%PDF-1.3 1 0 obj << /Type /Catalog /Outlines 2 0 R /Pages 3 0 R >> endobj 2 0 obj << /Type /Outlines /Count 0 >> endobj 3 0 obj << /Type /Pages /Kids [6 0 R 14 0 R 25 0 R 27 0 R 29 0 R 37 0 R 39 0 R 44 0 R 55 0 R 57 0 R ] /Count 10 /Resources << /ProcSet 4 0 R /Font << /F1 8 0 R /F2 9 0 R /F3 10 0 R >> /XObject << /I1 11 0 R >> >> /MediaBox [0.000 0.000 595.280 841.890] >> endobj 4 0 obj [/PDF /Text /ImageC ] endobj 5 0 obj << /Creator (DOMPDF) /CreationDate (D:20141126224127+00'00') /ModDate (D:20141126224127+00'00') /Title (Managing Uncertainty: Women and Cancer in Contemporary History) >> endobj 6 0 obj << /Type /Page /Parent 3 0 R /Annots [ 12 0 R ] /Contents 7 0 R >> endobj 7 0 obj << /Length 2799 >> stream q 381.750 0 0 120.000 34.016 687.874 cm /I1 Do Q 0.000 0.000 0.000 rg BT 34.016 676.469 Td /F1 12.0 Tf [(Published on )] TJ ET BT 99.356 676.469 Td /F2 12.0 Tf [(Reviews in History)] TJ ET BT 190.016 676.469 Td /F1 12.0 Tf [( \()] TJ ET 0.000 0.000 0.800 rg BT 197.012 676.469 Td /F1 12.0 Tf [(http://www.history.ac.uk/reviews)] TJ ET 0.000 0.000 0.800 RG 0.24 w 0 J [ ] 0 d 197.012 675.075 m 357.332 675.075 l S 0.000 0.000 0.000 rg BT 357.332 676.469 Td /F1 12.0 Tf [(\))] TJ ET 0.502 0.502 0.502 RG 0.75 w 0 J [ ] 0 d 34.391 653.743 526.499 1.500 re S BT 34.016 615.321 Td /F3 18.0 Tf [(Managing Uncertainty: Women and Cancer in Contemporary )] TJ ET BT 34.016 593.937 Td /F3 18.0 Tf [(History)] TJ ET BT 34.016 563.315 Td /F3 12.0 Tf [(Review Number:)] TJ ET BT 34.016 549.059 Td /F1 12.0 Tf [(1239)] TJ ET BT 34.016 534.803 Td /F3 12.0 Tf [(Publish date:)] TJ ET BT 34.016 520.547 Td /F1 12.0 Tf [(Thursday, 19 April, 2012)] TJ ET BT 34.016 506.291 Td /F3 12.0 Tf [(Author:)] TJ ET BT 34.016 492.035 Td /F1 12.0 Tf [(Linda Bryder)] TJ ET BT 34.016 477.779 Td /F3 12.0 Tf [(ISBN:)] TJ ET BT 34.016 463.523 Td /F1 12.0 Tf [(9780230236035)] TJ ET BT 34.016 449.267 Td /F3 12.0 Tf [(Date of Publication:)] TJ ET BT 34.016 435.011 Td /F1 12.0 Tf [(2010)] TJ ET BT 34.016 420.755 Td /F3 12.0 Tf [(Price:)] TJ ET BT 34.016 406.499 Td /F1 12.0 Tf [(60.00)] TJ ET BT 34.016 392.243 Td /F3 12.0 Tf [(Pages:)] TJ ET BT 34.016 377.987 Td /F1 12.0 Tf [(256pp.)] TJ ET BT 34.016 363.731 Td /F3 12.0 Tf [(Publisher:)] TJ ET BT 34.016 349.475 Td /F1 12.0 Tf [(Palgrave Macmillan)] TJ ET BT 34.016 335.219 Td /F3 12.0 Tf [(Place of Publication:)] TJ ET BT 34.016 320.963 Td /F1 12.0 Tf [(Basingstoke)] TJ ET BT 34.016 306.707 Td /F3 12.0 Tf [(Author:)] TJ ET BT 34.016 292.451 Td /F1 12.0 Tf [(Ilana Lwy)] TJ ET BT 34.016 278.195 Td /F3 12.0 Tf [(ISBN:)] TJ ET BT 34.016 263.939 Td /F1 12.0 Tf [(9780801893643)] TJ ET BT 34.016 249.683 Td /F3 12.0 Tf [(Date of Publication:)] TJ ET BT 34.016 235.427 Td /F1 12.0 Tf [(2010)] TJ ET BT 34.016 221.171 Td /F3 12.0 Tf [(Price:)] TJ ET BT 34.016 206.915 Td /F1 12.0 Tf [(27.00)] TJ ET BT 34.016 192.659 Td /F3 12.0 Tf [(Pages:)] TJ ET BT 34.016 178.403 Td /F1 12.0 Tf [(344pp.)] TJ ET BT 34.016 164.147 Td /F3 12.0 Tf [(Publisher:)] TJ ET BT 34.016 149.891 Td /F1 12.0 Tf [(John Hopkins University Press)] TJ ET BT 34.016 135.635 Td /F3 12.0 Tf [(Publisher url:)] TJ ET BT 34.016 121.379 Td /F3 12.0 Tf [(Place of Publication:)] TJ ET BT 34.016 107.123 Td /F1 12.0 Tf [(Baltimore, MD)] TJ ET BT 34.016 92.867 Td /F3 12.0 Tf [(Author:)] TJ ET BT 34.016 78.611 Td /F1 12.0 Tf [(Ilana Lwy)] TJ ET BT 34.016 64.355 Td /F3 12.0 Tf [(ISBN:)] TJ ET BT 34.016 50.099 Td /F1 12.0 Tf [(9780199548811)] TJ ET endstream endobj 8 0 obj << /Type /Font /Subtype /Type1 /Name /F1 /BaseFont /Times-Roman /Encoding /WinAnsiEncoding >> endobj 9 0 obj << /Type /Font /Subtype /Type1 /Name /F2 /BaseFont /Times-Italic /Encoding /WinAnsiEncoding >> endobj 10 0 obj << /Type /Font /Subtype /Type1 /Name /F3 /BaseFont /Times-Bold /Encoding /WinAnsiEncoding >> endobj 11 0 obj << /Type /XObject /Subtype /Image /Width 509 /Height 160 /Filter /FlateDecode /DecodeParms << /Predictor 15 /Colors 3 /Columns 509 /BitsPerComponent 8>> /Mask [ 255 255 255 255 255 255 ] /ColorSpace /DeviceRGB /BitsPerComponent 8 /Length 3280>> stream x[EQ㎦fVttҒ +3O{?lGDQԯDrB^.ϯ%~'0۠/2>0AG_>0j0GCfE67>rB^}@  !&y+r?INp:erc b8f=rQC!~-Wf^^zF[)G 2ޯe7V_Go3Ke GEGOo8rώ#\1ZY~N6^H}yLxS-!:412V+u\-LSO?xVvZ|GjǮT_8EYJF=Tw^ 7GxfN/S:Ʌ~ʟtt?5n÷J'JcF-GVξx{rO~tJd;#a\7}|~y'>}c2C vR}f׈**h.)_&@pfzjsx:5;S\vKhM5j=!Cn+h"u]a EUN]jn=k<,:Ք>sU!ni~6EJ)¦72?G}[y}_vc$t?iSܟ2Zݞ,VN?_`='RFK1A2qv&X_lLRWY'%:I㢖zb_UEx\>&ɆBˏ~K@ \gYØU4}$8Dv!'Q'*+Εj(UCGo[#< 2Ja(sZi9fZKE Rn`u\9r^Zmɯ׹}mstO4uc~#'jEvۼ Dx[z ޏQ4KL5,5u3>i^uÒ-53ba ~,~/pyt1fMU'CVm:qv~=Y'Es"WsφG?l_kN5}],Ow7 uh`xƫ?zMl7ٻv$A(4Dl(wwH} ?=[=S;yC]^BK>㕪9`Z'Wj;E|:bf>kCԘ#RY,iv쵗~}n'"1u" *uO΄/2^Sxr(!/DD\~mJyZ!MmrA!#u[if|99WB WΡpp}w}sh#,\ &:%˳X?D3 %W0cC?o̲^} F3XLVn]Cߖiϧ!7}yZJ#P7]=)7Ρp;>> Ye^xx{Oafw{ ;>4gfLt ʊ:q%#r/)pv!O4wGh|dS ӣݽހ-gVUC'pBxrB^} 7JA^} /'8!`:r?}}],X  }6y!`/~Br?}Q< >k7vx"] ,' .3jn{-i}|~%-};b6#U)7繎kiEw 㤳:E}[޼c"rꬊ7Dc$~"/Y&zSd:tFȌCrʙ`7u .#[-<)j ?TGS(j~oTup(hjU4PlJ=}|it.ҽ@\wʨuXÞZcx18Wo<~ikOg,ވ\^?EneyZcc0[R١z|zv7_m:_n]a?osS3~j^ hD.a_X'KfBX6w wݶ"Oa:,bvhrWH[uCF-Xfc}>x+Rz)2N-B 7y^٨;[/vg? | |2Sve}=o䑰j[vWjF0{굦?VI~}xM(_TlG__+]:#к?S} c>GŸD7 !w{S{B =x7a?oE#)+Gz:o_4Q<;n?\tt7?mGCџQGu4kņOF>F?#} hP&ђߴM#u!.СtL2^#o nIk_i.~7tr@n 1P~3?.[]=S5b߮~Yo^HFH YBi8a4iom>CKgMy*;?zqEӕ` >zB9iFzC?XF?ޟIܰ펉A}{I5ᄊx%ez#Mp@rߎpi]IOVjzuJt\۰f׺u5><,J~PTJp1)}){9N {!`/> endstream endobj 12 0 obj << /Type /Annot /Subtype /Link /A 13 0 R /Border [0 0 0] /H /I /Rect [ 197.0117 675.3895 357.3317 687.2695 ] >> endobj 13 0 obj << /Type /Action /S /URI /URI (http://www.history.ac.uk/reviews) >> endobj 14 0 obj << /Type /Page /Parent 3 0 R /Annots [ 17 0 R 20 0 R 23 0 R ] /Contents 15 0 R >> endobj 15 0 obj << /Length 6615 >> stream 0.000 0.000 0.000 rg 0.502 0.502 0.502 RG 0.75 w 0 J [ ] 0 d BT 34.016 599.141 Td /F1 12.0 Tf [(The last decade has witnessed a flowering of interest in the history of women and cancer, alongside studies )] TJ ET BT 34.016 584.885 Td /F1 12.0 Tf [(on the history of cancer and related topics.)] TJ ET 0.000 0.000 0.800 rg BT 237.968 584.885 Td /F1 12.0 Tf [(\(1\))] TJ ET 0.000 0.000 0.800 RG 0.24 w 0 J [ ] 0 d 237.968 583.491 m 251.960 583.491 l S 0.000 0.000 0.000 rg BT 251.960 584.885 Td /F1 12.0 Tf [( While there might be historical trends that explain the )] TJ ET BT 34.016 570.629 Td /F1 12.0 Tf [(attention paid to certain topics in medical history at particular times, the literature on the history of cancer )] TJ ET BT 34.016 556.373 Td /F1 12.0 Tf [(deals with an inherently controversial disease, with historians themselves risking being caught up in the )] TJ ET BT 34.016 542.117 Td /F1 12.0 Tf [(controversy. Most diseases can be described as complex entities, but few of them can be defined as having a )] TJ ET BT 34.016 527.861 Td /F1 12.0 Tf [(pre-disease form that has itself become a separate entity, although one with diffused boundaries. The idea of )] TJ ET BT 34.016 513.605 Td /F1 12.0 Tf [(a pre-cancer stage, or the acknowledgement of the existence of pre-cancerous cells, dates back to the end of )] TJ ET BT 34.016 499.349 Td /F1 12.0 Tf [(the 19th century, yet achieving a clear identification of these cells and debating their potential to become )] TJ ET BT 34.016 485.093 Td /F1 12.0 Tf [(cancerous occupied the whole of the 20th century and, in many respects, diagnostic uncertainties persist in )] TJ ET BT 34.016 470.837 Td /F1 12.0 Tf [(today?s oncology. All three books under review attest to just how controversial the control of cancer and its )] TJ ET BT 34.016 456.581 Td /F1 12.0 Tf [(precursor stages have been, and in so doing, they provide an insightful historical perspective to current )] TJ ET BT 34.016 442.325 Td /F1 12.0 Tf [(policy debates. This is not a concerted effort to prove history?s utility, like that which historians are now )] TJ ET BT 34.016 428.069 Td /F1 12.0 Tf [(compelled to make to prove professional ?impact?, which may risk imbuing past events with improbable )] TJ ET BT 34.016 413.813 Td /F1 12.0 Tf [(connections to present problems. However, a historical account can challenge the ?selective? use of history )] TJ ET BT 34.016 399.557 Td /F1 12.0 Tf [(by policy makers, especially when they use past events as a powerful rationale to support programmes that )] TJ ET BT 34.016 385.301 Td /F1 12.0 Tf [(hold a formidable impact on health issues.)] TJ ET BT 34.016 359.045 Td /F1 12.0 Tf [(From international policy makers to health activists, the resort to historical events, as Anne-Emanuelle Birn )] TJ ET BT 34.016 344.789 Td /F1 12.0 Tf [(rightly affirms, is ?often selectively invoked ? to push forward particular agendas based on \(mis\)perceived )] TJ ET BT 34.016 330.533 Td /F1 12.0 Tf [(successes of the past?.)] TJ ET 0.000 0.000 0.800 rg BT 141.320 330.533 Td /F1 12.0 Tf [(\(2\))] TJ ET 0.24 w 0 J [ ] 0 d 141.320 329.139 m 155.312 329.139 l S 0.000 0.000 0.000 rg BT 155.312 330.533 Td /F1 12.0 Tf [( The role of health or medical historians is crucial in these cases as their )] TJ ET BT 34.016 316.277 Td /F1 12.0 Tf [(examination of medical and health interventions can question the validity of specific policies that have been )] TJ ET BT 34.016 302.021 Td /F1 12.0 Tf [(tailored on a distorted appreciation of past events. One of the most alluded-to examples is the ?successful? )] TJ ET BT 34.016 287.765 Td /F1 12.0 Tf [(smallpox eradication programme \(1980\), which today is often cited to support global health policies that )] TJ ET BT 34.016 273.509 Td /F1 12.0 Tf [(propose technical interventions \(vaccines, drugs, diagnostic tests, etc.\) as the best approach to deal with )] TJ ET BT 34.016 259.253 Td /F1 12.0 Tf [(countries? main diseases. As shown by Sanjoy Bhattacharya?s detailed analysis of smallpox in India, its )] TJ ET BT 34.016 244.997 Td /F1 12.0 Tf [(effective eradication has often glossed over the enormous complexities and diversity of actors involved in )] TJ ET BT 34.016 230.741 Td /F1 12.0 Tf [(the programme.)] TJ ET 0.000 0.000 0.800 rg BT 110.000 230.741 Td /F1 12.0 Tf [(\(3\))] TJ ET 0.24 w 0 J [ ] 0 d 110.000 229.347 m 123.992 229.347 l S 0.000 0.000 0.000 rg BT 123.992 230.741 Td /F1 12.0 Tf [( These studies suggest that a thorough assessment of past health initiatives could at most )] TJ ET BT 34.016 216.485 Td /F1 12.0 Tf [(assist global policy makers in a more comprehensive reading of what the past can teach, or at least alert them )] TJ ET BT 34.016 202.229 Td /F1 12.0 Tf [(of the existence of a less complacent story of previous health interventions.)] TJ ET BT 34.016 175.973 Td /F1 12.0 Tf [(By engaging with historical and contemporary analyses of female cancers, the books under review show the )] TJ ET BT 34.016 161.717 Td /F1 12.0 Tf [(value of rounded histories: they show that past health interventions need careful historical contextualisation )] TJ ET BT 34.016 147.461 Td /F1 12.0 Tf [(to be meaningful today and to be fully comprehensive. They also have an additional strength, that unlike )] TJ ET BT 34.016 133.205 Td /F1 12.0 Tf [(many disease-specific histories whose broader implications are sometimes difficult to deduce, cancer )] TJ ET BT 34.016 118.949 Td /F1 12.0 Tf [(appears here as a hub to explore and reflect on contemporary medical practices, policies and technologies, )] TJ ET BT 34.016 104.693 Td /F1 12.0 Tf [(and individuals and patients? groups. This opens up avenues for further enquiries, some of which will be )] TJ ET BT 34.016 90.437 Td /F1 12.0 Tf [(suggested in the next sections. )] TJ ET BT 34.016 64.181 Td /F1 12.0 Tf [( )] TJ ET BT 34.016 796.469 Td /F3 12.0 Tf [(Date of Publication:)] TJ ET BT 34.016 782.213 Td /F1 12.0 Tf [(2011)] TJ ET BT 34.016 767.957 Td /F3 12.0 Tf [(Price:)] TJ ET BT 34.016 753.701 Td /F1 12.0 Tf [(14.99)] TJ ET BT 34.016 739.445 Td /F3 12.0 Tf [(Pages:)] TJ ET BT 34.016 725.189 Td /F1 12.0 Tf [(240pp.)] TJ ET BT 34.016 710.933 Td /F3 12.0 Tf [(Publisher:)] TJ ET BT 34.016 696.677 Td /F1 12.0 Tf [(Oxford University Press)] TJ ET BT 34.016 682.421 Td /F3 12.0 Tf [(Publisher url:)] TJ ET BT 34.016 668.165 Td /F3 12.0 Tf [(Place of Publication:)] TJ ET BT 34.016 653.909 Td /F1 12.0 Tf [(Oxford)] TJ ET BT 34.016 639.653 Td /F3 12.0 Tf [(Reviewer:)] TJ ET BT 34.016 625.397 Td /F1 12.0 Tf [(Yolanda Eraso)] TJ ET endstream endobj 16 0 obj [14 0 R /Fit] endobj 17 0 obj << /Type /Annot /Subtype /Link /A 18 0 R /Border [0 0 0] /H /I /Rect [ 237.9677 583.8055 251.9597 595.6855 ] >> endobj 18 0 obj << /Type /Action >> endobj 19 0 obj [14 0 R /Fit] endobj 20 0 obj << /Type /Annot /Subtype /Link /A 21 0 R /Border [0 0 0] /H /I /Rect [ 141.3197 329.4535 155.3117 341.3335 ] >> endobj 21 0 obj << /Type /Action >> endobj 22 0 obj [14 0 R /Fit] endobj 23 0 obj << /Type /Annot /Subtype /Link /A 24 0 R /Border [0 0 0] /H /I /Rect [ 109.9997 229.6615 123.9917 241.5415 ] >> endobj 24 0 obj << /Type /Action >> endobj 25 0 obj << /Type /Page /Parent 3 0 R /Contents 26 0 R >> endobj 26 0 obj << /Length 7584 >> stream 0.000 0.000 0.000 rg 0.000 0.000 0.800 RG 0.24 w 0 J [ ] 0 d BT 34.016 784.469 Td /F3 12.0 Tf [(2. Uncertain entities, tentative diagnosis)] TJ ET BT 34.016 758.213 Td /F1 12.0 Tf [(All three works focus on female cancers; Bryder and Lwy \(2011\) exclusively on cervical cancer, and Lwy )] TJ ET BT 34.016 743.957 Td /F1 12.0 Tf [(\(2010\) on cervical and breast cancer. Beyond the most obvious biological reason that makes these diseases )] TJ ET BT 34.016 729.701 Td /F1 12.0 Tf [(?women?s cancers?, the authors provide historical and contemporary insights into how women?s )] TJ ET BT 34.016 715.445 Td /F1 12.0 Tf [(gynaecological tumours are metonyms for cancer in medical, social, and cultural terms. They also exemplify )] TJ ET BT 34.016 701.189 Td /F1 12.0 Tf [(how different women?s groups and feminist activists envisioned gynaecological cancers as a site of political )] TJ ET BT 34.016 686.933 Td /F1 12.0 Tf [(ownership, but one that has served to advance multiple and sometimes contesting aims, from specific public )] TJ ET BT 34.016 672.677 Td /F1 12.0 Tf [(health interventions and ascending career opportunities to a broader political agenda.)] TJ ET BT 34.016 646.421 Td /F2 12.0 Tf [(Women?s Bodies and Medical Science. An Inquiry into Cervical Cancer)] TJ ET BT 381.296 646.421 Td /F1 12.0 Tf [( examines the events that led to the )] TJ ET BT 34.016 632.165 Td /F1 12.0 Tf [(development of the 1987?8 Cartwright Inquiry in New Zealand, a government inquiry set up to investigate )] TJ ET BT 34.016 617.909 Td /F1 12.0 Tf [(the responsibility of a group of gynaecologists at the prestigious National Women?s Hospital \(NWH\) in )] TJ ET BT 34.016 603.653 Td /F1 12.0 Tf [(Auckland for the \(mis\)management of cervical cancer patients between the 1960s and the 1980s. Portrayed )] TJ ET BT 34.016 589.397 Td /F1 12.0 Tf [(by the press as ?the biggest medical scandal of the century?, the Inquiry was instigated by an article that )] TJ ET BT 34.016 575.141 Td /F1 12.0 Tf [(appeared in the magazine )] TJ ET BT 159.308 575.141 Td /F2 12.0 Tf [(Metro)] TJ ET BT 188.636 575.141 Td /F1 12.0 Tf [( \(1987\) co-written by feminist activist and journalist Sandra Coney and )] TJ ET BT 34.016 560.885 Td /F1 12.0 Tf [(sociologist Phillida Bunkle. They denounced what they thought was ?an unfortunate experiment? conducted )] TJ ET BT 34.016 546.629 Td /F1 12.0 Tf [(by Dr Herber Green at the NWH in 1966, who in his \(supposed\) attempt to study the natural course of )] TJ ET BT 34.016 532.373 Td /F1 12.0 Tf [(cervical cancer deliberately withheld conventional treatment in women diagnosed with early stages of the )] TJ ET BT 34.016 518.117 Td /F1 12.0 Tf [(disease [carcinoma in situ \(CIS\), or CIN3]. The expos was based on a 1984 medical study ? elaborated by )] TJ ET BT 34.016 503.861 Td /F1 12.0 Tf [(doctors in opposition to Green?s ideas who retrospectively followed 948 cases of CIS from 1955 to 1976. )] TJ ET BT 34.016 489.605 Td /F1 12.0 Tf [(The study concluded that those women treated by Green?s conservative approach which had two years of )] TJ ET BT 34.016 475.349 Td /F1 12.0 Tf [(positive Pap smears were 25 times more likely to develop invasive cancer than those treated by )] TJ ET BT 34.016 461.093 Td /F1 12.0 Tf [(hysterectomy and whose smear tests were negative. In these groups deaths were four and eight respectively )] TJ ET BT 34.016 446.837 Td /F1 12.0 Tf [(\(here I deleted text in brackets\), a rather low rate considering international statistics of the time. The aim of )] TJ ET BT 34.016 432.581 Td /F1 12.0 Tf [(the medical report was to provide evidence for a prompt surgical treatment of all )] TJ ET BT 423.932 432.581 Td /F2 12.0 Tf [(in situ)] TJ ET BT 453.608 432.581 Td /F1 12.0 Tf [( cancers as the )] TJ ET BT 34.016 418.325 Td /F1 12.0 Tf [(authors thought it had a considerable invasive potency. Yet the study had significant consequences when it )] TJ ET BT 34.016 404.069 Td /F1 12.0 Tf [(was reinterpreted by the )] TJ ET BT 152.648 404.069 Td /F2 12.0 Tf [(Metro)] TJ ET BT 181.976 404.069 Td /F1 12.0 Tf [( article and the Cartwright Inquiry as an ?experimental study? to ?differently )] TJ ET BT 34.016 389.813 Td /F1 12.0 Tf [(treat? women diagnosed with CIS. The latter was denied not only by Green but by the authors of the study )] TJ ET BT 34.016 375.557 Td /F1 12.0 Tf [(itself.)] TJ ET BT 34.016 349.301 Td /F1 12.0 Tf [(A core aim of Bryder?s book is to explain this misunderstanding. In Green?s conservative treatment of CIS, )] TJ ET BT 34.016 335.045 Td /F1 12.0 Tf [(there was no experiment, nor a division between two groups of patients that were treated differently in order )] TJ ET BT 34.016 320.789 Td /F1 12.0 Tf [(to prove a medical hypothesis or ?personal belief? about the nature of CIS. Beyond the controversies arising )] TJ ET BT 34.016 306.533 Td /F1 12.0 Tf [(in the 1980s from this specific group of patients, and the extended repercussions it had in ethical terms, one )] TJ ET BT 34.016 292.277 Td /F1 12.0 Tf [(of the elements that Bryder as a medical historian successfully contributes in her thorough reconstruction of )] TJ ET BT 34.016 278.021 Td /F1 12.0 Tf [(the case, is the historical context in which Green?s ideas were framed and developed. One allegation in the )] TJ ET BT 34.016 263.765 Td /F1 12.0 Tf [(Cartwright Inquiry was that Green and his colleagues at NWH were aware of and dismissive of a ?world )] TJ ET BT 34.016 249.509 Td /F1 12.0 Tf [(view that CIS was a precancerous condition? \(p. 26\). Bryder?s detailed research demonstrates that, on the )] TJ ET BT 34.016 235.253 Td /F1 12.0 Tf [(contrary, the Inquiry had ?inadvertently revealed a profession divided? \(p. 74\), because from the 1960s until )] TJ ET BT 34.016 220.997 Td /F1 12.0 Tf [(the 1980s there was no such thing as a ?universally accepted? or a ?world consensus? about the diagnosis or )] TJ ET BT 34.016 206.741 Td /F1 12.0 Tf [(the treatment of CIS. Throughout chapters one to six, the book provides a rich body of medical literature that )] TJ ET BT 34.016 192.485 Td /F1 12.0 Tf [(points to this disagreement within the medical profession, from pathologists and gynaecologists to )] TJ ET BT 34.016 178.229 Td /F1 12.0 Tf [(epidemiologists and cytologists, revealing a long-simmering controversy over the potential of CIS to become )] TJ ET BT 34.016 163.973 Td /F1 12.0 Tf [(invasive. Lwy?s books also elaborate extensively on the conundrums of identifying and legitimating a )] TJ ET BT 34.016 149.717 Td /F1 12.0 Tf [(specific pre-cancerous lesion of the cervix and the breast, thus confirming from a historigraphical point of )] TJ ET BT 34.016 135.461 Td /F1 12.0 Tf [(view that the quest for cancer diagnosis has provided an impetus for scholarly research on the history of this )] TJ ET BT 34.016 121.205 Td /F1 12.0 Tf [(disease, and constituting indispensable reference works for every scholar of the subject.)] TJ ET BT 34.016 94.949 Td /F1 12.0 Tf [(At an international level, discrepancies about CIS were on three significant levels, a\) on diagnosing )] TJ ET BT 34.016 80.693 Td /F1 12.0 Tf [(\(classifying\) intraepithelial lesions of the cervix into a series of borderline categories \(mild, intermediate, or )] TJ ET BT 34.016 66.437 Td /F1 12.0 Tf [(severe dysplasia, and CIS\); b\) the prognosis from CIS to invasive cancer; and c\) the management of CIS )] TJ ET BT 34.016 52.181 Td /F1 12.0 Tf [(lesions. An eminent American pathologist, Leopold Koss, made a legendary comment in 1979 that )] TJ ET endstream endobj 27 0 obj << /Type /Page /Parent 3 0 R /Contents 28 0 R >> endobj 28 0 obj << /Length 7548 >> stream 0.000 0.000 0.000 rg 0.000 0.000 0.800 RG 0.24 w 0 J [ ] 0 d BT 34.016 796.469 Td /F1 12.0 Tf [(summarises the differences observed amongst pathologists when assessing abnormal lesions of the cervix: )] TJ ET BT 34.016 782.213 Td /F1 12.0 Tf [(?one man?s dysplasia is another man?s carcinoma )] TJ ET BT 277.628 782.213 Td /F2 12.0 Tf [(in situ)] TJ ET BT 307.304 782.213 Td /F1 12.0 Tf [(? \(p. 75\). Long-term follow-up studies of women )] TJ ET BT 34.016 767.957 Td /F1 12.0 Tf [(with )] TJ ET BT 58.352 767.957 Td /F2 12.0 Tf [(in situ)] TJ ET BT 88.028 767.957 Td /F1 12.0 Tf [( cancers that were not treated but under careful observation returned inconclusive responses as to )] TJ ET BT 34.016 753.701 Td /F1 12.0 Tf [(the natural course of the disease: In one study conducted in Denmark \(1955\) 35 per cent of women )] TJ ET BT 34.016 739.445 Td /F1 12.0 Tf [(developed invasive cancer, leading the author to consider CIS as slow-evolving disease, for which )] TJ ET BT 34.016 725.189 Td /F1 12.0 Tf [(immediate treatment was not necessary. Another 1963 American study considered that in 25 per cent of )] TJ ET BT 34.016 710.933 Td /F1 12.0 Tf [(cases the lesion disappeared, while in 6 per cent of cases it developed into invasive cancer. Yet in the latter )] TJ ET BT 34.016 696.677 Td /F1 12.0 Tf [(the performed biopsy was thought to be an important cause for the lesion?s disappearance thus suggesting )] TJ ET BT 34.016 682.421 Td /F1 12.0 Tf [(that a minor intervention could be sufficient to deal with this type of cervical lesions. This view was shared )] TJ ET BT 34.016 668.165 Td /F1 12.0 Tf [(by Green when he proposed a protocol to treat women with CIS by ?lesser procedures? which included )] TJ ET BT 34.016 653.909 Td /F1 12.0 Tf [(follow up with Pap smears, colposcopy and punch biopsy, that is, a lesser surgical excision than the most )] TJ ET BT 34.016 639.653 Td /F1 12.0 Tf [(common cone biopsy, which had a higher associated morbidity. )] TJ ET BT 34.016 613.397 Td /F1 12.0 Tf [(Although in the 1950s and 1960s many doctors took a radical approach by treating CIS with hysterectomy, )] TJ ET BT 34.016 599.141 Td /F1 12.0 Tf [(the idea was far from being ubiquitous. Bryder?s analysis focuses mainly in the literature that circulated in )] TJ ET BT 34.016 584.885 Td /F1 12.0 Tf [(the Anglo-Saxon world to support this view. What strikes this reviewer as being less evident, is not the )] TJ ET BT 34.016 570.629 Td /F1 12.0 Tf [(conservative treatment and follow up in itself, but the use of colposcopy as a diagnostic tool, a technique that )] TJ ET BT 34.016 556.373 Td /F1 12.0 Tf [(in Anglo-Saxon countries was far less widespread at the time. Increasing attention to CIS and dysplasia was )] TJ ET BT 34.016 542.117 Td /F1 12.0 Tf [(due to the dissemination of diagnostic tools for the early detection of cervical cancer. The Pap smear test was )] TJ ET BT 34.016 527.861 Td /F1 12.0 Tf [(heavily promoted by the American Cancer Society from 1945, and its rapid internationalisation was secured )] TJ ET BT 34.016 513.605 Td /F1 12.0 Tf [(by training programmes for foreign doctors alongside the availability of American grants. Parallel to the )] TJ ET BT 34.016 499.349 Td /F1 12.0 Tf [(growing enthusiasm for the Pap test, another diagnostic technique, colposcopy, was being disseminated in )] TJ ET BT 34.016 485.093 Td /F1 12.0 Tf [(South America. Both diagnostic tools aimed at detecting cancer of the cervix in its early stages, but they )] TJ ET BT 34.016 470.837 Td /F1 12.0 Tf [(differed greatly in the way they were performed, the people involved, and the skills required, all of which )] TJ ET BT 34.016 456.581 Td /F1 12.0 Tf [(induced a different management of the disease. By the mid 1950s, in parts of Germany, Austria, Switzerland, )] TJ ET BT 34.016 442.325 Td /F1 12.0 Tf [(Brazil and Argentina, colposcopy became routinely used in gynaecological clinics, while in the main )] TJ ET BT 34.016 428.069 Td /F1 12.0 Tf [(European and United States centres the Pap test was the preferred tool. Interestingly enough, since the 1950s )] TJ ET BT 34.016 413.813 Td /F1 12.0 Tf [(onwards, what we see in those countries that adopted colposcopy is a conservative treatment of CIS. Follow )] TJ ET BT 34.016 399.557 Td /F1 12.0 Tf [(up using the colposcope alongside a rigorous histopathological analysis of the removed tissue, gave )] TJ ET BT 34.016 385.301 Td /F1 12.0 Tf [(gynaecologists trained in colposcopy a confidence in the management of CIS that the Pap test alone lacked. )] TJ ET BT 34.016 371.045 Td /F1 12.0 Tf [(In times of uncertainty about the diagnosis of CIS, those who became familiar with the colposcope thought )] TJ ET BT 34.016 356.789 Td /F1 12.0 Tf [(that they had a safer scientific instrument for monitoring the status of those ambiguous cells, in most cases )] TJ ET BT 34.016 342.533 Td /F1 12.0 Tf [(with the added reassurance of a Pap test. Those who thought that colposcopy training was too demanding )] TJ ET BT 34.016 328.277 Td /F1 12.0 Tf [(and time-consuming relied on the simplicity and growing popularity of the Pap test, and managed the )] TJ ET BT 34.016 314.021 Td /F1 12.0 Tf [(disease following the cytologist?s dictum. In the case of the NWH, Bryder notes that there existed )] TJ ET BT 34.016 299.765 Td /F1 12.0 Tf [(personality clashes and strong rivalries between the pathologist, and crucially the colposcopist, and Dr Green )] TJ ET BT 34.016 285.509 Td /F1 12.0 Tf [(who was leading the treatment. It seems there existed a division in the work of diagnosis that simply did not )] TJ ET BT 34.016 271.253 Td /F1 12.0 Tf [(work. For historians interested in medical technologies and their competitive introduction into hospital )] TJ ET BT 34.016 256.997 Td /F1 12.0 Tf [(services, as in this case with the Pap test and colposcopy, a focus on personal disputes may fall short as an )] TJ ET BT 34.016 242.741 Td /F1 12.0 Tf [(explanation. From this perspective, Bryder leaves one wondering if the aura of hope, confidence and )] TJ ET BT 34.016 228.485 Td /F1 12.0 Tf [(technical zeal that colposcopy inculcated in its users in other parts of the world would apply too to its )] TJ ET BT 34.016 214.229 Td /F1 12.0 Tf [(adoption in New Zealand, and if so, whether that was a triggering factor for the controversies that followed )] TJ ET BT 34.016 199.973 Td /F1 12.0 Tf [(or something that precipitated a pre-existent awkward scenario \(that is, divided diagnostic labour and )] TJ ET BT 34.016 185.717 Td /F1 12.0 Tf [(personal rivalries\).)] TJ ET BT 34.016 159.461 Td /F1 12.0 Tf [()] TJ ET BT 34.016 133.205 Td /F3 12.0 Tf [(3. Women and cancer )] TJ ET BT 34.016 106.949 Td /F1 12.0 Tf [(As Bryder documents, the perception that Green experimented on women?s bodies was all-pervasive after )] TJ ET BT 34.016 92.693 Td /F1 12.0 Tf [(the )] TJ ET BT 51.680 92.693 Td /F2 12.0 Tf [(Metro)] TJ ET BT 81.008 92.693 Td /F1 12.0 Tf [( publication and was judged against somewhat extemporaneous notions of medical ethics, patient?s )] TJ ET BT 34.016 78.437 Td /F1 12.0 Tf [(informed choice, and doctor-patient relationships which she analyses in chapter four. These notions were )] TJ ET BT 34.016 64.181 Td /F1 12.0 Tf [(increasingly debated from the 1970s, which saw the rise of the international consumer movement, driven by )] TJ ET BT 34.016 49.925 Td /F1 12.0 Tf [(patient groups and women?s health activists, and paved the way for the figure of the patient-consumer. In )] TJ ET endstream endobj 29 0 obj << /Type /Page /Parent 3 0 R /Annots [ 32 0 R 35 0 R ] /Contents 30 0 R >> endobj 30 0 obj << /Length 8201 >> stream 0.000 0.000 0.000 rg 0.000 0.000 0.800 RG 0.24 w 0 J [ ] 0 d BT 34.016 796.469 Td /F1 12.0 Tf [(addition to the investigation of the alleged ill-treatment of carcinoma )] TJ ET BT 367.976 796.469 Td /F2 12.0 Tf [(in situ)] TJ ET BT 397.652 796.469 Td /F1 12.0 Tf [(, several aspects were included )] TJ ET BT 34.016 782.213 Td /F1 12.0 Tf [(in the terms of reference of the Inquiry, namely, the protection of patient rights in any research conducted at )] TJ ET BT 34.016 767.957 Td /F1 12.0 Tf [(the NWH, patient information about treatment options, the training and teaching of medical students about )] TJ ET BT 34.016 753.701 Td /F1 12.0 Tf [(CIS, doctors? perspectives on cervical cancer screening, and vaginal examinations on anesthetised women )] TJ ET BT 34.016 739.445 Td /F1 12.0 Tf [(without consent. These are analysed in chapter eight. The broadening of issues thus discussed at the Inquiry, )] TJ ET BT 34.016 725.189 Td /F1 12.0 Tf [(according to Bryder, ?suited the feminist lobby who saw it as a unique opportunity to canvass those issues )] TJ ET BT 34.016 710.933 Td /F1 12.0 Tf [(relating to women?s health for which they had been campaigning and about which they felt so passionate? )] TJ ET BT 34.016 696.677 Td /F1 12.0 Tf [(\(p. 127\). The report concluded that the medical profession had failed patients, and many important )] TJ ET BT 34.016 682.421 Td /F1 12.0 Tf [(recommendations were subsequently implemented, most notably patient advocacy and a national screening )] TJ ET BT 34.016 668.165 Td /F1 12.0 Tf [(programme for cervical cancer. In relation to the former, it is instructive to see certain developments that )] TJ ET BT 34.016 653.909 Td /F1 12.0 Tf [(took place at the time in the UK, a comparison maintained elsewhere by the book given New Zealand?s )] TJ ET BT 34.016 639.653 Td /F1 12.0 Tf [(close relationship and integration within British medical professional bodies. While in the 1980s patient )] TJ ET BT 34.016 625.397 Td /F1 12.0 Tf [(consumer groups in the UK campaigned for more information about health services and disease prognosis, )] TJ ET BT 34.016 611.141 Td /F1 12.0 Tf [(in order to become active partners in their own treatment, statutory acknowledgement was not )] TJ ET BT 34.016 596.885 Td /F1 12.0 Tf [(straightforward. When the )] TJ ET BT 163.316 596.885 Td /F2 12.0 Tf [(Patient?s Charter)] TJ ET BT 249.656 596.885 Td /F1 12.0 Tf [( was sanctioned by the UK government in 1991, it reflected less )] TJ ET BT 34.016 582.629 Td /F1 12.0 Tf [(the principles of patient?s rights and choice as a collective group and more the figure of the patient as an )] TJ ET BT 34.016 568.373 Td /F1 12.0 Tf [(individual consumer of health services within the internal market introduced by the Conservative )] TJ ET BT 34.016 554.117 Td /F1 12.0 Tf [(government. As explained by Alex Mold, both the changing nature of the concept of the patient-consumer )] TJ ET BT 34.016 539.861 Td /F1 12.0 Tf [(and the different groups that historically have represented them should ?raise doubts about any authority that )] TJ ET BT 34.016 525.605 Td /F1 12.0 Tf [(claims to know what patient-consumers ?really? want?.)] TJ ET 0.000 0.000 0.800 rg BT 300.296 525.605 Td /F1 12.0 Tf [(\(4\))] TJ ET 0.24 w 0 J [ ] 0 d 300.296 524.211 m 314.288 524.211 l S 0.000 0.000 0.000 rg BT 314.288 525.605 Td /F1 12.0 Tf [( Bryder paints a similar picture in New Zealand, )] TJ ET BT 34.016 511.349 Td /F1 12.0 Tf [(when she argues that the different feminist groups that supported the Inquiry did not represent all women?s )] TJ ET BT 34.016 497.093 Td /F1 12.0 Tf [(voices in relation to the services provided at NWH or to Green?s treatment, nor were unified views the ones )] TJ ET BT 34.016 482.837 Td /F1 12.0 Tf [(offered by organisations representing nurses and Maori women. While in chapter seven Bryder frames the )] TJ ET BT 34.016 468.581 Td /F1 12.0 Tf [(demands of Coney and Bunkle as part of a longstanding battle of feminist health activists against male )] TJ ET BT 34.016 454.325 Td /F1 12.0 Tf [(dominance at NWH, rather more consideration about the development of other patient groups acting in New )] TJ ET BT 34.016 440.069 Td /F1 12.0 Tf [(Zealand, beyond women?s hospitals, would have been welcomed, as would greater reflection on the extent )] TJ ET BT 34.016 425.813 Td /F1 12.0 Tf [(to which the patient-consumer was shaped by the Cartwright report alone.)] TJ ET BT 34.016 399.557 Td /F1 12.0 Tf [(The implementation of a national screening programme in 1990 was another measure celebrated as a direct )] TJ ET BT 34.016 385.301 Td /F1 12.0 Tf [(result of the Inquiry, but this is too subject to historical scrutiny. On the one hand, Bryder argues, New )] TJ ET BT 34.016 371.045 Td /F1 12.0 Tf [(Zealand?s Health Department had been planning the implementation of screening programmes before the )] TJ ET BT 34.016 356.789 Td /F1 12.0 Tf [(Inquiry, and on the other, discussions of the pros and cons of Pap smear screening \(discussed in particular in )] TJ ET BT 34.016 342.533 Td /F1 12.0 Tf [(chapter six\), and to which Lwy \(2011\) too offers a rich international literature, were concealed at the time )] TJ ET BT 34.016 328.277 Td /F1 12.0 Tf [(due to feminists? portrayal of any questioning of screening as being against women?s interests. In addition, )] TJ ET BT 34.016 314.021 Td /F1 12.0 Tf [(feminist views in the late 1980s of screening programmes were not uniform. Many viewed it as a )] TJ ET BT 34.016 299.765 Td /F1 12.0 Tf [(paternalistic medical intervention, which ignored women?s choice and championed the lab?s commercial )] TJ ET BT 34.016 285.509 Td /F1 12.0 Tf [(interests over the physical and emotional effects of the test in women; other groups, as in the case of New )] TJ ET BT 34.016 271.253 Td /F1 12.0 Tf [(Zealand, embraced it as a woman?s right, and blamed an already under fire male medical profession for its )] TJ ET BT 34.016 256.997 Td /F1 12.0 Tf [(lack of sensitivity towards the prevention of the disease. It is true, however, that at that time, cervical cancer )] TJ ET BT 34.016 242.741 Td /F1 12.0 Tf [(was not perceived as a woman?s scourge because of the persistent decline of morbidity and mortality rates in )] TJ ET BT 34.016 228.485 Td /F1 12.0 Tf [(Western societies. Unlike breast cancer, which remained high in the statistics of industrialised countries and )] TJ ET BT 34.016 214.229 Td /F1 12.0 Tf [(led to the formation of powerful women?s movements in the 1990s, cervical cancer plausibly lacked )] TJ ET BT 34.016 199.973 Td /F1 12.0 Tf [(representativeness, but with it too, it obscured debates around pre-cancer management \(screening and )] TJ ET BT 34.016 185.717 Td /F1 12.0 Tf [(treatment\) and its likely outcomes: discomfort during the test, anxiety, preterm birth, and loss of quality of )] TJ ET BT 34.016 171.461 Td /F1 12.0 Tf [(life.)] TJ ET BT 34.016 145.205 Td /F1 12.0 Tf [(In recent years, the consolidation of consumer groups and the incorporation of guidelines directing clinicians )] TJ ET BT 34.016 130.949 Td /F1 12.0 Tf [(to involve the patient?s decision in their care, alongside studies on women?s preferences and perspectives in )] TJ ET BT 34.016 116.693 Td /F1 12.0 Tf [(breast cancer screening have promoted awareness on the importance of incorporating the patient?s view in )] TJ ET BT 34.016 102.437 Td /F1 12.0 Tf [(the evaluation of screening programmes.)] TJ ET 0.000 0.000 0.800 rg BT 229.640 102.437 Td /F1 12.0 Tf [(\(5\))] TJ ET 0.24 w 0 J [ ] 0 d 229.640 101.043 m 243.632 101.043 l S 0.000 0.000 0.000 rg BT 243.632 102.437 Td /F1 12.0 Tf [( Surprisingly, this has such a short history thus far that to unravel )] TJ ET BT 34.016 88.181 Td /F1 12.0 Tf [(its implications in a comprehensive way is still a task for historians in the future. The issue of informed )] TJ ET BT 34.016 73.925 Td /F1 12.0 Tf [(consent for screening \(providing patients with information about both benefits and potential harms\) is being )] TJ ET BT 34.016 59.669 Td /F1 12.0 Tf [(discussed in some industrialised countries and subject to contested views. Since 2009, women can express in )] TJ ET endstream endobj 31 0 obj [29 0 R /Fit] endobj 32 0 obj << /Type /Annot /Subtype /Link /A 33 0 R /Border [0 0 0] /H /I /Rect [ 300.2957 524.5255 314.2877 536.4055 ] >> endobj 33 0 obj << /Type /Action >> endobj 34 0 obj [29 0 R /Fit] endobj 35 0 obj << /Type /Annot /Subtype /Link /A 36 0 R /Border [0 0 0] /H /I /Rect [ 229.6397 101.3575 243.6317 113.2375 ] >> endobj 36 0 obj << /Type /Action >> endobj 37 0 obj << /Type /Page /Parent 3 0 R /Contents 38 0 R >> endobj 38 0 obj << /Length 7325 >> stream 0.000 0.000 0.000 rg 0.000 0.000 0.800 RG 0.24 w 0 J [ ] 0 d BT 34.016 796.469 Td /F1 12.0 Tf [(writing ?informed dissent?, in order to withdraw from cancer screening programmes in the UK, and it is )] TJ ET BT 34.016 782.213 Td /F1 12.0 Tf [(possible that other countries will follow suit and mandate balanced information available to patients.)] TJ ET BT 34.016 755.957 Td /F1 12.0 Tf [(The last two chapters of )] TJ ET BT 152.324 755.957 Td /F2 12.0 Tf [(Women?s Bodies and Medical Science)] TJ ET BT 337.616 755.957 Td /F1 12.0 Tf [( foreground the implementation of the )] TJ ET BT 34.016 741.701 Td /F1 12.0 Tf [(Cartwright Inquiry and the enduring impact this exemplary case had, and still has, for the protagonists and )] TJ ET BT 34.016 727.445 Td /F1 12.0 Tf [(the medical profession more broadly. Both chapters demonstrate that the relationship between consumerism, )] TJ ET BT 34.016 713.189 Td /F1 12.0 Tf [(women?s health movements and the medical profession can enhance, as well as detract from more )] TJ ET BT 34.016 698.933 Td /F1 12.0 Tf [(conventional patient-doctor relationships. Polarized attitudes, as analysed by the book, namely, a complete )] TJ ET BT 34.016 684.677 Td /F1 12.0 Tf [(mistrust of the medical profession, or a blind confidence in medicine and technology, increase the difficulty )] TJ ET BT 34.016 670.421 Td /F1 12.0 Tf [(of elaborating a constructive, balanced and rounded critique of medical interventions and health care )] TJ ET BT 34.016 656.165 Td /F1 12.0 Tf [(practices, but, as Bryder?s account shows, they do not render it impossible.)] TJ ET BT 34.016 629.909 Td /F1 12.0 Tf [()] TJ ET BT 34.016 603.653 Td /F3 12.0 Tf [(4. Breast cancer genetics: from family to ethnicity)] TJ ET BT 34.016 577.397 Td /F1 12.0 Tf [(The analysis of the notion of CIS and borderline lesions that troubled pathologists, cytologists and )] TJ ET BT 34.016 563.141 Td /F1 12.0 Tf [(gynaecologists constitutes the core theme of Ilana Lwy?s book )] TJ ET BT 344.300 563.141 Td /F2 12.0 Tf [(Preventive Strikes. Women, Precancer, and )] TJ ET BT 34.016 548.885 Td /F2 12.0 Tf [(Prophylactic Surgery)] TJ ET BT 137.000 548.885 Td /F1 12.0 Tf [(. She offers a holistic and formidable account of pre-cancer in comparative perspective, )] TJ ET BT 34.016 534.629 Td /F1 12.0 Tf [(including Britain, USA and France. Her register is less an illustration of different approaches and more a )] TJ ET BT 34.016 520.373 Td /F1 12.0 Tf [(reflection on the local basis of a presupposed universality of medical knowledge and its hegemonic claims. )] TJ ET BT 34.016 506.117 Td /F1 12.0 Tf [(?Medical cultures vary as least as much as national cultures do? \(p. 35\), she anticipates. In her study of )] TJ ET BT 34.016 491.861 Td /F1 12.0 Tf [(cervical cancer, French gynaecologists, for example, appeared less prone to perform hysterectomies in cases )] TJ ET BT 34.016 477.605 Td /F1 12.0 Tf [(of CIS, because the sterilisation of fertile women was not a welcome idea in a country that endorsed pro-)] TJ ET BT 34.016 463.349 Td /F1 12.0 Tf [(natalist polices. The development of X-ray and curietherapy technology in the Radium Institute of Paris, )] TJ ET BT 34.016 449.093 Td /F1 12.0 Tf [(which soon became a world renowned specialised institute, provided radiologists with a share in the )] TJ ET BT 34.016 434.837 Td /F1 12.0 Tf [(treatment of cancer which largely differed from the surgical-oriented management observed in the US. In )] TJ ET BT 34.016 420.581 Td /F1 12.0 Tf [(France, the combination of therapy \(surgery and radiotherapy\) led specialists on occasions to perform )] TJ ET BT 34.016 406.325 Td /F1 12.0 Tf [(radiotherapy as the treatment of preference, especially for cervical cancer, which unlike breast cancer, )] TJ ET BT 34.016 392.069 Td /F1 12.0 Tf [(proved to be highly radiosensitive.)] TJ ET BT 34.016 365.813 Td /F1 12.0 Tf [(In this volume Lwy introduces a very detailed analysis of cervical and mainly breast cancer, their changing )] TJ ET BT 34.016 351.557 Td /F1 12.0 Tf [(histological notions, their modus of detection and treatment. Chapters one and two trace the definition of )] TJ ET BT 34.016 337.301 Td /F1 12.0 Tf [(premalignant lesions by pathologists and with them the notion of cancer as a disease of transformed cells )] TJ ET BT 34.016 323.045 Td /F1 12.0 Tf [(and tissues, that spurred in turn the dogma of ?early detection?. Radical surgical treatments, which also )] TJ ET BT 34.016 308.789 Td /F1 12.0 Tf [(pervaded the field of breast cancer diagnosis when mastectomy was performed as a diagnostic technique )] TJ ET BT 34.016 294.533 Td /F1 12.0 Tf [(\(chapter three\), corresponded to an era that conceived cancer as a localised disease that later expanded, )] TJ ET BT 34.016 280.277 Td /F1 12.0 Tf [(invading distant organs. The generalisation of the notion of )] TJ ET BT 321.320 280.277 Td /F2 12.0 Tf [(in situ)] TJ ET BT 350.996 280.277 Td /F1 12.0 Tf [( cancers discussed in chapter four )] TJ ET BT 34.016 266.021 Td /F1 12.0 Tf [(highlights the different approaches that informed treatment: while in the case of cervical cancer )] TJ ET BT 34.016 251.765 Td /F1 12.0 Tf [(hysterectomy was gradually abandoned in favour of conservative methods, )] TJ ET BT 396.608 251.765 Td /F2 12.0 Tf [(in situ)] TJ ET BT 426.284 251.765 Td /F1 12.0 Tf [( breast cancers continued )] TJ ET BT 34.016 237.509 Td /F1 12.0 Tf [(to be treated with radical interventions \(mastectomies\) well on until the 1980s. The role of screening )] TJ ET BT 34.016 223.253 Td /F1 12.0 Tf [(methods such us the Pap test led to an increase in overtreatment which both transformed the meaning of the )] TJ ET BT 34.016 208.997 Td /F1 12.0 Tf [(test, from diagnosing cancer, to a pre-diagnostic test that indicates the existence of cell abnormalities, whose )] TJ ET BT 34.016 194.741 Td /F1 12.0 Tf [(extirpation concealed in turn the need to establish an accurate diagnosis. These aspects alongside the )] TJ ET BT 34.016 180.485 Td /F1 12.0 Tf [(development of screening campaigns are the subject of chapters five and six, which also introduce the use of )] TJ ET BT 34.016 166.229 Td /F1 12.0 Tf [(mammography screening alongside the controversies arising from the setting up of programmes at )] TJ ET BT 34.016 151.973 Td /F1 12.0 Tf [(population level. Emphasis on the latter leads the author to a broader discussion of screening extending the )] TJ ET BT 34.016 137.717 Td /F1 12.0 Tf [(analysis to three other cancers \(prostate, lung, and colon\), which appears as a departure from the focus of the )] TJ ET BT 34.016 123.461 Td /F1 12.0 Tf [(book. The section on mammography, on the other hand, offers little discussion in terms of what the )] TJ ET BT 34.016 109.205 Td /F1 12.0 Tf [(technology, as a diagnostic tool, was introducing, and in terms of the novel cancer notions radiologists )] TJ ET BT 34.016 94.949 Td /F1 12.0 Tf [(incorporated as they entered into the field of cancer diagnosis.)] TJ ET BT 34.016 68.693 Td /F1 12.0 Tf [(Overall Lowy?s well-selected case notes extracted from pathology records of different hospitals in the US, )] TJ ET BT 34.016 54.437 Td /F1 12.0 Tf [(UK and France add depth and detail to a history that has been reconstructed at a national level, most )] TJ ET endstream endobj 39 0 obj << /Type /Page /Parent 3 0 R /Annots [ 42 0 R ] /Contents 40 0 R >> endobj 40 0 obj << /Length 7606 >> stream 0.000 0.000 0.000 rg 0.000 0.000 0.800 RG 0.24 w 0 J [ ] 0 d BT 34.016 796.469 Td /F1 12.0 Tf [(successfully by Barron Lerner \(2001\) and Robert Aronowitz \(2007\) in the case of the US. Her attention to )] TJ ET BT 34.016 782.213 Td /F1 12.0 Tf [(local variations allows Lwy to formulate a critical and more nuanced perspective on the foundations of )] TJ ET BT 34.016 767.957 Td /F1 12.0 Tf [(cancer diagnosis. Yet variations in diagnosis, and the divergent ways in which pathologists working in )] TJ ET BT 34.016 753.701 Td /F1 12.0 Tf [(different settings have correlated breast lesions with a prediction of their malignancy, it is only part of the )] TJ ET BT 34.016 739.445 Td /F1 12.0 Tf [(story. There were also the series of strategies that have variously attempted to curb a breast cancer death toll )] TJ ET BT 34.016 725.189 Td /F1 12.0 Tf [(that for decades has remained stubbornly high, but not without consequences for those who became )] TJ ET BT 34.016 710.933 Td /F1 12.0 Tf [(survivors of the disease. ?Preventive strikes? could be read as a series of reactions/responses to the fear of a )] TJ ET BT 34.016 696.677 Td /F1 12.0 Tf [(devastating disease whose course and exact development could not be anticipated accurately even in the era )] TJ ET BT 34.016 682.421 Td /F1 12.0 Tf [(of evidence-based medicine. In case of doubt, doctors often stated: ?we cut it out? or ?burn it out?, or it is )] TJ ET BT 34.016 668.165 Td /F1 12.0 Tf [(?better to err on the side of caution?. These ideas underpinned the professional attitudes that somehow )] TJ ET BT 34.016 653.909 Td /F1 12.0 Tf [(entered in the deontology of medical practice unsettling the balance of decision making: it presupposed )] TJ ET BT 34.016 639.653 Td /F1 12.0 Tf [(medical intervention as radical ?action? as opposed to conservative treatment and follow up as ?neglation?. )] TJ ET BT 34.016 625.397 Td /F1 12.0 Tf [(This is not to say that conservative treatment and watchful care of cancer patients did not exist as an )] TJ ET BT 34.016 611.141 Td /F1 12.0 Tf [(acceptable treatment at particular points in time. It is simply that the latter, as demonstrated by the case of )] TJ ET BT 34.016 596.885 Td /F1 12.0 Tf [(the NWH in New Zealand, was far more questioned than the former. The idea of agency behind an )] TJ ET BT 34.016 582.629 Td /F1 12.0 Tf [(anticipated response to an unexpected outcome of the disease has engulfed patients too, who were also )] TJ ET BT 34.016 568.373 Td /F1 12.0 Tf [(induced to develop ?preventive strikes? to tame risk. This is more clearly revealed in the last two chapters of )] TJ ET BT 34.016 554.117 Td /F1 12.0 Tf [(the book through a focus on the developments of oncogenetics in the 1980s and 1990s, which transformed )] TJ ET BT 34.016 539.861 Td /F1 12.0 Tf [(the hereditary suspicion of breast cancer from a disease that ran in the family to an identified localised gen )] TJ ET BT 34.016 525.605 Td /F1 12.0 Tf [(mutation: BRCA \(1\) and \(2\). Women carriers of these mutations have a higher than average risk of )] TJ ET BT 34.016 511.349 Td /F1 12.0 Tf [(developing a tumour early in life, bilateral tumours and ovarian cancer. BRCA-positive women are )] TJ ET BT 34.016 497.093 Td /F1 12.0 Tf [(encouraged to undergo prophylactic surgery \(bilateral mastectomies, ovariectomy\) or to live a life of )] TJ ET BT 34.016 482.837 Td /F1 12.0 Tf [(constant follow up tests \(mammography\) and above all, live with the threat and anxiety about the ?higher )] TJ ET BT 34.016 468.581 Td /F1 12.0 Tf [(than average? appearance of the disease. Their prospectus does not differ much from those diagnosed with )] TJ ET BT 34.016 454.325 Td /F1 12.0 Tf [(CIS, as Lwy puts it, they:)] TJ ET BT 34.016 428.069 Td /F1 12.0 Tf [(?enter a limbo between health and disease \(becoming a ?healthy ill?\), which change the way they feel about )] TJ ET BT 34.016 413.813 Td /F1 12.0 Tf [(their dangerous body parts \(?living with a ticking time bomb?\), and lead to a split between the self and the )] TJ ET BT 34.016 399.557 Td /F1 12.0 Tf [(treacherous part of the body? \(p. 4\).)] TJ ET BT 34.016 373.301 Td /F1 12.0 Tf [(Despite the standardisation of genetic tests, ?the meaning of hereditary risk of breast cancer risk is shaped )] TJ ET BT 34.016 359.045 Td /F1 12.0 Tf [(locally? \(p. 181\), Lwy argues, depending on the organisation of health services, the existence or not of a )] TJ ET BT 34.016 344.789 Td /F1 12.0 Tf [(universal healthcare system, intellectual property rules, and the broader configurations of cancer )] TJ ET BT 34.016 330.533 Td /F1 12.0 Tf [(management in particular places. The discovery that women of Ashkenazi Jewish origin had a higher )] TJ ET BT 34.016 316.277 Td /F1 12.0 Tf [(incidence of a specific mutation of BRCA led, however, to different approaches about the role of ethnicity in )] TJ ET BT 34.016 302.021 Td /F1 12.0 Tf [(medical testing. In the US, home to the first laboratory that patented the BRCA genes and subsequently its )] TJ ET BT 34.016 287.765 Td /F1 12.0 Tf [(test, the combination of an aggressive testing campaign ? initiated by the laboratory which also offered a )] TJ ET BT 34.016 273.509 Td /F1 12.0 Tf [(cheaper test to scrutinise Ashkenazi mutations in Jewish women ? is coupled with a perceived anxiety within )] TJ ET BT 34.016 259.253 Td /F1 12.0 Tf [(this community about the predisposition to certain diseases. Thus, medical intervention counted on the )] TJ ET BT 34.016 244.997 Td /F1 12.0 Tf [(support of the Jewish community and health groups that embraced a screening culture for breast cancer )] TJ ET BT 34.016 230.741 Td /F1 12.0 Tf [(grounded in their ethnic traits. By contrast, in France, ethnicity does not feature as an independent category )] TJ ET BT 34.016 216.485 Td /F1 12.0 Tf [(in risk assessment, and \(any\) woman with a strong family history of breast cancer can be deferred to a cancer )] TJ ET BT 34.016 202.229 Td /F1 12.0 Tf [(genetic service for a test. A similar pattern is followed in the UK.)] TJ ET BT 34.016 175.973 Td /F1 12.0 Tf [(The persistence of the association of breast cancer genes with ethnic groups in the US, however, points to )] TJ ET BT 34.016 161.717 Td /F1 12.0 Tf [(further directions making the one analysed by Lwy and the Jewish community merely a start. Observation )] TJ ET BT 34.016 147.461 Td /F1 12.0 Tf [(that Hispanic-Latino women in the US have a higher mortality rate compared to white women, led to )] TJ ET BT 34.016 133.205 Td /F1 12.0 Tf [(population studies seeking to elucidate the ethnic profile that helps explain differences in breast cancer )] TJ ET BT 34.016 118.949 Td /F1 12.0 Tf [(outcomes: they found that Latinas have a higher incidence of advanced stages of the disease, tumours of a )] TJ ET BT 34.016 104.693 Td /F1 12.0 Tf [(larger size, developed at a younger age, and with a higher incidence of triple-negative breast cancers \(are )] TJ ET BT 34.016 90.437 Td /F1 12.0 Tf [(negative for hormone therapy, and have a poorer prognosis\), and a higher incidence of pathogenic BRCA1 )] TJ ET BT 34.016 76.181 Td /F1 12.0 Tf [(mutations.)] TJ ET 0.000 0.000 0.800 rg BT 84.356 76.181 Td /F1 12.0 Tf [(\(6\))] TJ ET 0.24 w 0 J [ ] 0 d 84.356 74.787 m 98.348 74.787 l S 0.000 0.000 0.000 rg BT 98.348 76.181 Td /F1 12.0 Tf [( These studies have prompted the analysis of the genotype of breast cancer in Latino woman, )] TJ ET BT 34.016 61.925 Td /F1 12.0 Tf [(currently being investigated by a multi-site study sponsored by the Susan G. Komen for the Cure ? the )] TJ ET endstream endobj 41 0 obj [39 0 R /Fit] endobj 42 0 obj << /Type /Annot /Subtype /Link /A 43 0 R /Border [0 0 0] /H /I /Rect [ 84.3557 75.1015 98.3477 86.9815 ] >> endobj 43 0 obj << /Type /Action >> endobj 44 0 obj << /Type /Page /Parent 3 0 R /Annots [ 47 0 R 50 0 R 53 0 R ] /Contents 45 0 R >> endobj 45 0 obj << /Length 8083 >> stream 0.000 0.000 0.000 rg 0.000 0.000 0.800 RG 0.24 w 0 J [ ] 0 d BT 34.016 796.469 Td /F1 12.0 Tf [(world?s largest charity devoted to the fight against breast cancer ? the National Cancer Institute and five )] TJ ET BT 34.016 782.213 Td /F1 12.0 Tf [(Latin American countries. Other studies, on the contrary, have pointed to the existence of health inequalities )] TJ ET BT 34.016 767.957 Td /F1 12.0 Tf [(as an essential factor behind differences in health outcomes. More specifically, Latino women leaving in the )] TJ ET BT 34.016 753.701 Td /F1 12.0 Tf [(US have higher poverty rates, are less educated, are largely uninsured and in many, their undocumented )] TJ ET BT 34.016 739.445 Td /F1 12.0 Tf [(status prevents them from access to health care at all compared to white women.)] TJ ET 0.000 0.000 0.800 rg BT 419.936 739.445 Td /F1 12.0 Tf [(\(7\))] TJ ET 0.24 w 0 J [ ] 0 d 419.936 738.051 m 433.928 738.051 l S 0.000 0.000 0.000 rg BT 433.928 739.445 Td /F1 12.0 Tf [( If, as Lwy has noted for )] TJ ET BT 34.016 725.189 Td /F1 12.0 Tf [(the case of Ashkenazi Jewish women ?the relative wealth of this population, its elevated level of education, )] TJ ET BT 34.016 710.933 Td /F1 12.0 Tf [(and its high level of health consciousness, made it an excellent target for the marketing of tailored services )] TJ ET BT 34.016 696.677 Td /F1 12.0 Tf [([BRCA test]? \(p. 192\), one may presume that the same will apply to a selected group of Latino women, )] TJ ET BT 34.016 682.421 Td /F1 12.0 Tf [(while in the vast majority it may lead to an increase in health inequalities. In addition, the impact on )] TJ ET BT 34.016 668.165 Td /F1 12.0 Tf [(employability and in access to life and health insurance has been noted by various observers that cautiously )] TJ ET BT 34.016 653.909 Td /F1 12.0 Tf [(look at the surge of genetic tests and the increased commodification of genome products within the broader )] TJ ET BT 34.016 639.653 Td /F1 12.0 Tf [(context of health inequalities in specific healthcare systems. At this juncture, historians such as Daniel )] TJ ET BT 34.016 625.397 Td /F1 12.0 Tf [(Kevles have drawn a connection between new genetic screening policies and the long history of eugenics.)] TJ ET 0.000 0.000 0.800 rg BT 542.564 625.397 Td /F1 12.0 Tf [(\(8\))] TJ ET 0.24 w 0 J [ ] 0 d 542.564 624.003 m 556.556 624.003 l S 0.000 0.000 0.000 rg BT 34.016 611.141 Td /F1 12.0 Tf [(Social and medical historians have yet to contribute much to this new association of medical genetics and )] TJ ET BT 34.016 596.885 Td /F1 12.0 Tf [(ethnicity and its impact on health policies, public and lay perceptions of immigration, risk, and identity, and )] TJ ET BT 34.016 582.629 Td /F1 12.0 Tf [(crucially, in bringing to the fore discussion on the social determinants of health alongside \(re-\)emerging )] TJ ET BT 34.016 568.373 Td /F1 12.0 Tf [(propositions of biological determinism.)] TJ ET BT 34.016 542.117 Td /F1 12.0 Tf [()] TJ ET BT 34.016 515.861 Td /F3 12.0 Tf [(5. Secrecy, exposure, and locality: cervical cancer and the politics of visibility)] TJ ET BT 34.016 489.605 Td /F1 12.0 Tf [(Lwy opens her latest book, )] TJ ET BT 172.664 489.605 Td /F2 12.0 Tf [(A Woman?s Disease. The History of Cervical Cancer)] TJ ET BT 429.308 489.605 Td /F1 12.0 Tf [( \(2011\), by reviewing the )] TJ ET BT 34.016 475.349 Td /F1 12.0 Tf [(story of three famous figures of the 19th, 20th, and 21st centuries: mathematician and computing pioneer )] TJ ET BT 34.016 461.093 Td /F1 12.0 Tf [(Ada Lovelace, politician and First Lady Eva Pern, and TV celebrity Jade Goody. Women of completely )] TJ ET BT 34.016 446.837 Td /F1 12.0 Tf [(different traditions, they share a young and painful death of cervical cancer, whose distinct experiences with )] TJ ET BT 34.016 432.581 Td /F1 12.0 Tf [(the disease provide the author with a springboard to reflect on the changing perception of cervical cancer at )] TJ ET BT 34.016 418.325 Td /F1 12.0 Tf [(different historical times: from a trait of women?s weak constitution, to denial and secrecy, to TV and media )] TJ ET BT 34.016 404.069 Td /F1 12.0 Tf [(exposure. The public perception of the disease mirrors the forms of medical knowledge as well as the fate of )] TJ ET BT 34.016 389.813 Td /F1 12.0 Tf [(its victims.)] TJ ET BT 34.016 363.557 Td /F1 12.0 Tf [(The political secrecy that surrounded Eva?s illness \(she was never told she had cancer\) seems to escape )] TJ ET BT 34.016 349.301 Td /F1 12.0 Tf [(comparison with the mediatisation of Goody?s disease, whose chemotherapy sessions featured in the media )] TJ ET BT 34.016 335.045 Td /F1 12.0 Tf [(on a daily basis until her death. She was not immune to a political touch when PM Gordon Brown expressed )] TJ ET BT 34.016 320.789 Td /F1 12.0 Tf [(his sympathy with the ?courageous woman?. Just fifty years or so separates her case from Eva?s, but the )] TJ ET BT 34.016 306.533 Td /F1 12.0 Tf [(formulations of Western medicine and patients? attitude \(cancer-fighters\) seem to have changed )] TJ ET BT 34.016 292.277 Td /F1 12.0 Tf [(dramatically. During the 20th century it was not uncommon to withhold diagnosis of cancer from patients, )] TJ ET BT 34.016 278.021 Td /F1 12.0 Tf [(yet it is difficult to think that had Eva been diagnosed with any other deadly disease, her illness would have )] TJ ET BT 34.016 263.765 Td /F1 12.0 Tf [(had a different patient/public treatment. Eva?s corporality in Argentina was as present in life as in death. Her )] TJ ET BT 34.016 249.509 Td /F1 12.0 Tf [(body did not ?leave? political life, initially, as a part of the unprecedented ritualisation that characterised the )] TJ ET BT 34.016 235.253 Td /F1 12.0 Tf [(paraphernalia of )] TJ ET BT 115.316 235.253 Td /F2 12.0 Tf [(peronismo)] TJ ET BT 165.980 235.253 Td /F1 12.0 Tf [( which secured her posterity by the technique of embalmment. Subsequently, her )] TJ ET BT 34.016 220.997 Td /F1 12.0 Tf [(body fell prey to the country?s political instabilities feeding Argentinian political divisions during the 25 )] TJ ET BT 34.016 206.741 Td /F1 12.0 Tf [(years in which it was lost \(stolen and hidden\), until finally buried in a family pantheon in Buenos Aires. )] TJ ET BT 34.016 192.485 Td /F1 12.0 Tf [(Secrecy about her disease and the most advanced treatment she received ? she is reported to be the first )] TJ ET BT 34.016 178.229 Td /F1 12.0 Tf [(patient treated with chemotherapy in Argentina ? endured in the medical profession even after her death. )] TJ ET BT 34.016 163.973 Td /F1 12.0 Tf [(Revealingly, the First International Congress in Antibiotics and Chemotherapy was held in Buenos Aires )] TJ ET BT 34.016 149.717 Td /F1 12.0 Tf [(just months after Eva?s death in 1952, and although her portrait presided over the inaugural session, no )] TJ ET BT 34.016 135.461 Td /F1 12.0 Tf [(reference was made to the pioneering chemotherapy treatment she received.)] TJ ET 0.000 0.000 0.800 rg BT 398.564 135.461 Td /F1 12.0 Tf [(\(9\))] TJ ET 0.24 w 0 J [ ] 0 d 398.564 134.067 m 412.556 134.067 l S 0.000 0.000 0.000 rg BT 412.556 135.461 Td /F1 12.0 Tf [( The politics of secrecy in )] TJ ET BT 34.016 121.205 Td /F1 12.0 Tf [(Eva Peron?s case may not epitomise that for women in general at the time, but it does serve to illustrate how )] TJ ET BT 34.016 106.949 Td /F1 12.0 Tf [(cancer was perceived as a fatal, outrageous disease as opposed to the contemporary notion of pre-cancer as a )] TJ ET BT 34.016 92.693 Td /F1 12.0 Tf [(disease that can be diagnosed and prevented. To explore the meaning of these transformations, Lwy )] TJ ET BT 34.016 78.437 Td /F1 12.0 Tf [(engages with the longer history of cervical cancer, offering a review of one-and-a-half centuries of )] TJ ET BT 34.016 64.181 Td /F1 12.0 Tf [(preventive policies, treatments, and changing explanatory theories, balancing ruptures and continuities while )] TJ ET BT 34.016 49.925 Td /F1 12.0 Tf [(offering a perspective to interpret its successes and failures in a convincing and much needed elaboration for )] TJ ET endstream endobj 46 0 obj [44 0 R /Fit] endobj 47 0 obj << /Type /Annot /Subtype /Link /A 48 0 R /Border [0 0 0] /H /I /Rect [ 419.9357 738.3655 433.9277 750.2455 ] >> endobj 48 0 obj << /Type /Action >> endobj 49 0 obj [44 0 R /Fit] endobj 50 0 obj << /Type /Annot /Subtype /Link /A 51 0 R /Border [0 0 0] /H /I /Rect [ 542.5637 624.3175 556.5557 636.1975 ] >> endobj 51 0 obj << /Type /Action >> endobj 52 0 obj [44 0 R /Fit] endobj 53 0 obj << /Type /Annot /Subtype /Link /A 54 0 R /Border [0 0 0] /H /I /Rect [ 398.5637 134.3815 412.5557 146.2615 ] >> endobj 54 0 obj << /Type /Action >> endobj 55 0 obj << /Type /Page /Parent 3 0 R /Contents 56 0 R >> endobj 56 0 obj << /Length 7679 >> stream 0.000 0.000 0.000 rg 0.000 0.000 0.800 RG 0.24 w 0 J [ ] 0 d BT 34.016 796.469 Td /F1 12.0 Tf [(current debates. The book is shaped in a very readable way and remains accessible to any newcomer to the )] TJ ET BT 34.016 782.213 Td /F1 12.0 Tf [(field.)] TJ ET BT 34.016 755.957 Td /F1 12.0 Tf [(The first three chapters are devoted to cervical cancer conceptualisation \(irritation theory\) and treatment )] TJ ET BT 34.016 741.701 Td /F1 12.0 Tf [(\(surgery and radiotherapy\) and the expectations and frustrations that therapeutic approaches generated in the )] TJ ET BT 34.016 727.445 Td /F1 12.0 Tf [(European and US context until the 1930s. Although chronic irritation as an explanatory theory for cancer )] TJ ET BT 34.016 713.189 Td /F1 12.0 Tf [(waned in the post-Second War World era, the real breakthrough came in the mid 1960s from the field of )] TJ ET BT 34.016 698.933 Td /F1 12.0 Tf [(virology. The relationship of viruses as causal agents of cancer in humans was first established after a )] TJ ET BT 34.016 684.677 Td /F1 12.0 Tf [(tumour virus was identified \(Epstein-Barr Virus\) from a common childhood tumour in central Africa )] TJ ET BT 34.016 670.421 Td /F1 12.0 Tf [(\(Burkitt?s lymphoma\). Since then, six human viruses have been identified as etiologic agents of human )] TJ ET BT 34.016 656.165 Td /F1 12.0 Tf [(cancers, including )] TJ ET BT 124.328 656.165 Td /F2 12.0 Tf [(human papilloma virus)] TJ ET BT 235.664 656.165 Td /F1 12.0 Tf [( \(HPV\) and cervical cancer in the early 1980s. The latter )] TJ ET BT 34.016 641.909 Td /F1 12.0 Tf [(inaugurated a new era for the perception of the disease, transforming cervical cancer into a sexually )] TJ ET BT 34.016 627.653 Td /F1 12.0 Tf [(transmitted disease. ?In the 1980s, as in 1826, this disease was linked with a ?greater moral laxity? ? or, in )] TJ ET BT 34.016 613.397 Td /F1 12.0 Tf [(today?s terms, ?promiscuity? ? of women from lower social classes? \(p. 141\), says Lwy. Although the )] TJ ET BT 34.016 599.141 Td /F1 12.0 Tf [(?promiscuity? hypothesis has lost its class-association after the sexual revolution, it has retained its )] TJ ET BT 34.016 584.885 Td /F1 12.0 Tf [(explanatory value for deprived women who show a tendency of both earlier and more numerous pregnancies.)] TJ ET BT 34.016 558.629 Td /F1 12.0 Tf [(Today experts agree that HPV strains 16 and 18 account for around 70 per cent of cervical cancer, that only )] TJ ET BT 34.016 544.373 Td /F1 12.0 Tf [(a percentage of women infected with HPV will develop the disease, while in the majority of cases the )] TJ ET BT 34.016 530.117 Td /F1 12.0 Tf [(infection regresses spontaneously; that between the detection of premalignant lesions and the development )] TJ ET BT 34.016 515.861 Td /F1 12.0 Tf [(of invasive cancer elapses a period of ten to 15 years. Statistics show that in industrialised countries, the )] TJ ET BT 34.016 501.605 Td /F1 12.0 Tf [(incidence and mortality of cervical cancer has declined to the extent that its prominence no longer )] TJ ET BT 34.016 487.349 Td /F1 12.0 Tf [(constitutes a serious public health problem. Yet the perspective for women, Lwy argues, is still somber. )] TJ ET BT 34.016 473.093 Td /F1 12.0 Tf [(The new visibility provided by HPV infection and the presence of ?atypical squamous cells of unknown )] TJ ET BT 34.016 458.837 Td /F1 12.0 Tf [(significance? \(ASCUS\) only triggers further examinations, HPV test, Pap tests, colposcopy and biopsies, )] TJ ET BT 34.016 444.581 Td /F1 12.0 Tf [(which extend the uncertainty of diagnosis to women?s perception of their body as a nebulous health-ill state. )] TJ ET BT 34.016 430.325 Td /F1 12.0 Tf [(The visibility of diagnostic tests and screening programmes from the 1950s onwards \(explored in chapters )] TJ ET BT 34.016 416.069 Td /F1 12.0 Tf [(four and five\) contrasts with the less publicised psychological and physical effects on women?s lives. In this )] TJ ET BT 34.016 401.813 Td /F1 12.0 Tf [(sense, )] TJ ET BT 66.008 401.813 Td /F2 12.0 Tf [(A Woman?s Disease)] TJ ET BT 164.660 401.813 Td /F1 12.0 Tf [( seems to retain, and single out from its title, the individual, personal account )] TJ ET BT 34.016 387.557 Td /F1 12.0 Tf [(behind the more general, statistic, average, idea of cervical cancer as ?a women?s disease?. The book is )] TJ ET BT 34.016 373.301 Td /F1 12.0 Tf [(intercalated with stories and narratives of women that navigate the sequence of diagnostic tools in search for )] TJ ET BT 34.016 359.045 Td /F1 12.0 Tf [(the illumination of a clear diagnostic, while others, despite their loyal compliance to tests, succumb to the )] TJ ET BT 34.016 344.789 Td /F1 12.0 Tf [(disease.)] TJ ET BT 34.016 318.533 Td /F1 12.0 Tf [(Cervical cancer and the politics of visibility can easily be extended to Bryder?s account of the NWH and the )] TJ ET BT 34.016 304.277 Td /F1 12.0 Tf [(Cartwright Inquiry, not least because of the role of the media in conveying simplified and distorted versions )] TJ ET BT 34.016 290.021 Td /F1 12.0 Tf [(of the events, but more broadly, because the whole case seems to cast a shadow on cervical cancer and the )] TJ ET BT 34.016 275.765 Td /F1 12.0 Tf [(politics of visibility, one that synthesises the encounter of two temporalities. On the one hand, the )] TJ ET BT 34.016 261.509 Td /F1 12.0 Tf [(incessantly promoted effectiveness of diagnostic tools, screening, prevention, treatment, evidence-based )] TJ ET BT 34.016 247.253 Td /F1 12.0 Tf [(medicine, and ethical \(and shared\) decision-making; and on the other, the nature of the medical encounter, )] TJ ET BT 34.016 232.997 Td /F1 12.0 Tf [(where doctors and patients reach decisions, sometimes together and at other times unilaterally, balancing )] TJ ET BT 34.016 218.741 Td /F1 12.0 Tf [(different fears and hopes, elaborating on risk, and living with their life-changing decisions. The latter points )] TJ ET BT 34.016 204.485 Td /F1 12.0 Tf [(to an increasingly occluded story, and an altogether alternative, less progressive, history. An excessive )] TJ ET BT 34.016 190.229 Td /F1 12.0 Tf [(confidence in the former can easily make the latter sound arbitrary, backward or unreasonable. )] TJ ET BT 34.016 163.973 Td /F1 12.0 Tf [(The last chapter of )] TJ ET BT 126.656 163.973 Td /F2 12.0 Tf [(A Woman?s Disease)] TJ ET BT 225.308 163.973 Td /F1 12.0 Tf [( addresses the persistent burden of cervical cancer in developing )] TJ ET BT 34.016 149.717 Td /F1 12.0 Tf [(countries, where management and prevention programmes reflect a quite different debate. Focussing on )] TJ ET BT 34.016 135.461 Td /F1 12.0 Tf [(Brazil, Lwy provides a further reminder of the limitations that new interventions may have in the )] TJ ET BT 34.016 121.205 Td /F1 12.0 Tf [(population. As Pap smear screening is considered to have failed in low-resource settings, new approaches to )] TJ ET BT 34.016 106.949 Td /F1 12.0 Tf [(cervical cancer screening are being tested \(HPV test, visual inspection with acetic acid and treatment with )] TJ ET BT 34.016 92.693 Td /F1 12.0 Tf [(cryosurgery\) which reveal a global, technical approach instead of the delineation of health policies that will )] TJ ET BT 34.016 78.437 Td /F1 12.0 Tf [(?act upon economic and social conditions that hamper the diffusion of preventive measures? \(p. 173\). )] TJ ET BT 34.016 64.181 Td /F1 12.0 Tf [(Arguably, there is much more historical work needed in the assessment of Pap smear ?failure? in developing )] TJ ET BT 34.016 49.925 Td /F1 12.0 Tf [(countries. Although there is some substance to this repeated claim by policy makers, they paint a very partial )] TJ ET endstream endobj 57 0 obj << /Type /Page /Parent 3 0 R /Annots [ 59 0 R 61 0 R 63 0 R 65 0 R 67 0 R 69 0 R 71 0 R 73 0 R 75 0 R 77 0 R 79 0 R ] /Contents 58 0 R >> endobj 58 0 obj << /Length 8604 >> stream 0.000 0.000 0.000 rg 0.000 0.000 0.800 RG 0.24 w 0 J [ ] 0 d BT 34.016 796.469 Td /F1 12.0 Tf [(picture. As historians came to recognize, and as all three books here attest, the diversity and dynamism of )] TJ ET BT 34.016 782.213 Td /F1 12.0 Tf [(local contexts, issues such as ethnicity, health inequalities, and local medical configurations amount to a )] TJ ET BT 34.016 767.957 Td /F1 12.0 Tf [(more complex scenario for the adoption of technological interventions. And, as in the case of the selective )] TJ ET BT 34.016 753.701 Td /F1 12.0 Tf [(historical ?success? of smallpox eradication, it seems that the past ?failure? of Pap smear screening in )] TJ ET BT 34.016 739.445 Td /F1 12.0 Tf [(developing countries merits too a closer historical examination.)] TJ ET BT 34.016 713.189 Td /F1 12.0 Tf [(There is a great additional value to be garnered from reading these books collectively. Considered side-by-)] TJ ET BT 34.016 698.933 Td /F1 12.0 Tf [(side these volumes point to a much deeper understanding of the complex interdependencies that exist )] TJ ET BT 34.016 684.677 Td /F1 12.0 Tf [(between women?s bodies, medicine, technologies, policy makers, health activists, the health industry, and )] TJ ET BT 34.016 670.421 Td /F1 12.0 Tf [(the press. Their work is clearly of relevance to scholars in a number of fields, certainly beyond that of )] TJ ET BT 34.016 656.165 Td /F1 12.0 Tf [(medical history.)] TJ ET BT 34.016 621.267 Td /F3 18.0 Tf [(Notes)] TJ ET BT 48.816 590.650 Td /F1 12.0 Tf [(1.)] TJ ET BT 64.016 590.645 Td /F1 12.0 Tf [(On women and cancer, see for example, Barron Lerner, )] TJ ET BT 333.920 590.645 Td /F2 12.0 Tf [(The Breast Cancer Wars: Hope, Fear, and the )] TJ ET BT 64.016 576.389 Td /F2 12.0 Tf [(Pursuit of a Cure in Twentieth-Century America)] TJ ET BT 296.684 576.389 Td /F1 12.0 Tf [( \(New York, NY, 2001\); James Olson, )] TJ ET BT 484.652 576.389 Td /F2 12.0 Tf [(Bathsheba's )] TJ ET BT 64.016 562.133 Td /F2 12.0 Tf [(Breast: Women, Cancer, and History)] TJ ET BT 242.660 562.133 Td /F1 12.0 Tf [( \(Baltimore, MD, 2005\); Robert Aronowitz, )] TJ ET BT 456.308 562.133 Td /F2 12.0 Tf [(Unnatural History: )] TJ ET BT 64.016 547.877 Td /F2 12.0 Tf [(Breast Cancer and American Society)] TJ ET BT 241.988 547.877 Td /F1 12.0 Tf [( \(Cambridge, 2007\); Kirsten Gardner, )] TJ ET BT 426.284 547.877 Td /F2 12.0 Tf [(Early Detection: Women, )] TJ ET BT 64.016 533.621 Td /F2 12.0 Tf [(Cancer, & Awareness Campaigns in the Twentieth-Century United States)] TJ ET BT 417.680 533.621 Td /F1 12.0 Tf [( \(Chapel Hill, NC, 2006\); )] TJ ET BT 64.016 519.365 Td /F2 12.0 Tf [(Three Shots at Prevention: The HPV Vaccine and the Politics of Medicine's Simple Solutions)] TJ ET BT 510.884 519.365 Td /F1 12.0 Tf [(, ed. )] TJ ET BT 64.016 505.109 Td /F1 12.0 Tf [(Keith Wailoo )] TJ ET BT 132.008 505.109 Td /F2 12.0 Tf [(et al)] TJ ET BT 153.008 505.109 Td /F1 12.0 Tf [(. \(Baltimore, MD, 2010\) Keith Wailoo, )] TJ ET BT 344.324 505.109 Td /F2 12.0 Tf [(How Cancer Crossed the Color Line)] TJ ET BT 520.664 505.109 Td /F1 12.0 Tf [( \(New )] TJ ET BT 64.016 490.853 Td /F1 12.0 Tf [(York, NY, 2011\); )] TJ ET BT 152.336 490.853 Td /F2 12.0 Tf [(Cancer in the Twentieth Century)] TJ ET BT 309.668 490.853 Td /F1 12.0 Tf [(, ed. David Cantor \(Baltimore, MD, 2008\).)] TJ ET 0.000 0.000 0.800 rg BT 515.312 490.853 Td /F1 12.0 Tf [(Back to )] TJ ET 0.24 w 0 J [ ] 0 d 515.312 489.459 m 555.308 489.459 l S BT 64.016 476.597 Td /F1 12.0 Tf [(\(1\))] TJ ET 0.24 w 0 J [ ] 0 d 64.016 475.203 m 78.008 475.203 l S 0.000 0.000 0.000 rg BT 48.816 462.346 Td /F1 12.0 Tf [(2.)] TJ ET BT 64.016 462.341 Td /F1 12.0 Tf [(Anne-Emanuelle Birn, ?The stages of international \(global\) health: Histories of success or successes )] TJ ET BT 64.016 448.085 Td /F1 12.0 Tf [(of history? )] TJ ET BT 118.676 448.085 Td /F2 12.0 Tf [(Global Public Health)] TJ ET BT 222.008 448.085 Td /F1 12.0 Tf [(, 4, 1 \(2009\), 50?68, 51.)] TJ ET 0.000 0.000 0.800 rg BT 337.328 448.085 Td /F1 12.0 Tf [(Back to \(2\))] TJ ET 0.24 w 0 J [ ] 0 d 337.328 446.691 m 391.316 446.691 l S 0.000 0.000 0.000 rg BT 48.816 433.834 Td /F1 12.0 Tf [(3.)] TJ ET BT 64.016 433.829 Td /F1 12.0 Tf [(Sanjoy Bhattacharya, ?The World Health Organization and global smallpox eradication?, )] TJ ET BT 64.016 419.573 Td /F2 12.0 Tf [(Journal of Epidemiology and Community Health)] TJ ET BT 298.340 419.573 Td /F1 12.0 Tf [(, 62, 2008, 909?12.)] TJ ET 0.000 0.000 0.800 rg BT 390.668 419.573 Td /F1 12.0 Tf [(Back to \(3\))] TJ ET 0.24 w 0 J [ ] 0 d 390.668 418.179 m 444.656 418.179 l S 0.000 0.000 0.000 rg BT 48.816 405.322 Td /F1 12.0 Tf [(4.)] TJ ET BT 64.016 405.317 Td /F1 12.0 Tf [(Alex Mold, ?Patient groups and the construction of the patient-consumer in Britain: an historical )] TJ ET BT 64.016 391.061 Td /F1 12.0 Tf [(overview)] TJ ET BT 108.668 391.061 Td /F3 12.0 Tf [(?, )] TJ ET BT 120.668 391.061 Td /F2 12.0 Tf [(Journal of Social Policy)] TJ ET BT 236.996 391.061 Td /F1 12.0 Tf [(, 39, 4\(2010\), 505?521, 518.)] TJ ET 0.000 0.000 0.800 rg BT 376.316 391.061 Td /F1 12.0 Tf [(Back to \(4\))] TJ ET 0.24 w 0 J [ ] 0 d 376.316 389.667 m 430.304 389.667 l S 0.000 0.000 0.000 rg BT 48.816 376.810 Td /F1 12.0 Tf [(5.)] TJ ET BT 64.016 376.805 Td /F1 12.0 Tf [(Jolyn Hersch, )] TJ ET BT 133.004 376.805 Td /F2 12.0 Tf [(et al.)] TJ ET BT 157.004 376.805 Td /F1 12.0 Tf [( ?How do we achieve informed choice for women considering breast screening??, )] TJ ET BT 64.016 362.549 Td /F2 12.0 Tf [(Preventive Medicine)] TJ ET BT 162.980 362.549 Td /F1 12.0 Tf [(, 53, 3 \(2011\), 144?6.)] TJ ET 0.000 0.000 0.800 rg BT 266.300 362.549 Td /F1 12.0 Tf [(Back to \(5\))] TJ ET 0.24 w 0 J [ ] 0 d 266.300 361.155 m 320.288 361.155 l S 0.000 0.000 0.000 rg BT 48.816 348.298 Td /F1 12.0 Tf [(6.)] TJ ET BT 64.016 348.293 Td /F1 12.0 Tf [(Tejal Patel )] TJ ET BT 118.676 348.293 Td /F2 12.0 Tf [(et al.)] TJ ET BT 142.676 348.293 Td /F1 12.0 Tf [(,)] TJ ET BT 145.676 348.293 Td /F3 12.0 Tf [( ?)] TJ ET BT 154.676 348.293 Td /F1 12.0 Tf [(Breast cancer in Latinas: Gene expression, differential response to treatments, and )] TJ ET BT 64.016 334.037 Td /F1 12.0 Tf [(differential toxicities in Latinas compared with other population groups?, )] TJ ET BT 418.640 334.037 Td /F2 12.0 Tf [(The Oncologist)] TJ ET BT 492.308 334.037 Td /F1 12.0 Tf [(, 15 \(2010\), )] TJ ET BT 64.016 319.781 Td /F1 12.0 Tf [(466?75.)] TJ ET 0.000 0.000 0.800 rg BT 102.344 319.781 Td /F1 12.0 Tf [(Back to \(6\))] TJ ET 0.24 w 0 J [ ] 0 d 102.344 318.387 m 156.332 318.387 l S 0.000 0.000 0.000 rg BT 48.816 305.530 Td /F1 12.0 Tf [(7.)] TJ ET BT 64.016 305.525 Td /F1 12.0 Tf [(Ibid.)] TJ ET 0.000 0.000 0.800 rg BT 86.348 305.525 Td /F1 12.0 Tf [(Back to \(7\))] TJ ET 0.24 w 0 J [ ] 0 d 86.348 304.131 m 140.336 304.131 l S 0.000 0.000 0.000 rg BT 48.816 291.274 Td /F1 12.0 Tf [(8.)] TJ ET BT 64.016 291.269 Td /F1 12.0 Tf [(Daniel Kevles, ?From eugenics to patents: genetics, law, and human rights?, )] TJ ET BT 433.628 291.269 Td /F2 12.0 Tf [(Annals of Human )] TJ ET BT 64.016 277.013 Td /F2 12.0 Tf [(Genetics)] TJ ET BT 106.004 277.013 Td /F1 12.0 Tf [(, 75 \(2011\), 326?33.)] TJ ET 0.000 0.000 0.800 rg BT 203.324 277.013 Td /F1 12.0 Tf [(Back to \(8\))] TJ ET 0.24 w 0 J [ ] 0 d 203.324 275.619 m 257.312 275.619 l S 0.000 0.000 0.000 rg BT 48.816 262.762 Td /F1 12.0 Tf [(9.)] TJ ET BT 64.016 262.757 Td /F2 12.0 Tf [(Primer Congreso Internacional de Antibiticos y Quimioterpicos)] TJ ET BT 383.336 262.757 Td /F1 12.0 Tf [( \(Buenos Aires, 1953\).)] TJ ET 0.000 0.000 0.800 rg BT 492.320 262.757 Td /F1 12.0 Tf [(Back to \(9\))] TJ ET 0.24 w 0 J [ ] 0 d 492.320 261.363 m 546.308 261.363 l S 0.000 0.000 0.000 rg BT 34.016 236.501 Td /F1 12.0 Tf [(Ilana Lwy is happy to accept this review and does not wish to comment further.)] TJ ET 0.502 0.502 0.502 RG 0.75 w 0 J [ ] 0 d 34.391 219.775 526.499 1.500 re S BT 34.016 201.995 Td /F3 12.0 Tf [(Source URL:)] TJ ET 0.000 0.000 0.800 rg BT 104.672 201.995 Td /F1 12.0 Tf [(http://www.history.ac.uk/reviews/review/1239)] TJ ET 0.000 0.000 0.800 RG 0.24 w 0 J [ ] 0 d 104.672 200.601 m 328.316 200.601 l S 0.000 0.000 0.000 rg BT 34.016 175.624 Td /F3 12.0 Tf [(Links:)] TJ ET BT 34.016 161.224 Td /F1 12.0 Tf [([1] http://www.history.ac.uk/reviews/item/13731)] TJ ET BT 34.016 146.824 Td /F1 12.0 Tf [([2] http://www.history.ac.uk/reviews/item/13732)] TJ ET BT 34.016 132.424 Td /F1 12.0 Tf [([3] http://www.history.ac.uk/reviews/item/13733)] TJ ET endstream endobj 59 0 obj << /Type /Annot /Subtype /Link /A 60 0 R /Border [0 0 0] /H /I /Rect [ 515.3117 489.7735 555.3077 501.6535 ] >> endobj 60 0 obj << /Type /Action /S /GoTo /D 16 0 R >> endobj 61 0 obj << /Type /Annot /Subtype /Link /A 62 0 R /Border [0 0 0] /H /I /Rect [ 64.0157 475.5175 78.0077 487.3975 ] >> endobj 62 0 obj << /Type /Action /S /GoTo /D 16 0 R >> endobj 63 0 obj << /Type /Annot /Subtype /Link /A 64 0 R /Border [0 0 0] /H /I /Rect [ 337.3277 447.0055 391.3157 458.8855 ] >> endobj 64 0 obj << /Type /Action /S /GoTo /D 19 0 R >> endobj 65 0 obj << /Type /Annot /Subtype /Link /A 66 0 R /Border [0 0 0] /H /I /Rect [ 390.6677 418.4935 444.6557 430.3735 ] >> endobj 66 0 obj << /Type /Action /S /GoTo /D 22 0 R >> endobj 67 0 obj << /Type /Annot /Subtype /Link /A 68 0 R /Border [0 0 0] /H /I /Rect [ 376.3157 389.9815 430.3037 401.8615 ] >> endobj 68 0 obj << /Type /Action /S /GoTo /D 31 0 R >> endobj 69 0 obj << /Type /Annot /Subtype /Link /A 70 0 R /Border [0 0 0] /H /I /Rect [ 266.2997 361.4695 320.2877 373.3495 ] >> endobj 70 0 obj << /Type /Action /S /GoTo /D 34 0 R >> endobj 71 0 obj << /Type /Annot /Subtype /Link /A 72 0 R /Border [0 0 0] /H /I /Rect [ 102.3437 318.7015 156.3317 330.5815 ] >> endobj 72 0 obj << /Type /Action /S /GoTo /D 41 0 R >> endobj 73 0 obj << /Type /Annot /Subtype /Link /A 74 0 R /Border [0 0 0] /H /I /Rect [ 86.3477 304.4455 140.3357 316.3255 ] >> endobj 74 0 obj << /Type /Action /S /GoTo /D 46 0 R >> endobj 75 0 obj << /Type /Annot /Subtype /Link /A 76 0 R /Border [0 0 0] /H /I /Rect [ 203.3237 275.9335 257.3117 287.8135 ] >> endobj 76 0 obj << /Type /Action /S /GoTo /D 49 0 R >> endobj 77 0 obj << /Type /Annot /Subtype /Link /A 78 0 R /Border [0 0 0] /H /I /Rect [ 492.3197 261.6775 546.3077 273.5575 ] >> endobj 78 0 obj << /Type /Action /S /GoTo /D 52 0 R >> endobj 79 0 obj << /Type /Annot /Subtype /Link /A 80 0 R /Border [0 0 0] /H /I /Rect [ 104.6717 200.9155 328.3157 212.7955 ] >> endobj 80 0 obj << /Type /Action /S /URI /URI (http://www.history.ac.uk/reviews/review/1239) >> endobj xref 0 81 0000000000 65535 f 0000000008 00000 n 0000000073 00000 n 0000000119 00000 n 0000000385 00000 n 0000000422 00000 n 0000000608 00000 n 0000000690 00000 n 0000003541 00000 n 0000003650 00000 n 0000003760 00000 n 0000003869 00000 n 0000007430 00000 n 0000007558 00000 n 0000007642 00000 n 0000007740 00000 n 0000014408 00000 n 0000014438 00000 n 0000014566 00000 n 0000014602 00000 n 0000014632 00000 n 0000014760 00000 n 0000014796 00000 n 0000014826 00000 n 0000014954 00000 n 0000014990 00000 n 0000015055 00000 n 0000022692 00000 n 0000022757 00000 n 0000030358 00000 n 0000030449 00000 n 0000038703 00000 n 0000038733 00000 n 0000038861 00000 n 0000038897 00000 n 0000038927 00000 n 0000039055 00000 n 0000039091 00000 n 0000039156 00000 n 0000046534 00000 n 0000046618 00000 n 0000054277 00000 n 0000054307 00000 n 0000054431 00000 n 0000054467 00000 n 0000054565 00000 n 0000062701 00000 n 0000062731 00000 n 0000062859 00000 n 0000062895 00000 n 0000062925 00000 n 0000063053 00000 n 0000063089 00000 n 0000063119 00000 n 0000063247 00000 n 0000063283 00000 n 0000063348 00000 n 0000071080 00000 n 0000071234 00000 n 0000079891 00000 n 0000080019 00000 n 0000080074 00000 n 0000080200 00000 n 0000080255 00000 n 0000080383 00000 n 0000080438 00000 n 0000080566 00000 n 0000080621 00000 n 0000080749 00000 n 0000080804 00000 n 0000080932 00000 n 0000080987 00000 n 0000081115 00000 n 0000081170 00000 n 0000081297 00000 n 0000081352 00000 n 0000081480 00000 n 0000081535 00000 n 0000081663 00000 n 0000081718 00000 n 0000081846 00000 n trailer << /Size 81 /Root 1 0 R /Info 5 0 R >> startxref 81942 %%EOF