Browsing by Author "Kesic, Vesna (6701664626)"

Histological diagnosis of cervical intraepithelial neoplasia grade 2 (CIN2) has traditionally been the cutoff for local surgical treatment, due to a substantial risk of cancer development. However, evidence from the past decade suggests 50–60% of CIN2 lesions spontaneously regress, and active surveillance (or conservative management—ie, leaving the lesion untreated) might be justified in some cases. Active surveillance of CIN2 lesions is now practised widely, although clear recommendations on eligibility, frequency of surveillance, threshold for treatment, and criteria for return to routine recall are insufficient in most countries. In 2023, the cumulative risk of invasive cancer over 20 years was found to be substantially higher in patients under active surveillance when compared with patients who received immediate local treatment, with the greatest difference observed in women older than 30 years. This Policy Review and practice algorithm from the British Society of Colposcopy and Cervical Pathology and the European Society of Gynaecologic Oncology prevention committees aims to review existing evidence and present clear recommendations to assist clinical decision making. Active surveillance, rather than immediate treatment, might be reasonable in a carefully selected cohort of patients. The risk of progression, need for repeat visits, and cumulative risk of future invasion associated with active surveillance should be carefully balanced against the benefits of awaiting regression, including consideration of the woman's age, fertility wishes, additional risk factors, and likelihood of compliance to follow-up. Clinical audit and, ideally, prospective databases are required to monitor long-term outcomes and safety. © 2025 Elsevier Ltd

Purpose: Among harmful effects of chemotherapy is the reduction of ovarian function. The aim was to determine the serum levels of FSH, LH, estradiol and AMH after chemotherapy followed by endocrine therapy in breast cancer patients. Methods: The study included 40 premenopausal hormone receptor-positive breast cancer patients aged 33–50 years. Anthracycline-based chemotherapy received 14/40 while anthracycline–taxane combination received 26/40 of patients, followed by tamoxifen (30/40) or tamoxifen plus goserelin (10/40). All of them experienced chemotherapy-induced secondary amenorrhea. Hormone levels were determined by ELISA. Statistics included Spearman’s test, Mann–Whitney test and multiple linear regression analysis. Results: Undetectable AMH levels were observed in 62.5 and 33.3% of patients with time period < 2 and ≥ 2 years from completion of chemotherapy to sample collection. Median levels of hormones for patients treated with anthracycline-based compared to anthracycline–taxane therapy were: 15.5 vs. 22.3 IU/L for FSH; 10.9 vs. 13.6 IU/L for LH; 55.5 vs. 39.5 pg/mL for estradiol; 0.11 vs. 0.11 ng/mL for AMH. The multiple linear regression showed that: women who received goserelin had significantly lower FSH; those with shorter time from completion of chemotherapy to sample collection had significantly higher LH and lower estradiol; younger women had higher AMH levels. Conclusions: The ovarian function was recovered from chemotherapy-induced secondary amenorrhea with time elapsed since the completion of adjuvant chemotherapy. It may be less disrupted in patients who received anthracycline-based chemotherapy and goserelin plus tamoxifen, as well. © 2017, Springer-Verlag GmbH Germany.

To assess which obstetrical characteristics and treatment improved outcomes and prognosis of pregnant women with malignancy. A prospective study, undertaken between 2005 and 2014, involving 35 pregnant women who were diagnosed with malignant tumors during pregnancy. Patients were followed-up for 1 year after delivery. The pregnancy course and outcome and parameters that could influence the condition of mother and fetus were evaluated. Most malignancies were hematological, diagnosed in the second trimester and treated with combined therapy (surgery/adjuvant) after pregnancy. Most fetuses were in good state throughout pregnancy, but were delivered by caesarean section (CS) before term. Adjuvant therapy during pregnancy mostly caused transitory deterioration of fetal conditions. The majority of both mothers and infants were in a good state 12 months postpartum, although numerous mothers were still ill and on therapy. Surviving pregnancy and preventing tumors progression during pregnancy were the best predictors of mothers' future condition (P=0.022). High birthweight and term delivery were the most important factors for good outcome of the infants (P=0.001). If the tumor is not progressing, pregnancy should be continued as long as possible to obtain adequate birthweight of the infant. Second trimester surgery is safe, while other therapies should preferably be applied after delivery. © 2018 Walter de Gruyter GmbH, Berlin/Boston.

Introduction: Cancer complicating pregnancy is a rare but potentially life-threatening condition for both the mother and her child. The aim of the present study was to assess the outcomes for mothers and children after pregnancy complicated by malignancy and to investigate which parameters are important for their 1-year survival. Material and methods: The study included 84 pregnant women diagnosed with malignant tumors during pregnancy from 2001 to 2022. The pregnancy course and outcome, as well as parameters that could influence the survival and condition of the mother and child were evaluated. Mothers and children were followed up for 1 year after delivery to assess their condition/complications and overall survival. Results: Most malignancies were gynecological (31%) or hematological (23.8%) and were diagnosed and surgically treated in the second trimester. Most children (69%) showed adequate growth and development throughout pregnancy but were delivered before term (53.6%) to allow mothers to receive therapy. Adjuvant therapy during pregnancy mostly caused a transitory deterioration of the child's condition, while surgery did not significantly impact the pregnancy course. Deliveries, on average, occurred during the 33.01 ± 6.16 gestational week (range: 20–40) and mostly by cesarean section (76.2%). For mothers, the pregnancy survival rate was 95.2% and survival after 1 year was 87.5%. However, 37.5% of women were still ill and required additional therapy 1 year postpartum. The pregnancy survival rate for children was 94%, whereas the 1-year survival rate was 76.2%. Most children had a favorable condition (alive, adequately growing and developing, and without complications) at birth (81%) as well as at the 1-year follow-up (63.7%). Regression analysis identified the following predictors of favorable 1-year maternal condition: applying therapy during pregnancy, no progression of the malignancy during pregnancy, and delivery at a later gestational week. Predictors of favorable 1-year condition of children were lower histopathological grade of malignancy, surgery as therapy for malignancy, obtaining higher birthweight, and delivery by cesarean section. Conclusions: If the malignancy is not progressing, pregnancy should be continued as long as possible for the child to obtain adequate birthweight. Both surgery and chemotherapy were safe therapeutic choices, as most pregnancies continued successfully after therapy. © 2024 The Authors. Acta Obstetricia et Gynecologica Scandinavica published by John Wiley & Sons Ltd on behalf of Nordic Federation of Societies of Obstetrics and Gynecology (NFOG).

Cervical cancer is an important public health care problem in Europe. The overall incidence rate of cervical cancer in Europe is 10.6 per 100,000. However, within Europe, the incidence rates significantly differ, being lower in Western Europe where prevention programs are better developed. Significantly higher are the incidence and mortality rates in Central and Eastern Europe, being in close correlation to the intensity of organized screening. Human papillomavirus (HPV) vaccines are being delivered to the low-incidence populations that already have extensive screening programs, whereas the high-incidence countries have not implemented the vaccination programs yet. The resolution of the problem of cervical cancer control in Europe will be a matter of the implementation of public health care programs across the whole continent. © 2012 AACR.

This paper summarises the position of ESGO and EFC on cervical screening based on existing guidelines and opinions of a team of lead experts. HPV test is replacing cytology as this offers greater protection against cervical cancer and allows longer screening intervals. Only a dozen of HPV tests are considered as clinically validated for screening. The lower specificity of HPV test dictates the use of triage tests that can select women for colposcopy. Reflex cytology is currently the only well validated triage test; HPV genotyping and p16 immunostaining may be used in the future, although methylation assays and viral load also look promising. A summary of quality assurance benchmarks is provided, and the importance to audit the screening histories of women who developed cancer is noted as a key objective. HPV-based screening is more cost-effective than cytology or cotesting. HPV-based screening should continue in the post-vaccination era. Only a fraction of the female population is vaccinated, and this varies across countries. A major challenge will be to personalise screening frequency according to vaccination status. Still the most important factor for successful prevention by screening is high population coverage and organised screening. Screening with self-sampling to reach under-screened women is promising. © 2020, Cancer Research UK.

This paper summarises the position of ESGO and EFC on cervical screening based on existing guidelines and opinions of a team of lead experts. HPV test is replacing cytology as this offers greater protection against cervical cancer and allows longer screening intervals. Only a dozen of HPV tests are considered as clinically validated for screening. The lower specificity of HPV test dictates the use of triage tests that can select women for colposcopy. Reflex cytology is currently the only well validated triage test; HPV genotyping and p16 immunostaining may be used in the future, although methylation assays and viral load also look promising. A summary of quality assurance benchmarks is provided, and the importance to audit the screening histories of women who developed cancer is noted as a key objective. HPV-based screening is more cost-effective than cytology or cotesting. HPV-based screening should continue in the post-vaccination era. Only a fraction of the female population is vaccinated, and this varies across countries. A major challenge will be to personalise screening frequency according to vaccination status. Still the most important factor for successful prevention by screening is high population coverage and organised screening. Screening with self-sampling to reach under-screened women is promising. © 2020, Cancer Research UK.

Radical trachelectomy (RT) is a fertility-sparing procedure with the aim to provide adequate oncological safety to patients with cervical cancer while preserving their fertility. In the current review, indications, development of the procedure, technical aspects, preoperative and postoperative management, and oncological, fertility, and obstetric outcomes are discussed and studied with respect to whether the procedure is performed abdominally or vaginally. Complications of RT, staging, and more conservative alternatives to RT are discussed as well. A systematic MEDLINE search was performed, which yielded 218 articles, of which 75 were selected for further analysis based on the number of patients and the quality of the study. Strict morphologic criteria should be applied to the candidates to maintain oncological safety. When limited to a tumor less than 2 cm in diameter, the overall recurrence rate after vaginal RT is 3% to 6% and the death rate is 2% to 5%. Data on fertility and obstetric outcome are mostly based on the results of patients who underwent vaginal RT. More data are needed to be able to draw the same conclusions for abdominal RT. Fertility seems not to be decreased, but the risk for premature delivery is 2 to 3 times higher compared to women with an intact cervix. In locally advanced cervical tumors with a diameter larger than 2 cm, neoadjuvant chemotherapy followed by RT may be offered after explaining the experimental nature to the patient. In conclusion, RT is an oncologically safe technique in women with early invasive cancer. The rate of term pregnancies still needs improvement. Fertility-preserving treatment of women with tumors larger than 2 cm in diameter can be done by combining neoadjuvant chemotherapy and trachelectomy; however, experience is still limited. Copyright © 2012 by IGCS and ESGO.

Identifying the factors that deter or stimulate the women to participate in screening activities is very important in order to design effective education and motivation strategies, particularly in the countries without an organized system. The study employed a case-control design. The participants were recruited in four primary health care institutions in Belgrade over a month. The study group comprised all women aged 18-70 years, who demonstrated an initiative for a PAP- smear. The controls were women with no Pap smears within the last 4 years, matched by age (±2 years), education and marital status with the study group participants. The study instrument was the 62-item self-administered questionnaire. According to multivariate analysis, adherence to cervical cancer screening practices is significantly related to better financial status [odds ratio (OR) = 10.8, P = 0.001], no gender preference for a gynecologist (OR = 3.1, P = 0.015), consultations with a gynecologist (OR = 4.7, P = 0.029), conversation with the women with cervical cancer about that disease (OR = 2.8, P = 0.029) and higher media exposure to information about cervical cancer prevention (OR = 5.0, P = 0.004). Open communication, social networks and improving social-economic status of women in our society are the most prominent factors, most of which are mainly outside the health services' domain and require multisectoral collaboration to improve women's reproductive health. © The Author 2010.

Objective The aim of the study was to assess the impact of human papillomavirus (HPV) awareness and knowledge on physiological state and quality of life of women referred to colposcopy and/or HPV testing. Materials and Methods A cross-sectional study was carried out at University Hospital, Belgrade, Serbia. The women with abnormal Pap test results obtained at the primary care centers requiring colposcopy and/or HPV testing were included. Before gynecological examination, participants filled the questionnaire on demographic characteristics, gynecological history, questionnaire for the evaluation of HPV awareness and HPV knowledge level, a set of self-report questionnaires assessing the anxiety level, quality of life, and concern about the smear and colposcopy results and perceived risk of developing cervical cancer. Results Of 324 women, 196 (60.5%) were aware of HPV. They reported higher concern about test results (p <.001), perceived risk of developing cervical cancer (p <.001), and had significantly lower quality of life (p =.004) than women who did not hear anything about this virus. On contrary, better knowledge correlated with younger age (p <.001) and better quality of life (p <.0001) and was associated with lower anxiety, lower concern about smear test results, and lower perceived risk of developing cancer. Conclusions Human papillomavirus awareness and knowledge have different impact on psychological state and quality of life. Being aware of HPV is not enough for reducing the stress and anxiety and increasing the coverage of screening. Therefore, it is necessary to increase women's knowledge through more detailed information about HPV in different public health messages and education programs. © 2018, ASCCP.

Endometrial cancer (EC) in young women of reproductive age is a relatively rare diagnosis. However, since in the modern era women delay their childbearing for a variety of social reasons, more and more women in the near future will be nulliparous and have a diagnosis of EC at the same time. Hence, a more conservative approach of EC is desirable to preserve fertility of these women, without compromising their survival. Recently, the number of studies reporting encouraging results on fertility-sparing management of EC with high dose of progestins is increasing. It seems that preserving the uterus and the ovaries in a carefully selected patient with EC confers only a very small risk combined with an enormous benefit. Selection of women suitable for such a conservative approach, as well as method of treatment, follow-up, recurrence, obstetric outcomes, and survival rates are very important parameters when consulting women with EC wishing to preserve their fertility. In this article, we try to elucidate all the previously mentioned aspects and formulate clinical recommendations, based on published data, about the most proper approach and consultation of these patients. © 2015 by IGCS and ESGO.

Objectives: This study aimed to provide timely and effective guidance for pregnant women and health care providers to optimize maternal treatment and fetal protection and to promote effective management of the mother, fetus, and neonate when administering potentially teratogenic medications. New insights and more experience were gained since the first consensus meeting 5 years ago. Methods: Members of the European Society of Gynecological Oncology task force "Cancer in Pregnancy" in concert with other international experts reviewed the existing literature on their respective areas of expertise. The summaries were subsequently merged into a complete article that served as a basis for discussion during the consensus meeting. All participants approved the final article. Results: In the experts' view, cancer can be successfully treated during pregnancy in collaboration with a multi-disciplinary team, optimizing maternal treatment while considering fetal safety. To maximize the maternal outcome, cancer treatment should follow a standard treatment protocol as for non pregnant patients. Iatrogenic pre-maturity should be avoided. Individualization of treatment and effective psychologic support is imperative to provide throughout the pregnancy period. Diagnostic procedures, including staging examinations and imaging, such as magnetic resonance imaging and sonography, are preferable. Pelvic surgery, either open or laparoscopic, as part of a treatment protocol, may reveal beneficial outcomes and is preferably performed by experts. Most standard regimens of chemotherapy can be administered from 14 weeks gestational age onward. Apart from cervical and vulvar cancer, as well as important vulvar scarring, the mode of delivery is determined by the obstetrician. Term delivery is aimed for. Breast-feeding should be considered based on individual drug safety and neonatologist-breast-feeding expert's consult. Conclusions: Despite limited evidence-based information, cancer treatment during pregnancy can succeed. State-of-the-art treatment should be provided for this vulnerable population to preserve maternal and fetal prognosis. Supplementary Information: Supplementary data on teratogenic effects, ionizing examinations, sentinel lymph node biopsy, tumor markers during pregnancy, as well as additional references and tables are available at the extended online version of this consensus article, go to http://links.lww.com/ IGC/A197. Copyright © 2014 by IGCS and ESGO.

[No abstract available]

Introduction: Colposcopy is an important part of the diagnostic work-up of women with an abnormal cervical screening test as it is used to guide the collection of biopsies. Although quality assurance has been used in the evaluation of screening programs, not much is known about quality indicators for the diagnostics and treatment of screen-positive women. Therefore, the European Federation for Colposcopy developed quality indicators aiming to support colposcopy practice across Europe. We performed a survey of colposcopy cases to determine if the quality indicators are understandable, relevant, and reproducible. Material and Methods: We conducted a survey among all members of the European Federation for Colposcopy Quality and Standards Group from November 2022 to March 2023. Members were asked to collect information on a total of 17 quality indicators for 50 women who had been newly referred for colposcopy due to an abnormal screening test between January 1, 2020 to December 31, 2021. Results were reported descriptively. Results: We included data on 609 cases from 12 members across Europe. The majority of the quality indicators were either achieved or within reach of the agreed standard, often due to few countries with outlying data. One quality indicator had very low performance, although stratified results indicated that two countries had different clinical management of the patient type thereby skewing the results. In addition, discrepancies between the number of cases included in each quality indicator raised concerns regarding potential misunderstanding of the quality indicator and its objective. Conclusions: Quality indicators on colposcopy must be understandable to those collecting data, highlighting the importance of validating quality indicators before data collection. © 2024 The Author(s). Acta Obstetricia et Gynecologica Scandinavica published by John Wiley & Sons Ltd on behalf of Nordic Federation of Societies of Obstetrics and Gynecology (NFOG).

[No abstract available]

Background Considering the morbidity of radical hysterectomy, the advent of fertility-sparing approaches, and the low risk of parametrial involvement in patients with early stage I cervical tumors, the benefit from parametrial resection is debatable. Objectives of this study were to determine factors predicting parametrial tumor spread and to define a group of patients who might be safely spared parametrial resection. Methods Pathology review was done on patients with stages IA2 and small IB1, treated by radical hysterectomy and pelvic lymph node dissection. Analysis was performed to determine factors associated with parametrial spread and to define risks of obeying parametrial resection. Results A total of 223 patients with tumors less than 20 mm in diameter were identified. Parametrial metastases were documented in 8 patients (3.6%); nodes, 1.3%; lymphovascular space invasion (LVSI), 1.8%; contiguous spread, 0.9%. Of 211 (94.6%) patients with negative pelvic nodes, none had parametrial nodal involvement, 0.9% had LVSI, and 0.4% had contiguous spread. Factors associated with parametrial disease were deep cervical invasion, LVSI, tumor volume, and pelvic lymph node metastases (P < 0.01 for each). In patients without tumor LVSI and the depth of invasion was within the inner third, the rate of parametrial spread was 0.45%. Conclusions Our data show a risk of parametrial spread of 0.45% for tumors less than 20 mm in diameter, no LVSI, and a depth of invasion within the inner third. Patients wanting fertility preservation might be prepared to take this risk of recurrence. Morbidity after nerve-sparing radical hysterectomy is tolerably low, and for patients in whom fertility preservation is not an issue, this should be considered the standard of care. © 2016 by IGCS and ESGO.

Introduction Advanced minimal access surgical training is an important component of training in gynecological oncology (GO). Europe-wide data on this topic are lacking. We present data on availability and trainee experience of advanced laparoscopic surgical (ALS) and robotic surgical (RS) training in GO across Europe. Method A prospective web-based anonymized survey of European GO trainees was sent to the European Network of Young Gynaecological Oncologists members/trainees. It included sociodemographic information and specific questions pertaining to training experience or satisfaction in laparoscopic and robotic surgery. χ 2 test was used for evaluating categorical variables and Mann-Whitney/Kruskal-Wallis (nonparametric) tests for continuous variables between 2 and more independent groups. Results A total of 113 GO trainees from 29 countries responded. The mean (standard deviation) age was 35.2 (6.1) years, 59.3% were men, 40.7% were women, and 46% were in accredited training posts. The ALS and RS training was offered in only 43% and 23% of institutes respectively, and 54% and 23% of trainees had undergone some form of formal or informal training in ALS and RS respectively. A total of 62.4% felt that RS should be a formal component of GO training programs. A total of 61% and 35% planned to go outside their institute for ALS or RS training respectively. Trainees rating (1-5 scale) of their open surgery and ALS or RS skills (3.3/2.6/1.9) and training experience (3.5/2.8/2.1), respectively, were higher for open surgery than ALS or RS (P < 0.0005). Accredited posts were more likely than nonaccredited posts to offer ALS training (60%/31%, P = 0.002), formal training schedules (27.9%/4.4%, P = 0.003), and use of logbooks (46%/23%, P = 0.035). Conclusions Training and experience in ALS and RS are poorly rated by GO trainees across Europe, and only few centers offer this. There is an urgent need to expand and harmonize training opportunities for ALS and RS. Most trainees want RS included as a formal component of their training. © 2017 by IGCS and ESGO.

The European Society of Gynaecological Oncology (ESGO), the International Society for the Study of Vulvovaginal Disease (ISSVD), the European College for the Study of Vulval Disease (ECSVD), and the European Federation for Colposcopy (EFC) developed consensus statements on pre-invasive vulvar lesions in order to improve the quality of care for patients with vaginal intraepithelial neoplasia (VaIN). The management of VaIN varies according to the grade of the lesion: VaIN 1 (low grade vaginal squamous intraepithelial lesions (SIL)) can be subjected to follow-up, while VaIN 2-3 (high-grade vaginal SIL) should be treated. Treatment needs individualization according to the patient's characteristics, disease extension and previous therapeutic procedures. Surgical excision is the mainstay of treatment and should be performed if invasion cannot be excluded. Total vaginectomy is used only in highly selected cases of extensive and persistent disease. Carbon dioxide (CO 2) laser may be used as both an ablation method and an excisional one. Reported cure rates after laser excision and laser ablation are similar. Topical agents are useful for persistent, multifocal lesions or for patients who cannot undergo surgical treatment. Imiquimod was associated with the lowest recurrence rate, highest human papillomavirus (HPV) clearance, and can be considered the best topical approach. Trichloroacetic acid and 5-fluorouracil are historical options and should be discouraged. For VaIN after hysterectomy for cervical intraepithelial neoplasia (CIN) 3, laser vaporization and topical agents are not the best options, since they cannot reach epithelium buried in the vaginal scar. In these cases surgical options are preferable. Brachytherapy has a high overall success rate but due to late side effects should be reserved for poor surgical candidates, having multifocal disease, and with failed prior treatments. VaIN tends to recur and ensuring patient adherence to close follow-up visits is of the utmost importance. The first evaluation should be performed at 6 months with cytology and an HPV test during 2 years and annually thereafter. The implementation of vaccination against HPV infection is expected to contribute to the prevention of VaIN and thus cancer of the vagina. The effects of treatment can have an impact on quality of life and result in psychological and psychosexual issues which should be addressed. Patients with VaIN need clear and up-to-date information on a range of treatment options including risks and benefits, as well as the need for follow-up and the risk of recurrence. © ESGO, ISSVD, EFC, ECSVD 2023. Re-use permitted under CC BY. Published by BMJ.

The European Society of Gynaecological Oncology (ESGO), the International Society for the Study of Vulvovaginal Disease (ISSVD), the European College for the Study of Vulval Disease (ECSVD), and the European Federation for Colposcopy (EFC) developed consensus statements on pre-invasive vulvar lesions in order to improve the quality of care for patients with vaginal intraepithelial neoplasia (VaIN). The management of VaIN varies according to the grade of the lesion: VaIN 1 (low grade vaginal squamous intraepithelial lesions (SIL)) can be subjected to follow-up, while VaIN 2-3 (high-grade vaginal SIL) should be treated. Treatment needs individualization according to the patient's characteristics, disease extension and previous therapeutic procedures. Surgical excision is the mainstay of treatment and should be performed if invasion cannot be excluded. Total vaginectomy is used only in highly selected cases of extensive and persistent disease. Carbon dioxide (CO2) laser may be used as both an ablation method and an excisional one. Reported cure rates after laser excision and laser ablation are similar. Topical agents are useful for persistent, multifocal lesions or for patients who cannot undergo surgical treatment. Imiquimod was associated with the lowest recurrence rate, highest human papillomavirus (HPV) clearance, and can be considered the best topical approach. Trichloroacetic acid and 5-fluorouracil are historical options and should be discouraged. For VaIN after hysterectomy for cervical intraepithelial neoplasia (CIN) 3, laser vaporization and topical agents are not the best options, since they cannot reach epithelium buried in the vaginal scar. In these cases surgical options are preferable. Brachytherapy has a high overall success rate but due to late side effects should be reserved for poor surgical candidates, having multifocal disease, and with failed prior treatments. VaIN tends to recur and ensuring patient adherence to close follow-up visits is of the utmost importance. The first evaluation should be performed at 6 months with cytology and an HPV test during 2 years and annually thereafter. The implementation of vaccination against HPV infection is expected to contribute to the prevention of VaIN and thus cancer of the vagina. The effects of treatment can have an impact on quality of life and result in psychological and psychosexual issues which should be addressed. Patients with VaIN need clear and up-to-date information on a range of treatment options including risks and benefits, as well as the need for follow-up and the risk of recurrence. © 2023 Lippincott Williams and Wilkins. All rights reserved.

Background: Vulvar squamous cell carcinoma incidence is increasing, especially among women under 60, largely attributed to human papillomavirus infections. Precursor pre-invasive vulvar lesions are frequently underdiagnosed. Routine vulvar inspection during cervical cancer screening could offer an opportunity for the detection of these lesions. Objective: To emphasize the importance of integrating routine vulvar inspection during cervical cancer screening procedures and to raise awareness about the early detection of vulvar squamous cell carcinoma and its precursors to reduce the diagnostic delay of vulvar pathologies. Methods: A multidisciplinary task force comprising experts from 4 international scientific societies was formed. A focused literature review was conducted, and consensus statements were developed through a structured voting process to ensure clinical relevance and comprehensiveness. Results: The consensus defines key elements of normal vulvar anatomy, identifies potential pre-cancerous dermatoses, and highlights risk factors for vulvar malignancy. The consensus statements promote the integration of vulvar inspection into cervical cancer screening procedures, urging health care professionals across various levels to receive training and guidance in vulvar examinations and enhancing patient education. Health care providers are recommended to gather a brief history of vulvar symptoms, conduct comprehensive inspections of the vulvar area, and report any abnormalities. For patients with positive human papillomavirus or Pap tests, they should closely monitor vulvar findings, encourage self-examinations, and discuss risks for intra-epithelial or invasive neoplasia. Conclusions: Establishing standardized practices in vulvar inspection during cervical cancer screening procedures along with public awareness, could significantly impact early detection and timely interventions of vulvar pathologies at cancer risk ultimately reducing the burden of vulvar cancers. © 2024 European Society of Gynaecological Oncology and the International Gynecologic Cancer Society