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DEDICATORIA
A nuestra Escuela de Tecnologa Mdica, que nos acogi en sus aulas
donde recibimos toda nuestra formacin Profesional y Humanstica.
A todos nuestros
profesores y colegas, quienes siempre trataron de sacar lo mejor de nosotros. Al Instituto de
Patologa de la UNMSM, en especial a la Dra. Violeta Seminario y al Dr. Ernesto Raez, por su
gran apoyo y comprensin. Al Lic. Eduardo Verastegui Lara, nuestro asesor por su gran
apoyo para el desarrollo de la presente tesis. A la Lic. Nila Cristina Canta por su gran apoyo
e insistencia en todo momento para la culminacin del presente trabajo. A nuestras familias
por su gran Apoyo y Comprensin en todo momento de nuestras vidas.

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Adam E, Kaufman RH, Berkova Z, Icenogle J, Reeves WC. Is human papillomaviruses

testing an effective triage method for detection of high-grade (grade 2 or 3) cervical
intraepithelial neoplasia? Am J Obstet Gynecol 1998; 178:1235-44.
Alvarez M. Cncer de Cuello Uterino: Factores de Riesgo. En: Jornada Educativa de
Deteccin, Diagnstico y Manejo del Cncer de Cuello Uterino y Cncer de Mama
para Obstetrices. Instituto de Enfermedades Neoplsicas, Mayo de 1997.
Anonymous. Study shows insurers fall short on women's reproductive care. Best's
Review; Oldwick. Life/Health insurance edition 1998;99:18.
Averette HE, Nguyen H. Cncer Ginecolgico. En: Oncologa Clnica. 2da Edicin.
Publicacin Cientfica 559.
Bailie R, Sibthorpe B, Anderson I, Smith L. Data for diagnosis, monitoring and treatment
in Indigenous health: the case of cervical cancer. Aust n Z J Public Health
1998;22:303-306.
Becker TM, Cosette M, McGought NS, McPherson RS et all. Sexually transmitted
diseases and other risk factors for cervical dysplasia among southwestern hispanic
and non-hispanic white women. JAMA 1994;271:1181-1188.
Blanc B, Boubli L. Displasias del Cuello Uterino. En: Ginecologa. 2da Edicin, Editorial
Mosby-Doyma. 1993.
Braun V, Gavey N. Exploring the possibility of sexual-behavioural primary prevention
./0 12 ! &3 4
*5

" # .

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interventions for cervical cancer. Aust N Z J Public Health 1998;22:353-359.

Cannistra SA, Jonathan MN. Medical Progress: Cancer of the Uterine Cervix. N Eng J
Med 1996;334:1030-1038.
Cannon JM, Blythe JG. Comparison of the Cytobrush Plus Plastic Spatula with the
Cervex Brush for obtaining endocervical cells. Obstet Gynecol 1993;82:569-72.
Castellanos C, Alvarez M, Ramirez G, Santos C, Mariategui J. Neoplasia Intraepitelias
Cervical (NIC). En: Ginecologa y Obstetricia: Prevencin, Diagnstico y Tratamiento
de Abraham Ludmir. Concytec, Lima-Per, 1996.
Cheek J, Fuller J, Gilchrist S, Maddock, Ballantyne A. Vietnamese women and pap
smears. Issues in promotion. Aust N Z J Public Health 1999;23:72-76.
Cliby WA, Dodson MK, Podratz KC. Cervical cancer complicated by pregnancy:
Episiotomy site recurrences following vaginal delivery. Obstet gynecol
1994;84:179-82.
Dabancens A. Lesiones precursoras del carcinoma escamoso de cuello uterino. En:
Ginecologa de Alfredo Prez Snchez. 2da Edicin, Editorial Mediterrneo, 1995.
Daly SF, Doyle M, English J, Turner M, Clinch J, Prendiville W. Can the number of
cigarettes smoked predict high-grade cervical intraepithelial neoplasia among women
with mildy abnormal cervical smears?. Am J Obstet Gynecol 1998;179:399-402.
Davis JD, Connor EE, Clark P, Wilkinson EJ, Duff P. Correlation between cervical
cytologic results and Gram stain as diagnostic for bacterial vaginosis. Am J Obstet
Gynecol 1997;177:532-5.
DeMay RM. Cytopathology of false negatives preceding cervical carcinoma. Am J
Obstet Gynecol 1996; 175:1110-3.
Daz LA, Kabawat SE. Performance of a fluid-Based, Thin-Layer Papanicolaou Smear
Method in the Clinical Setting of an Independent Laboratory and an Outpatient
Screening Population in New England. Arch Pathol Lab Med 1999;123:817-821.
Doornewaard H, van der Schouw Y, van der Graaf Y, Bos AB, van den Tweel JG.
Observer Variation in Cytologic Grading for Cervical Dysplasia of Papanicolaou
Smears with the PAPNET Testing System. Cancer (Cancer Cytopathol)
1999;87:178-83.
Duarte I, Perez A, Chuaqui R. Citopatologa Ginecolgica. En: Ginecologa de Alfredo
Prez Snchez. 2da edicin, Editorial Mediterrneo, 1995.
Edelman M, Fox A, Alderman EM, Neal W, Shapiro A, Silver EJ, Spigland I, Suhrland
M. Cervical Papanicolaou Smear Abnormalities in Inner City Bronx Adolescents,
Prevalence, Progression and Immune Modifiers. Cancer (Cancer Cytopathol)
1999;87:184-9.
Eltabbakh GH, Eltabbakh GD, Broekhuizen FF, Griner BT. Value of Wet Mount And
Cervical Cultures at the time of Cervical Cytology in Asymptomatic Women. Obstet
Gynecol 1995;85:499-503.
Falls, RK. Spontaneous resolution rate of grade 1 cervical intraepithelial neoplasia in a
private practice. Am J Obstet Gynecol 1999;181:278-82.
Ferran M. SPSS para Windows: Programacin y anlisis estadstico. Editorial Mc
Graw-Hill, 1996.
JJ

./0 12 ! &3 4

*5

" # .

!!  

Frable WJ. Reflections on adequacy in cervical/vaginal cytology. Cancer (Cancer

Cytopathol) 1999;87:103-4.
Genest DR, Dean B, Lee KR, Sheets E, Crum CP, Cibas ES. Qualifying the Cytologic
Diagnosis of Atypical Squamous Cells of Undetermined Significance Affects the
Predictive Value of a Squamous Intraepithelial Lesion on Subsequent Biopsy. Arch
Pathol Lab Med 1998;122:338-341.
Germain M, Heaton R, Erickson D, Henry M, Nash J, OConnor D. A comparison of the
three most common Papanicolaou Smear collection techniques. Obstet Gynecol
1994;84:168-73.
Gorman Ch. Beyond the Pap: What you should know about a new gene test that could
someday replace the Pap smear. Time, January 17, 2000.
Gupta D, Balsara G. Extrauterine Malignancies: Role of Pap Smear in diagnosis and
management. Acta Cytol 1999;43:806-813.
Hancock L, Fisher S, Kentish L. Cervical cancer screening in rural NSW: Healt
Insurance Commission data compared to self-report. Aust N Z J Public Health
1998;22:307-312.
Hasenyager C. Knowledge of cervical cancer screening among women attending a
university health center. J Am Coll Health 1999;47:221-4
Hatch KD, Hacker NF. Enfermedad intraepitelial de cuello uterino, vagina y vulva. En:
Ginecologa de Novak. 12va Edicin. Editora McGraw Hill, 1997.
Herbst AL. Detection, prevention, and treatment of cervical of cervical neoplasia: The
clinical challenge. Am J Obstet Gynecol 1996; 175:1087.
Hildesheim A PhD, Hadjimichael O MPH, Schwartz P MD, Wheeler C PhD, Barnes W
MD, Lowell D MD, Willett J MD, Schiffman MD. Risk factors for rapid-onset cervical
cancer. Am J Obstet Gynecol 1999;180:571-7.
Hunt C, Lawton G, Straton J. Pap smear screening at an urban aboriginal health
service: Report of a practice of recruiment strategies. Aust N Z J Public Health
1998;22:720-725
International Academy of Cytology. The Bethesda System for Reporting
Cervical/Vaginal Cytologic Diagnoses. Acta Cytol 1993;37:115-123.
Kaufman RH, Adam E. Is human papillomavirus testing of value in clinical practice?. Am
J Obstet Gynecol 1999;180:1049-53.
Kirkman-Liff B DrPH, Jacobs J PhD. Access to Cancer Screening Services for Women.
Am J Public Health 1992;82:733-735.
Kiviat N. Natural history of cervical neoplasia: Overview and update. Am J Obstet
Gynecol 1996; 175:1099-104.
Kobak W, Roman LD, Felix JC, Muderspach LI, Schlaerth JB, Morrow CP. The role of
endocervical curettage at cervical conization for high-grade dysplasia. Obstet
Gynecol 1995;85:197-201.
Korn A MD, Autry M MD, DeRemer P RN, NP, MS, Tan W. MD. Sensitivy of the
Papanicolau Smear in Human Inmunodeficiency Virus-Infected Women. Obstetric
Gynecol 1994;83:401-4.
./0 12 ! &3 4
*5

" # .

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Kurman, RJ, Amin MB. Protocol for the Examination of Specimens From Patients With
Carcinomas of the Cervix. Arch. Pathol Lab Med 1999;123:55-61.
Lazcano-Ponce E, Njera-Aguilar P, Buiatti E, Alonso-de-Ruiz P, Kuri P, Cantoral L,
Hernndez-Avila M. The cervical cancer screening program in Mexico: problems with
acess and coverage.Cancer Causes and Control, 1997,8 pp.698-704.
Lee M PhD, Lee F MPH, Stewart S PhD. Pathways to Early Breast and Cervical
Detection for Chinese American Women. Health Education Quarterly, Vol.
23(Supplement):S76-S88(December 1996).
Linder J, Zahniser D. ThinPrep Papanicolaou testing to reduce false-negative cervical
cytology. Arch Pathol Lab Med 1998;122:139-144.
Loeches MM, Asins E, Llixiona J, Cazorla E, Bernebeu JR, Vias T. Influye la edad en
el pronstico de las pacientes afecta de cncer de cuello uterino tratadas mediante
ciruga radical? Prog Obstet Ginecol 1999;42:669-677.
Lonky NM, Navarre GL, Saunders S, Sadeghi M, Tasidk GW. Low-Grade Papanicolaou
Smears and the Bethesda System: A prospective cytohistopathologic analysis. Obstet
Gynecol 1995;85:716-20.
Lonky NM, Sadeghi M, Tsadik GW, Petitti D. The clinical significance of the poor
correlation of cervical dysplasia and cervical malignancy with referral cytologic
results. Am J Obstet Gynecol 1999;181:560-6.
Maneta A, Keefe K, Lin F, Ahdoot D, Kaleb V. Atypical glandular cells of undetermined
significance in cervical cytologic findings. Am J Obstet Gynecol 1999;180:883-8.
Mango LJ. Reducing false negatives in clinical practice: The role of neural network
technology. Am J Obstet Gynecol 1996; 175:1114-9.
Ministerio de Salud - Per. Plan Nacional de Prevencin del Cncer Ginecolgico:
Cuello Uterino y Mama. 1998 - 2000.
Ministerio de Salud - Per. Registro de Cncer de Lima, 1990-1991.
Montes MA, Cibas ES, DiNisco SA, Lee KR. Cytologic characteristics of anormal cells in
prior Normal cervical/vaginal Papanicolaou Smear from women whit a High Grade
Squamous Intraepithelial lesion. Cancer (Cancer Cytopathol) 1999;87:56-9.
Moulton D. A better test than Pap smear?. CMAJ 2000;162:689
Mount SL, Papillo JL. A Study of 10296 Pediatric and adolescents Papanicolaou Smear
Diagnoses in Northern New England. Pediatrics 1999;103:539-545.
Noller, KL. Incident and demographic trends in cervical neoplasia. Am J Obstet Gynecol
1996; 175:1088-90.
Organizacin Mundial de la Salud. Anticonceptivos Orales y Neoplasia. Serie de
Informes Tcnicos 817. 1992.
Paraso MF, Brady K, Helmchen R, Eoat TW. Evaluation of the endocervical Cytobrush
and Cervex Brush in pregnant women. Obstet Gynecol 1994;84:539-43.
Parazzini F, Sideri M, Restelli S, Schettino F, Chatenoud L, Crosignani PG.
Determinants of High-Grade Dysplasia Among Womwn With Mild Dyskaryosis on
Cervical Smear. Osbtet Gynecol 1995;86:754-7.
Prez-Stable E MD, Otero-Sabogal R PhD, Sabogal F PhD, Npoles-Springer A.
JK

./0 12 ! &3 4

*5

" # .

!!  

Pathways to early Cancer Detection for Latinas: en Accin contra el Cncer. Health
Education Quarterly 1996;23 (Supplement):S41-S59.
Ransdell JS, Davey DD, Zaleski S. Clinicopathologic correlation of the unsatisfactory
Papanicolaou Smear. Cancer (Cancer Cytopathol) 1997;81:139-43.
Rapid Communication: The Bethesda System for reporting Cervical/Vaginal Cytologic
diagnoses. JAMA 1989;262:931-934.
Renshaw AA, Lee KR, Graner SR. Use of Statistical Analysis of Cytologic Interpretation
to Determine the Causes of Interobserver Disagreement and in Quality Improvement.
Cancer (Cancer Cytopathol) 1997;81:212-9.
Renshaw AA. A practical problem with calculating the false-negative rate of
Papanicolaou Smear interpretation by rescreening negative cases alone. Cancer
(Cancer Cytopathol) 1999;87:351-3.
Schiff M, Becker T, Masuk M, Van Asselt-King L, Wheeler C, Altobelli, K, North Ch,
Nahmias A. Risk Factors for Cervical Intraepitelial Neoplasia in Southwestern
American Indian Women. Am J Epidemiol 2000;152(8):716-726.
Schneider A, Zahm DM, Kirchmayr R, Schneider VL. Screening for cervical
intraepithelial neoplasia grade 2/3: Validity of cytologic study, cervicography, and
human papillomaviruses detection. Am J Obstet Gynecol 1996;174:1534-41.
Silverberg SG. Molecular diagnosis and prognosis in gynecologic oncology. Arch Pathol
Lab Med 1999;123:1035-1040.
Stoler MH. A brief synopsis of the role of human papillomaviruses in cervical
carcinogenesis. Am J Obstet Gynecol 1996; 175:1091-98.
Trotto NE. Enfermedades de Transmisin Sexual: Est actualizado?. Patient Care
1999; 4-20
Vaughn IR, Kozlowski KJ, Warren AM, Hendon A, Davis P. Adolescents and
Colposcopy: The Use of Different Procedures to Reduce anxiety. Am J Obstet
Gynecol 1994;170:504-508.
Veneti S, Papaefthimiou M, Symiakaki H, Ioannidou L. PAPNET for cervical cytology
screening: Experience in Greece. Acta Cytol 1999;43:30-33.
Ward J, Donelly N, Phoebe H. Impact in general practice of the policies of the organised
approach to preventing cancer of the cervix. Aust N Z J Public Health
1998;22:336-341.
Warner EA, Parsons AK. Screening and early diagnosis of gynecologic cancer. Med
Clin North Am 1996;80:45-61
Wismer B, Moskowitz J, Chen A, Kang S et al. Rates and independent correlates of Pap
Smear testing among Korean-American women. Am J Public Health 1998;88:665-660
Woodhouse SL, Stastny JF, Styer PE, Kennedy M, Praestgaard AH, Davey DD.
Interobserver variability in subclassification of squamous intraephitelial lesion: Results
of the College of American Pathologist Interlaboratory Comparison Program in
Cervicovaginal Cytology. Arch Pathol Lab Med 1999;123:1079-1084.
Zunzunegui MV, King MC, Coria CF, Charlet J. Male Influences on cervical cancer risk.
Am J Epidemiol 1996;123:302-7.
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