Cancer Guidelines Database

This is a clinical practice guideline for women with a pathogenic or likely-pathogenic variant in their BRCA1 and BRCA2 genes. The guideline examines risk reduction strategies for this patient population, including screening, risk-reducing surgery, hormone therapy, surveillance, and more. The primary outcomes of interest are the prevention and early detection of cancers of the ovary and breast.

This is a clinical practice guideline for women who are at average risk for developing cervical cancer. The guideline examines cervical cancer screening in these patients, including screening techniques, when to instigate screening, and intervals for screening. Recommendations are provided based on age, such as whether patients are under 25 years of age, 25-65 years of age, or over 65 years of age.

This is a clinical practice guideline for adults with ovarian cancer. The guideline specifically examines the use of poly (ADP-ribose) polymerase inhibitors, or PARPis, for the management of epithelial ovarian, tubal, or primary peritoneal cancer. The management of newly diagnosed versus recurrent ovarian cancer, and the management of adverse events are discussed. Outcomes of interest include therapeutic efficacy (e.g., survival, response rate) and health-related quality of life.

This is a clinical practice guideline for women diagnosed with epithelial ovarian cancer. The guideline examines germline and somatic tumour testing in these patients. Specific topics addressed include genetic risk evaluation, the appropriate sequencing and timing of testing, genetic counseling, and testing of relatives.

This is a clinical practice guideline for women who have been diagnosed with endometrial cancer. The guideline examines the appropriateness of various imaging techniques during the pre-treatment evaluation and follow-up of these patients. Specific situations discussed include the initial staging of endometrial cancer, the surveillance of asymptomatic patients with treated low- or intermediate-risk endometrial cancer, as well as the post-therapy evaluation of clinically suspected recurrence of known endometrial cancer.

This is a clinical practice guideline for women with cervical cancer. The guideline examines the curative management of these patients with radiotherapy, including its indications, techniques and outcomes. Other therapies that modify the efficacy of radiotherapy when used concurrently or in sequence, such as chemotherapy or surgery, are also discussed.

This is a clinical practice guideline for newly diagnosed stage II, III, or IV epithelial ovary, fallopian tube, or primary peritoneal carcinoma. The guideline examines consolidation or maintenance systemic therapy for the treatment of these patients, after receiving first-line therapy with cytoreductive surgery and adjuvant therapy. Outcomes of interest include overall survival and progression-free survival.

This is a clinical practice guideline for women who have been diagnosed with vulvar cancer. The guideline provides recommendations on radiological imaging in these patients, for the purposes of pre-treatment staging and post-treatment follow-up. Magnetic resonance imaging (MRI), ultrasound (US), computed tomography (CT), and lymphoscintigraphy are specific imaging modalities discussed.

This is a clinical practice guideline for patients with vulvar cancer. The guideline examines the diagnosis, staging, treatment, and follow-up of these patients. Stages of vulvar cancer addressed include microinvasive (stage IA), early stage (> stage IA), and advanced stage (≥ stage 3). Please note that the sub-sections within this set were published and revised at varying dates, and that the publication year referenced here refers only to the date that the guideline set was accessed online.

This is a clinical practice guideline for patients with gynecological sarcomas. The guideline examines the staging, treatment, and follow-up of these patients. Surgical and adjuvant treatment options are discussed, as is the management of metastatic and recurrent disease. Please note that the sub-sections within this set were published and revised at varying dates, and that the publication year referenced here refers only to the date that the guideline set was accessed online.

This is a clinical practice guideline for women with advanced or recurrent endometrial cancer (excluding sarcomas and squamous cell carcinomas), or uterine papillary serous carcinoma. The guideline examines chemotherapeutic and hormonal therapy options for these patients. Outcomes of interest include response rate, toxicity, quality of life, and survival.

This clinical practice guideline for patients with suspected or confirmed non-epithelial ovarian cancer. The guideline discusses the prevention, diagnosis, staging, management, and follow-up of these patients. Specific conditions discussed include sex cord stromal tumours (SCSTs), and germ cell tumours (GCTs). Please note that the sub-sections within this set were published and revised at varying dates, and that the publication year referenced here refers only to the date that the guideline set was accessed online.

This is a clinical practice guideline for the management of gynecological cancers in women with Lynch syndrome. The guideline examines women with gynecological cancer who would benefit from Lynch syndrome screening, as well as how to best manage the risk of gynecological cancer in women with Lynch syndrome. The appropriate methods for screening for Lynch syndrome, and preventive measures for women with Lynch syndrome to reduce their risk of gynecological cancer, are specifically addressed.

This is a clinical practice guideline for patients with suspected or confirmed adenocarcinoma in situ (AIS) of the uterine cervix. Recommendations are provided for the diagnosis, treatment, and follow-up of these patients. The guideline discusses excisional treatment under colposcopic guidance, treatment for women who desire to preserve fertility, hysterectomy, and more.

This is a clinical practice guideline for women with endometrial carcinoma (EC). The guideline provides recommendations on the use of biomarkers to assess prognosis and predict response to therapy, and to identify patients carrying germline mutations associated with an increased risk of EC. Immunohistochemistry (IHC), ploidy analysis, and microsatellite instability (MSI) are specifically discussed.

This is a clinical practice guideline for pediatric and adolescent patients with ovarian masses. The guideline provides recommendations for the preoperative evaluation and operational management of these patients. Patients with benign-appearing ovarian lesions who are candidates for ovarian preservation, situations in which formal staging procedures or more extensive resections are warranted, and the safety of ovarian preservation in the setting of suspected malignant disease are specifically discussed.

This is a clinical practice guideline for patients with cancer of the uterine cervix, including those with squamous cell carcinomas, adenocarcinomas and adenosquamous carcinomas. The guideline examines screening, diagnosis, staging, treatment, and follow-up of these patients. Specific topics discussed include investigations of abnormal pap smears, investigations for staging, estrogen replacement therapy, and much more. Please note that the sub-sections within this set were published and revised at varying dates, and that the publication year referenced here refers only to the date that the guideline set was accessed online.

This is a clinical practice guideline for women with cervical cancer. The guideline examines the initial diagnosis and workup, staging, primary and adjuvant treatment, surveillance, and therapy following relapse for these patients. Treatment for metastatic disease is also discussed, as are the topics of incidental cervical cancer and the occurrence of cervical cancer in pregnant women.

This is a clinical practice guideline on cervical cancer screening. This guideline provides recommendations regarding screening intervals, the appropriate management of screen-detected abnormalities, screening in specific populations and abnormal vaginal bleeding. Outcomes of interest include cervical cancer mortality, cervical cancer diagnosis and precancerous high grade lesion detection. This guideline is wiki-based and is constantly updated as new evidence arises - this review pertains to the guideline as of August 30th, 2019.

This is a guideline for the prevention, screening/early detection, diagnosis, staging, and management of endometrial cancer. Management options examined include surgery, adjuvant therapy (e.g. pelvic radiotherapy, chemotherapy), and estrogen replacement therapy. Recommendations for follow-up are presented based on the type of treatment chosen. Please note that the sub-sections within this set were published and revised at varying dates, and that the publication year referenced here refers only to the date that the guideline set was accessed online.

This is a clinical practice guideline for asymptomatic women with suspected or confirmed adnexal masses. The guideline provides recommendations on various imaging procedures used to confirm the presence of adnexal masses, and to determine whether they are benign or malignant. The appropriateness of procedures indicated in specific clinical scenarios (measured by validity, reliability/reproducibility, clinical applicability, relative radiation levels, etc.) is examined. Recommendations are separated based on menopausal status.

This is a clinical practice guideline for women who have been diagnosed with uterine cervical cancer. The guideline discusses the treatment of these patients, and recommendations are separated based on disease type/stage. Specific topics examined include the primary treatment for cervical precancerous lesions and IA cervical cancer, the primary treatment for stage IB-II cervical cancer, postoperative therapy for stage IB–II cervical cancer, the primary therapy for stage III-IV cervical cancer, therapies for relapsed cervical cancer, and the management of cervical cancer during pregnancy.

This is a clinical practice guideline for women with cervical intraepithelial neoplasia (CIN). Recommendations are provided on the use of thermal ablation for the treatment of these women, with the ultimate goal of reducing the incidence of cervical cancer. The guideline compares thermal ablation to other treatment approaches such as cryotherapy, large loop excision of the transformation zone (LLETZ), and cold knife conization (CKC). Different modalities of thermal ablation (e.g., those that differ by temperature, number of applications, duration, etc.) are also discussed.

This is a clinical practice guideline for patients who may be at high-risk for developing breast and ovarian cancer due to genetic/familial predispositions. The guideline provides recommendations on genetic risk assessment and genetic counseling, and specifically discusses the management of individuals with hereditary breast or breast/ovarian syndromes, including BRCA-related breast/ovarian cancer syndrome, Li-Fraumeni syndrome, and Cowden syndrome.

This is a clinical practice guideline for adult patients who are undergoing surgery for gynecological cancers. The guideline provides preadmission, preoperative, intraoperative and postoperative recommendations. Patient education and counselling, pre-habilitation, surgical site infection (SSI) reduction bundles, and opioid sparing postoperative analgesia are some of the topics discussed. The primary outcomes of interest are reductions in perioperative morbidity and mortality, as well as improvements in recovery and decreased duration of hospital stays after surgery.

This clinical practice guideline is focused on the prevention, classification, diagnosis, staging, and management of ovarian epithelial carcinoma. Management options considered include surgery, chemotherapy, radiation therapy (for palliation), and approaches for fertility management. This guideline also discusses hereditary cancer syndromes, tumours of low malignant potential, estrogen replacement therapy, management of serous tubal intraepithelial carcinoma (STIC), and follow-up of patients after treatment. Please note that the sub-sections within this set were published and revised at varying dates, and that the publication year referenced here refers only to the date that the guideline set was accessed online.

This is a clinical practice guideline for patients with cancer of the fallopian tubes. The guideline examines the staging of these patients, and includes classification criteria and a staging diagram. Please note that the sub-sections within this set were published and revised at varying dates, and that the publication year referenced here refers only to the date that the guideline set was accessed online.

This is a clinical practice guideline for patients with ovarian cancer. Recommendations are provided for the diagnosis and management of these patients. The guideline specifically discusses how to determine the site of origin of extrauterine high-grade serous carcinomas (HGSC), which morphological criteria are useful for separating borderline from invasive ovarian neoplasias, as well as various aspects of treatment including exceptions to standard surgical management.

This is a clinical practice guideline on the screening for cervical cancer. The guideline examines the age at which to begin and end screening, the optimal interval for screening, the effectiveness of different screening strategies, and related benefits and harms of different screening strategies. Specific strategies discussed include screening for cervical cancer every 3 years with cervical cytology alone in women aged 21 to 29 years, screening every 3 years with cervical cytology alone, screening every 5 years with high-risk human papillomavirus (HPV) testing alone, and screening every 5 years with high-risk HPV testing in combination with cytology (co-testing) in women aged 30 to 65 years.

This is a clinical practice guideline for women with cervical cancer. The guideline examines the initial diagnosis and workup, staging, primary and adjuvant treatment, surveillance, and therapy following relapse for these patients. Treatment for metastatic disease is also discussed, as are the topics of incidental cervical cancer and the occurrence of cervical cancer in pregnant women.

This is a clinical practice guideline for patients with epithelial ovarian cancer (EOC). The guideline discusses the surgical management of these patients, and specifically examines the institutions and surgeons that should be performing surgery, imaging tools appropriate for use prior to surgery, approaches to patient selection, objectives of surgery, and quality assessment criteria. Major technical issues of surgery, genetic counselling, the role of surgery in EOC recurrence, indications for palliative surgery, and the role of adjuvant chemotherapy are also addressed.

This is a clinical practice guideline for patients with cervical cancer. The guideline examines the staging, management, and follow-up of these patients. Specific management recommendations are made for stage T1a, T1b1/T2a1 cancer, clinically occult cervical cancer diagnosed after simple hysterectomy, early and locally advanced cervical cancer (LACC), primary distant metastatic disease, cervical cancer in pregnancy (CCIP), and recurrent disease. The use of fertility sparing treatment (FST) is also discussed.

This is a clinical practice guideline for adult patients with ovarian cancer, fallopian tube cancer, or primary peritoneal cancer. Recommendations are provided for screening, staging, diagnosis, treatment, and follow-up. Treatment options discussed include debulking surgery, chemotherapy, and radiation therapy. Management of drug reactions is also discussed.

This is a clinical practice guideline for adult oncology patients with neutropenia. The guideline examines the appropriate prescribing of filgrastim for these patients. Indications for which filgrastim should be used are discussed by disease site group. Disease site groups considered include breast, central nervous system, gastrointestinal, gynecologic, genitourinary, hematologic, and thoracic, amongst others.

This is a clinical practice guideline for women with epithelial ovarian cancers, specifically focusing on patients with type-2 ovarian cancers. The guideline examines diagnostic imaging methods, used for both staging and evaluating potential recurrence. Imaging modalities discussed include x-ray, magnetic resonance imaging (MRI), fluorine-18-2-fluoro-2-deoxy-D-glucose positron emission tomography (FDG-PET), and computed tomography (CT).

This is a clinical practice guideline for women with vulvar cancer, and particularly those with squamous cell carcinoma (SCC) of the vulva. The guideline examines diagnosis and workup, as well as primary treatment, adjuvant radiotherapy and chemotherapy, and surveillance of these patients. Treatment options are discussed for early-stage disease, locally advanced disease, and metastases beyond the pelvis.

This is a clinical practice guideline for women with early-stage squamous cell vulvar cancer. The guideline examines sentinel lymph node biopsy (SLNB), including its safety and effectiveness in identifying women with node-negative, early-stage vulvar cancer. The appropriate procedures for SLNB in these patients are also discussed, such as selecting appropriate patients, determining the appropriate technique, and managing patients with positive sentinel lymph nodes.

This is a clinical practice guideline on the use of the 9-valent human papillomavirus (HPV) vaccine. The guideline examines the effect and safety of the 9-valent HPV vaccines, the recommended age for a 3-dose schedule, the vaccine's efficacy among middle-aged women, and the efficacy of a 2-dose schedule.

This is a clinical practice guideline for women with potentially curable, non-operable, locally advanced cervical cancer. The guideline provides recommendations on treatment using brachytherapy (BT), and compares different forms of BT such as two-dimensional BT, computed tomography-guided BT, magnetic resonance (MR)-guided intracavitary BT, and MR-guided intracavitary/interstitial BT. Outcomes of interest include survival, local tumour control, and toxicity.

This is a clinical practice guideline for women with an average risk of ovarian cancer. The guideline examines the benefits and harms of screening for ovarian cancer in these patients, including those of the screening test and of diagnostic evaluation. Screening tests considered include cancer antigen 125 (CA-125) screening and transvaginal ultrasound screening, on their own or combined. Outcomes of interest include ovarian cancer mortality, quality of life, false-positive rates, surgical complication rates, and the psychological effects of screening.

This is a clinical practice guideline for women with vulvar cancer, and particularly those with squamous cell carcinoma (SCC) of the vulva. The guideline examines diagnosis and workup, as well as primary treatment, adjuvant radiotherapy and chemotherapy, and surveillance of these patients. Treatment options are discussed for early-stage disease, locally advanced disease, and metastases beyond the pelvis.

This clinical practice guideline provides recommendations on the follow-up of patients with endometrial cancer who are clinically disease free after receiving primary treatment. The guideline reviews symptomatic signs of possible recurrence. Recommendations are provided on follow-up intervals and diagnostic interventions, stratified by risk of recurrence.

This is a clinical practice guideline for women with average risk and high risk for ovarian cancer. The guideline examines the role of imaging during ovarian cancer screening, and its effectiveness in detecting ovarian cancer at an early stage, in order to potentially improve survival. Variations of procedures, including ultrasound (US), computed tomography (CT), magnetic resonance imaging (MRI) and positron emission tomography using fluorine-18-2-fluoro-2-deoxy-D-glucose (FDG-PET), are discussed, as is their appropriateness in different clinical situations.

This is a clinical practice guideline for patients with uterine corpus cancer. These guideline discusses screening, surgery, adjuvant treatment, and advanced and recurrent disease with respect to endometrial carcinoma and uterine sarcoma. Other topics of interest include lymphadenectomy, fertility-sparing treatment, chemotherapy, and hormonal therapy.

This is a clinical practice guideline for women with recurrent epithelial ovarian cancer (EOC), including fallopian tube and primary peritoneal cancers. The guideline examines the most up-to-date systemic therapy treatment recommendations for recurrent EOC in order to promote evidence-based practice in Ontario. Outcomes of interest include improvements in progression-free survival and symptom control.

This is a clinical practice guideline for patients with epithelial ovarian-type cancers (e.g. ovary, fallopian tube or peritoneal origin) and borderline tumours. This guideline addresses epithelial cancers of varying histological subtypes. The guideline covers the full continuum of care including screening and prevention, diagnosis, treatment options such as surgery, systemic therapy and chemotherapy, follow-up, as well as management of recurrent disease. The guideline also highlights the support needs for women with ovarian cancer.

This is a clinical practice guideline for patients with vulvar and vaginal cancer, including those with epithelial tumours of the vulva or vagina, as well as those with primary vulvar Paget's disease or malignant melanomas of the vulva or vagina. The guideline provides recommendations for the treatment of these patients, and examines specific topics such as primary treatment, management of inguinal lymph nodes, treatment of distant metastases, and treatment of recurrent tumours.

This is a clinical practice guideline for patients with cervical cancer. The guideline discusses the diagnosis, treatment, and surveillance of patients with primary cervical cancer, and also provides recommendations regarding the treatment of recurrent cervical cancer. Specific diagnostic techniques examined include computed tomography (CT) and positron emission tomography (PET) scans, while treatment modalities examined include laparoscopic and robotic radical hysterectomy, nerve sparing radical hysterectomy, intensity-modulated radiation therapy (IMRT), and more.

This is a clinical practice guideline for patients who may be at high-risk for developing breast and ovarian cancer due to genetic/familial predispositions. The guideline provides recommendations on genetic risk assessment and genetic counseling, and specifically discusses the management of individuals with hereditary breast or breast/ovarian syndromes, including BRCA-related breast/ovarian cancer syndrome, Li-Fraumeni syndrome, and Cowden syndrome.

This is a clinical practice guideline for women with cervical cancer. The guideline examines the initial diagnosis and workup, staging, primary and adjuvant treatment, surveillance, and therapy following relapse for these patients. Treatment for metastatic disease is also discussed, as are the topics of incidental cervical cancer and the occurrence of cervical cancer in pregnant women.

A clinical practice guideline for asymptomatic, nonpregnant adult women. The guideline discusses pelvic examination as a screening method for gynecological conditions such as bacterial vaginosis, candidiasis, genital warts, genital herpes, trichomoniasis, pelvic inflammatory disease, cervical polyps, endometriosis, ovarian cysts, dysfunction of the pelvic wall and floor, and uterine fibroids, in addition to ovarian, uterine, and vaginal cancer. This guideline does not address the screening of cervical cancer, gonorrhea, or chlamydia.

This is a clinical practice guideline for patients with ovarian cancer, including epithelial ovarian, fallopian tube, and peritoneal cancers. The guideline examines the use of specialized multidisciplinary decision making, as well as the diagnosis, preoperative workup, and surgical management of these patients. Information to aid in discussions with patients and caregivers is also provided.

This is a clinical practice guideline for patients with squamous cell carcinoma of the vulva. The guideline examines diagnosis and referral, preoperative investigations, surgical management (i.e. local treatment, groin treatment and reconstructive surgery), sentinel lymph node procedures, radiation therapy, chemoradiation, systemic treatment, treatment of recurrent disease (i.e. vulvar recurrence, groin recurrence and distant metastases), and follow-up, in addition to providing information for discussions with patients and caregivers.

This is a clinical practice guideline for women with uterine cancer. The guideline provides recommendations for the screening and prevention of uterine cancer in the general population and in high risk groups, as well as for the pathological work-up, management, and follow-up of patients with uterine cancer. Specific conditions discussed include endometrioid endometrial cancer, as well as non-endometrioid cancers such as uterine serous carcinoma, uterine clear cell carcinoma, and uterine carcinosarcoma.

This is a clinical practice guideline for women who have both completed childbearing and are undergoing a gynecologic procedure (e.g., hysterectomy) with the intention of leaving the ovaries in situ. The guideline provides recommendations on the use of opportunistic salpingectomy in these patients, for the prevention of high grade serous cancers (HGSC) of the ovary, fallopian tube, and peritoneum. Other risk factors for developing HGSC are also discussed, including the use of oral contraceptives, the use of talcum powder, and the role played by diet and obesity.

This is a clinical practice guideline for adult female patients diagnosed with advanced stage or recurrent endometrial cancer (excluding sarcomas and squamous cell carcinomas) or uterine papillary serous carcinoma. The guideline examines chemotherapeutic and hormonal therapy options for patients with these cancers. Outcomes of interest include improved response rates and survival.

This recommendations report provides guidance on the investigation and management of suspected or proven pelvic and extra-pelvic gynecologic sarcomas. Recommendations are made on the use of pathology during investigation, while recommendations pertaining to treatment focus on surgery and adjuvant therapy. The guidance document also provides recommendations on a number of quality assurance measures to assess gynecologic sarcoma services.

This is a clinical practice guideline for patients with suspected or incidentally diagnosed adnexal masses. The guideline discusses the use of ultrasonography and serum marker testing during initial evaluation, which findings indicate malignant versus benign masses, and the appropriate situations for surgery versus observation. Specific recommendations are also provided for adolescents and pregnant women.

This is a clinical practice guideline for the vaccination of human papillomavirus (HPV) for the prevention of cervical cancer in women. The guideline examines the efficacy of 2-dose schedule vaccination, the efficacy of 3-dose schedule vaccination in middle-aged women, the ideal age of 3-dose schedule vaccination, the safety of HPV preventive vaccine, and the cross-protective ability of each HPV preventive vaccine.

A clinical practice guideline for women with stage I ovarian cancer. The guideline examines adjuvant therapy, primarily systemic therapies, in relation to surgical staging. Outcomes of interest include overall and disease-free survival.

This is a clinical practice guideline for women presenting with suspicious adnexal masses, either symptomatic or asymptomatic. The guideline examines the optimal strategies for preoperative identification of adnexal masses that are suspicious for ovarian cancer, and the most appropriate surgical procedures for those identified.

This is a clinical practice guideline to guide appropriate prescribing of filgrastim in adults. The guidelines looks at a variety of disease sites and is intended as a guide to facilitate a shared approach to the appropriate use of filgrastim. In order provide clarity surrounding the indications in which filgrastim should be used, the recommendations are presented by disease site.

This clinical practice guideline provides recommendations for the diagnosis, treatment, and follow-up of epithelial ovarian cancer. This guideline covers: carcinoma of the ovary, fallopian tube and primary peritoneal carcinoma; epithelial carcinoma, e.g. serious, mucinous, clear cell or endometrioid histology; borderline and invasive disease, diagnosis and first-line treatment; and follow-up after treatment. Recommendations consider patient values and preferences when treated for ovarian cancer.

This is a clinical practice guideline for the use of myeloid growth factors in adult patients with solid tumours and non-myeloid malignancies. Benefits and risks are reviewed, the role of biosimilars is discussed, and recommendations are provided for prophylactic and therapeutic uses of both granulocyte and granulocyte-macrophage colony stimulating factors (CSFs). Recommendations are also given regarding the use of CSFs in the hematopoietic cell transplant setting. Outcomes of interest include efficacy of CSFs, mortality, length of hospitalization, toxicity, and adverse effects.

This is a clinical practice guideline for women with vulvar cancer (VC) or vulvar intraepithelial neoplasia (VIN). The guideline provides recommendations for symptom management, with an emphasis on self-management interventions. Specific topics discussed include the handling of surgical wounds, as well as the management of acute postsurgical pain, postsurgical urinary symptoms, and lymphedema.

This is a clinical practice guideline for females and males between the ages of 9 and 26. The guideline examines the use of the human papillomavirus (HPV) vaccination for the purposes of cancer prevention. The ages at which routine vaccination and catch-up vaccination should occur are discussed, as well as which vaccines should be used for males and females. Special populations such as men who have sex with other men and immunocompromised persons are also addressed.

This is a clinical practice guideline for individuals at risk of or having genetic mutations that increase their risk of breast or ovarian cancer. The guideline reviews hereditary breast or breast/ovarian cancer syndrome, Li-Fraumeni syndrome, Cowden syndrome/PTEN Hamartoma tumor syndrome, and other genetic mutations associated with breast/ovarian cancer. Recommendations are provided for initial risk assessment, formal risk assessment and genetic counselling, and management options for individuals with a clinical diagnosis following genetic testing.

A clinical practice guideline for adult patients with recurrent endometrial cancer. The guideline examines management, including re-staging workups, and treatment through salvage radiotherapy and surgical intervention. Outcomes of interest include improved local control and 5-year survival rates through external beam radiation and brachytherapy.

This clinical practice guideline is an adoption of the American College of Physicians' 2014 guideline title Screening Pelvic Examination in Adult Women: A Clinical Practice Guideline from the American College of Physicians. The guideline examines the use of pelvic examinations to screen for noncervical cancer, pelvic inflammatory disease, or other benign gynecologic conditions in asymptomatic, non-pregnant adult women. Speculum or bimanual examinations are specifically discussed; the use of Pap tests for cervical cancer screening is not addressed in this guideline.

This is a clinical practice guideline for palliative oncology patients 18 years of age or older with low grade/ low volume/ malignancy-associated urogenital or gastrointestinal bleeding, or with malignant gastrointestinal obstruction, compression or invasion. External beam radiotherapy (EBRT) with or without , brachytherapy, stent placement, and surgical bypass are discussed as therapeutic options. Outcomes of interest include clinical improvement of symptoms, quality of life, and survival.

This is a clinical practice guideline for women who are at risk of developing cervical cancer. The guideline examines the optimal methods for cervical cancer screening and the management of women with abnormal screening results. Primary screening, exiting screening, triage and post-triage time periods, and the treatment of women with precursor lesions are all discussed. Different recommendations are provided based on economic resource level (i.e., basic, limited, enhanced or maximal).

This is a clinical practice guideline for women diagnosed with invasive cervical cancer. The guideline examines the most effective antitumour and palliative care interventions for clinicians and planners. Treatment options that are discussed include cone biopsy, extrafascial hysterectomy, modified radical or radical hysterectomy, and combinations of surgery, chemotherapy, and radiation therapy.

A clinical practice guideline for patients with early stage endometrial cancer. The guideline examined adjuvant therapy, including brachytherapy, radiation, chemotherapy, as well as observation in patients with low-grade/low-risk endometrial adenocarcinoma. Outcomes of interest include recurrence, local control, and overall survival.

This is a clinical practice guideline for patients with epithelial ovarian cancer including fallopian tube cancer and primary peritoneal cancer. Less common histopathologies including ovarian low malignant potential (LMP) tumor, malignant germ cell neoplasms, carcinosarcomas (malignant mixed Müllerian tumors [MMMTs] of the ovary), and malignant sex cord-stromal tumors, are also discussed. The guideline provides recommendations on diagnosis, treatment, follow-up, and relapse. Primary treatment options for ovarian cancer include surgery (risk-reducing or cytoreductive), chemotherapy (neoadjuvant and adjuvant), incomplete surgery and/or staging, anti-angiogenesis agents, and radiation therapy. The number of chemotherapy cycles and agents are reviewed, along with drug reactions.

This is a clinical practice guideline for patients with cervical cancer including squamous cell carcinoma, adenosquamous carcinoma, and adenocarcinoma of the cervix. The guideline discusses diagnosis and workup, principles of staging and surgery, primary treatment, adjuvant treatment, surveillance, and therapy for relapse. Special topics of consideration include incidental cervical cancer, radiation therapy, and cervical cancer and pregnancy.

This guideline outlines the screening, diagnosis, treatment, and follow-up of human papillomavirus related cancers. The guideline examines appropriate vaccination strategies, screening (including care controversies), and treatment including chemotherapy and surgical options. Outcomes of interest include fertility sparing and reduction of unnecessary Pap testing. Provincial resources are provided.

This is a clinical practice guideline for the screening and treatment of precancerous lesions for cervical cancer prevention. The guideline focuses specifically on the screening for cervical intraepithelial neoplasia 2 & 3 and the treatment of those lesions to prevent cervical cancer in women who tested positive after screening. In formulating the recommendations, the guideline authors specifically took into account resource implications in the Saudi context.

This clinical practice guideline examines the impact of fertility drugs on the risk of cancer in women. The guideline looks at the association between use of fertility drugs and increased risk of developing invasive ovarian, breast, endometrial, colon and thyroid cancers as well as non-Hodgkin lymphoma and malignant melanoma. The association between fertility drugs and borderline ovarian tumours is also examined.

This is a clinical practice guideline for women with newly diagnosed or suspected stage IIIC or IV epithelial ovarian cancer, fallopian tub cancer, or primary peritoneal cancer. More specifically, the guideline provides guidance to clinicians and patients regarding the use of neoadjuvant chemotherapy (NACT) and interval cytoreduction. The guideline addresses a number of clinical questions including: what clinical evaluations should be performed in all women with suspected or newly diagnosed stage IIIC or IV epithelial ovarian cancer; what is the preferred chemotherapy regimen for women with stage IIIC or IV epithelial ovarian cancer who will receive NACT; and what are the treatment options for patients with progressive disease on NACT.

This is a clinical practice guideline for women who are at increased risk of developing breast cancer. The guideline provides an overview on risk assessment, risk-reduction interventions including lifestyle interventions, risk-reduction surgery, and risk-reduction agents (tamoxifen, raloxifene, aromatase inhibitors). Recommendations are also provided for managing side effects of risk-reduction agents and monitoring for complications. Risk-reduction counselling is also discussed.

A clinical practice guideline for patients with suspected uterine neoplasms. The guideline examines surveillance, diagnostic assessment, and treatment focusing primarily on surgical interventions and systemic therapy. Outcomes of interest include long-term survival and reproductive sparing.