Anal cancer is rare in the general population but is steadily increasing in incidence over the past decade especially in women. Identification and screening of women with high risk facilitates detection of anal precancer and early-stage cancer, improves survival, and potentially uses less invasive therapies compared with the conventional chemoradiation treatments used for advanced cancers. No recently published guidelines currently describe details about screening women for anal squamous cell cancer (ASCC). The available evidence supports the existence of groups of women with higher prevalence of ASCC (e.g., women with human immunodeficiency virus, immune suppression, or previous lower-genital high-grade lesion or cancer) who would likely benefit from screening with some combination of anal cytology and human papillomavirus testing. Additional research is needed to establish the cost-effectiveness and the influence of screening on ASCC mortality rates.

No abstract

This review of current medical knowledge about the etiology, evaluation, medical, and pharmacologic treatment of obesity suggests patient care strategies emphasizing office evaluation and treatment. Office assessment of obesity, which is the consequence of multiple genetic, neurohormonal, environmental, and behavioral factors, should include a careful chronological history with calculation of body mass index and a focused examination. Treatment consideration should be given to recommendations about calorie intake, but debate continues over the ideal macronutrient composition. Other treatment recommendations for successful weight loss and maintenance include a high level of physical activity, behavior modification programs that improve adherence to diet and exercise, and pharmacologic therapy. Obesity is an increasingly prevalent medical problem in the United States that is best treated using a multidisciplinary approach. Medical providers require the most up-to-date information in order to provide their patients with a multifaceted approach to successful weight loss and lifelong weight maintenance.

No abstract