual Violence Against Men;188
8.9.4;Understanding Perpetration of Sexual Assault;188
8.9.5;Health Consequences of Sexual Assault;190
8.9.6;Ethics of Research on Sexual Violence;190
8.9.7;Responding to Sexual Assault in the Health Sector;191
8.9.8;Preventing Sexual Violence;191
8.9.9;Citations;192
8.9.10;Further Reading;192
8.9.11;Relevant Websites;192
8.10;Violence Against Women;193
8.10.1;Introduction;193
8.10.2;How Widespread Is Violence Against Women?;193
8.10.2.1;Intimate Partner Violence;193
8.10.2.2;Intimate Partner Violence during Pregnancy;197
8.10.2.3;Sexual Violence, Including during Conflict and Displacement;197
8.10.2.4;Child Sexual Abuse and Forced First Sex;197
8.10.2.5;Trafficking of Women;197
8.10.2.6;Female Genital Mutilation;197
8.10.3;The Sexual and Reproductive Health Consequences of Violence;198
8.10.4;Responding to Violence Against Women;199
8.10.5;Conclusion;200
8.10.6;Disclaimer;201
8.10.7;Citations;201
8.10.8;Further Reading;201
8.10.9;Relevant Websites;202
8.11;Fetal Growth Retardation: Causes and Outcomes;202
8.11.1;Introduction;202
8.11.2;Concepts about the Relationship between Birthweight and Gestational Age;203
8.11.3;Terminology and Definitions;203
8.11.3.1;Birth Weight for Gestational Age Reference Standards;204
8.11.4;Causes of Fetal Growth Retardation;205
8.11.5;Consequences of Fetal Growth Retardation;207
8.11.6;Prevention of Fetal Growth Retardation;208
8.11.7;Management of Fetal Growth Retardation;209
8.11.8;Educational Programs;210
8.11.9;Citations;210
8.11.10;Further Reading;210
8.12;Infant Mortality/Neonatal Disease;211
8.12.1;Introduction;211
8.12.1.1;History;211
8.12.2;Measurement of Infant Mortality;211
8.12.2.1;Definitions;211
8.12.2.2;Sources of Data;212
8.12.2.3;Global Patterns of Infant Mortality;212
8.12.3;Components of Infant Mortality;213
8.12.3.1;Neonatal Mortality;213
8.12.3.1.1;Low birthweight;213
8.12.3.1.2;Prematurity;213
8.12.3.1.3;Intrauterine growth retardation;214
8.12.3.1.4;Asphyxia;214
8.12.3.1.5;Pneumonia and sepsis;214
8.12.3.1.6;Tetanus;214
8.12.3.1.7;The importance of birthweight and causal interactions;214
8.12.3.1.7.1;Birthweight distribution effects;215
8.12.3.1.7.2;Birthweight-specific mortality effects;215
8.12.3.1.8;Neonatal mortality and women's health;216
8.12.3.2;Postneonatal Mortality;216
8.12.3.2.1;Pneumonia;216
8.12.3.2.2;Diarrhea;216
8.12.3.2.3;Birth defects;216
8.12.3.2.4;Malaria;216
8.12.3.2.5;Acquired Immune Deficiency Syndrome (AIDS);217
8.12.4;Conclusion;217
8.12.5;Further Reading;217
9;Section 3: Reproductive Cancers;218
9.1;Cancer Screening;219
9.1.1;Introduction;219
9.1.2;Cancers Suitable for Screening;219
9.1.3;Benefits and Harms of Screening;220
9.1.4;Validity of Screening;220
9.1.5;Predictive Values of a Screening Test;221
9.1.6;Evaluating the Effect of Screening;222
9.1.7;Organizing a Screening Program;223
9.1.8;Cancer Screening by Primary Site;224
9.1.8.1;Cervical Cancer Screening;224
9.1.8.1.1;Natural history;224
9.1.8.1.2;Screening with cervical smears;224
9.1.8.1.3;Effectiveness of screening;224
9.1.8.1.4;Screening programs;225
9.1.8.1.5;Adverse effects of screening;225
9.1.8.1.6;Other screening tests;225
9.1.8.2;Breast Cancer Screening;226
9.1.8.2.1;Natural history;226
9.1.8.2.2;Mammography screening;226
9.1.8.2.3;Effectiveness of screening;226
9.1.8.2.4;Service screening;227
9.1.8.2.5;Adverse effects;228
9.1.8.2.6;Other screening tests;228
9.1.8.3;Colorectal Cancer Screening;228
9.1.8.3.1;Natural history;228
9.1.8.3.2;Screening tests;228
9.1.8.3.3;Effectiveness of FOBT;229
9.1.8.3.4;Service screening;229
9.1.8.3.5;Adverse effects of screening;229
9.1.8.3.6;Other screening tests;229
9.1.8.4;Screening for Oral and Liver Cancer;230
9.1.8.5;Lung Cancer Screening;230
9.1.8.5.1;Natural history, diagnosis, and treatment;230
9.1.8.5.2;Screening with chest X-rays, with or without sputum cytology;230
9.1.8.5.3;Effectiveness of screening;230
9.1.8.5.4;Adverse effects of screening;230
9.1.8.5.5;Other screening methods;230
9.1.8.6;Neuroblastoma Screening;231
9.1.8.7;Prostate Cancer Screening;231
9.1.8.7.1;Natural history;231
9.1.8.7.2;Prostate cancer screening based on PSA;231
9.1.8.7.3;Effectiveness of PSA screening;231
9.1.8.7.4;Adverse effects of screening;232
9.1.8.7.5;Other screening tests;232
9.1.8.7.6;Screening for other cancers;232
9.1.9;Cancer Screening Guidelines;232
9.1.10;Conclusion;233
9.1.11;Citations;234
9.2;Worldwide Burden of Gynecologic Cancer: The Size of the Problem;235
9.2.1;Introduction;235
9.2.2;Indices of Cancer Burden;235
9.2.2.1;Sources and Methods of Estimation of Data;235
9.2.3;2002 Estimates of Gynecological Cancer Burden;236
9.2.3.1;Cancer of the Uterine Cervix;238
9.2.3.2;Cancer of the Uterine Body;239
9.2.3.3;Ovarian cancer;240
9.2.3.4;Other Gynecological Cancers;242
9.2.4;Discussion;242
9.2.5;Conclusion;244
9.2.5.1;Practice Points;244
9.2.5.2;Research Points;244
9.2.6;Citations;245
9.3;Cervical Cancer;246
9.3.1;Introduction;246
9.3.1.1;HPV;246
9.3.1.2;Cofactors of Risk for Cervical Cancer;246
9.3.2;Screening Tests and Their Efficacy;247
9.3.2.1;Conventional and Liquid-based Cytology;247
9.3.2.2;HPV Testing;248
9.3.2.3;VIA, VIAM and VILI;249
9.3.2.4;Concurrent Screening Test Assessment;250
9.3.3;Organization of Cervical Cancer Screening Programs;250
9.3.3.1;Age and Screening Interval;251
9.3.3.2;When to Stop Screening;251
9.3.3.3;Follow-up and Treatment of Detected Abnormalities;252
9.3.3.4;Recruiting the Women;252
9.3.4;Prospects for Controlling Cervical Cancer;252
9.3.5;Conclusion;253
9.3.5.1;Practice Points;253
9.3.5.2;Research Agenda;253
9.3.6;Acknowledgments;253
9.3.7;Citations;253
9.4;Endometrial Cancer;255
9.4.1;Introduction;255
9.4.2;Epidemiology;256
9.4.3;Risk Factors;256
9.4.3.1;Estrogen-Alone and Estrogen-With-Progestin Replacement;256
9.4.3.1.1;Tamoxifen;257
9.4.3.2;Obesity;257
9.4.3.3;Diabetes and Hypertension;257
9.4.3.4;Parity;258
9.4.3.5;Menstrual Factors;258
9.4.3.6;Diet;259
9.4.3.7;Genetic Predisposition;259
9.4.4;Prevention;259
9.4.4.1;Oral Contraceptives;259
9.4.4.2;Smoking;260
9.4.4.3;Physical Activity;260
9.4.5;Screening for Endometrial Cancer;260
9.4.5.1;Outpatient Endometrial Biopsy;261
9.4.5.2;Ultrasound;261
9.4.5.3;Mass Screening;262
9.4.6;Conclusion;262
9.4.6.1;Practice Points;262
9.4.6.2;Research Agenda;262
9.4.7;Citations;262
9.5;Breast Cancer;264
9.5.1;Introduction;264
9.5.2;Causes;265
9.5.2.1;Family History;265
9.5.2.2;Pregnancy-Related and Hormone-Related Factors;266
9.5.2.3;Anthropometric Indices and Physical Activity;266
9.5.2.4;Dietary Factors;267
9.5.2.5;Environmental Exposures;267
9.5.2.6;Possibilities of Chemoprevention;267
9.5.3;Pathogenesis;267
9.5.3.1;Progression from Healthy Tissue to Invasive Carcinoma;267
9.5.4;Diagnosis and Staging;269
9.5.4.1;Diagnostic Procedures;269
9.5.4.2;Staging;269
9.5.5;Surgery;270
9.5.6;Radiotherapy;270
9.5.6.1;Radiotherapy in Breast Conservation;270
9.5.6.1.1;Partial breast irradiation;271
9.5.6.1.2;Intraoperative radiotherapy;271
9.5.6.1.3;Radiotherapy for ductal carcinoma in situ;271
9.5.6.1.4;Development in radiation techniques;271
9.5.6.2;Radiotherapy in Locally Advanced Carcinoma;271
9.5.6.3;Radiotherapy of Metastases;271
9.5.7;Systemic Treatment;271
9.5.7.1;Treatment of Locally Advanced Disease;271
9.5.7.2;Adjuvant Treatments;272
9.5.7.3;Neoadjuvant (Primary) Systemic Treatments;272
9.5.8;Conclusion;273
9.5.9;Citations;273
9.6;Ovarian Cancer;273
9.6.1;Epidemiology;273
9.6.2;Biology and Etiology;274
9.6.3;Diagnosis and Treatment Pathway;274
9.6.3.1;Symptomatic Presentation;274
9.6.3.2;Screening;275
9.6.4;Primary Management;275
9.6.4.1;Surgery;275
9.6.4.2;Chemotherapy;276
9.6.5;Management of Relapse;277
9.6.6;Palliation;277
9.6.7;Prevention;277
9.6.8;Conclusion;278
9.6.9;Citations;278
9.6.10;Relevant Websites;278
9.7;Prostate Cancer;279
9.7.1;Introduction;279
9.7.2;Anatomy, Physiology, and Pathology;279
9.7.3;Diagnosis, Screening, and Treatment;281
9.7.4;Variation in Incidence and Mortality;281
9.7.5;Risk Factors for Prostate Cancer;282
9.7.5.1;Family History and Genetic Factors;283
9.7.5.2;Hormones;283
9.7.5.3;Sexual Activity;284
9.7.5.4;Infection and Inflammation;284
9.7.5.5;Dietary and Nutritional Factors;284
9.7.5.6;Other Factors;285
9.7.5.6.1;Alcohol;285
9.7.5.6.2;Tobacco;285
9.7.5.6.3;Radiation;286
9.7.5.6.4;Occupation;286
9.7.5.6.5;Vasectomy;286
9.7.6;Conclusion;286
9.7.7;Citations;286
9.7.8;Further Reading;286
9.8;Testicular Cancer;287
9.8.1;Introduction;287
9.8.2;Histology;287
9.8.2.1;Seminoma;287
9.8.2.2;Nonseminomatous Germ Cell Tumors;287
9.8.3;Incidence;288
9.8.3.1;Trends in Incidence;288
9.8.3.2;Birth Cohort Effect;289
9.8.3.3;Age;289
9.8.3.4;Racial Factors;290
9.8.3.5;Occupation and Sociodemographic Characteristics;290
9.8.3.6;Laterality;290
9.8.4;Risk Factors;290
9.8.4.1;Cryptorchidism;290
9.8.4.2;Hormones;290
9.8.4.3;Genetic Factors;291
9.8.4.4;Diet;291
9.8.5;Etiology and Pathogenesis;291
9.8.6;Diagnostic Delay;291
9.8.7;Signs and Symptoms;292
9.8.8;Physical Examination;292
9.8.9;Natural History;292
9.8.10;Staging;292
9.8.11;Treatment;292
9.8.12;Prognosis;292
9.8.12.1;Seminoma;292
9.8.12.2;Nonseminomatous Germ Cell Tumor;292
9.8.12.3;Trends in Mortality;293
9.8.13;Citations;293
9.8.14;Further Reading;295
10;Section 4: Selected Ethical Andother General Aspects;296
10.1;Reproductive Ethics: New Reproductive Technologies;297
10.1.1;Introduction;297
10.1.2;General Ethical Issues Associated with ARTs;297
10.1.3;Artificial Insemination;298
10.1.4;In Vitro Fertilization and Embryo Transfer;298
10.1.5;Other ARTs;299
10.1.6;Conclusion;300
10.1.7;Citations;300
10.1.8;Further Reading;300
10.2;Reproductive Ethics: Ethical Issues and Menopause;301
10.2.1;Introduction;301
10.2.2;Menopause;301
10.2.3;Culture and Menopause;301
10.2.4;Is Menopause a Disease?;302
10.2.5;Making Informed Decisions about Treatment for Menopause;302
10.2.6;Hormone Replacement Therapy and Disease Prevention;303
10.2.7;Research Ethics and Menopause;304
10.2.8;Conclusion;304
10.2.9;Citations;304
10.2.10;Further Reading;305
10.2.11;Relevant Websites;305
10.3;Reproductive Ethics: Perspectives on Contraception and Abortion;305
10.3.1;Introduction;305
10.3.2;The Autonomy of Women;306
10.3.3;Minimizing Harm;306
10.3.3.1;Is Self-Determination Harmful to Women?;306
10.3.3.2;Is Contraception or Abortion Harmful to Women?;307
10.3.4;Competing Interests;307
10.3.5;Justice;308
10.3.6;Conclusion;309
10.3.7;Citations;309
10.3.8;Further Reading;309
10.4;New Technologies: Ethics of Stem Cell Research;310
10.4.1;Introduction;310
10.4.2;Ethical Debates About the Moral Status of the Embryo;310
10.4.3;Cloning;311
10.4.4;Ethical Debates on Cloning;312
10.4.5;Other Issues Related to hESC Research;312
10.4.6;Conclusion;312
10.4.7;Citations;313
10.4.8;Further Reading;313
10.5;Gender Aspects of Sexual and Reproductive Health;313
10.5.1;Definitions;313
10.5.2;Dimensions of Gender Considerations;314
10.5.2.1;The Burden of Sexual and Reproductive Ill- Health, by Sex;314
10.5.2.2;Norms and Values;315
10.5.2.3;Access to Resources;316
10.5.2.4;Gender Biases in Health Services;317
10.5.2.5;Laws and Policies;318
10.5.3;Conclusion;318
10.5.4;Disclaimer;319
10.5.5;Citations;319
10.5.6;Further Reading;319
10.5.7;Relevant Websites;319
10.6;Reproductive Rights;320
10.6.1;Introduction;320
10.6.2;The Evolution of an International Consensus;320
10.6.2.1;Rights in the Service of Health, Welfare, and Development;320
10.6.2.2;Rights in Respect of the Inherent Dignity of the Individual;320
10.6.3;An International Consensus on Reproductive Rights;321
10.6.4;The Protection of Reproductive Rights as Human Rights;322
10.6.4.1;Rights to Reproductive Self-Determination;322
10.6.4.2;Rights to Sexual and Reproductive Health Services, Information and Education;323
10.6.4.3;Rights to Equality and Nondiscrimination;323
10.6.5;Conclusion;324
10.6.6;Citations;324
10.6.7;Further Reading;325
10.6.8;Relevant Websites;325
10.7;Cultural Context of Reproductive Health;325
10.7.1;Introduction;325
10.7.2;History of Anthropological Research on Human Reproduction;326
10.7.3;Biological Anthropology and the Study of Human Reproduction;326
10.7.4;Structural-Materialist Anthropology and the Study of Human Reproduction;327
10.7.5;Sociocultural Anthropology and the Study of Human Reproduction;327
10.7.6;Public Health and the Anthropology of Reproduction;328
10.7.7;Conclusion;329
10.7.8;Citations;329
10.7.9;Further Reading;329
10.8;Women's Mental Health Including in Relation to Sexuality and Reproduction;330
10.8.1;Introduction;330
10.8.2;Sex Differences and Mental Disorders;330
10.8.2.1;Which Mental Disorders Are More Common in Women?;330
10.8.2.2;Clinical Profile of Various Mental Disorders in Women;330
10.8.2.2.1;Depression;330
10.8.2.2.2;Anxiety disorders;331
10.8.2.2.3;Schizophrenia;331
10.8.2.2.4;Dementias: Alzheimer's Disease;331
10.8.2.2.5;Suicide;331
10.8.2.2.6;Substance Use;331
10.8.3;What Are the Factors That Contribute to Increased Vulnerability in Women to Mental Health Problems?;331
10.8.3.1;Life Stress and Mental Health Problems in Women;331
10.8.3.2;Sexual Abuse and Sexual Coercion;332
10.8.3.2.1;Intimate Partner Violence;332
10.8.3.3;Poverty;332
10.8.3.4;Migration;333
10.8.3.5;War;333
10.8.3.6;Natural Disasters;333
10.8.4;Clinical Interface of Women's Mental Health with Reproductive Health and Medical Disorders;333
10.8.4.1;Psychiatric Disorders in Relation to Pregnancy and the Postpartum Period;333
10.8.4.1.1;Major consequences of untreated maternal depression;334
10.8.4.1.1.1;In the mother;334
10.8.4.1.1.2;In the child;334
10.8.4.1.2;Postpartum psychiatric disorders;334
10.8.4.1.3;Epidemiology;334
10.8.4.1.4;Severe mental illness in the postpartum period;335
10.8.4.1.5;Depression;335
10.8.4.1.6;Treatment and prevention of maternal mental disorders;335
10.8.4.2;Menstrual Cycle and Menopause;336
10.8.4.3;Reproductive Health Problems and Women's Mental Health;336
10.8.4.4;Malignancies and Impact on Mental Health;337
10.8.4.5;HIV/AIDS;337
10.8.4.6;Medical Disorders and Impact on Mental Health;337
10.8.5;Interventions;337
10.8.5.1;Primary Prevention;337
10.8.5.2;Secondary Prevention;337
10.8.5.3;Tertiary Prevention;338
10.8.6;Conclusion;338
10.8.7;Citations;338
10.8.8;Further Reading;338
10.8.9;Relevant Websites;339
11;Subject Index;340