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Cervical Cancer: A Very Preventable Disease

Regular screenings can keep women safe

SUNDAY, Jan. 26, 2003 (HealthDayNews) -- Every year, 15,000 American women are told they have cervical cancer.

Worldwide, it's the second leading cancer killer of women.

Yet most of these cases are preventable.

"Cervical cancer is preventable," says Dr. Steven R. Goldstein, a professor of obstetrics and gynecology at New York University Medical Center.

The key, as with most cancers, is early detection.

Ninety-eight to 99 percent of all cervical cancers are caused by the human papillomavirus, or HPV. The virus, which is sexually transmitted and comes in several dozen different varieties, currently infects some 20 percent of American adults. While most cases of HPV resolve on their own, a small minority progress to cervical cancer, making it the biggest health threat to this part of the female anatomy.

One of the problems with genital HPV infections is that often they don't come with visible signs and symptoms. A National Institute of Allergy and Infectious Diseases study found that almost half the women infected with HPV had no clear symptoms. What's more, people infected but who have no symptoms may not know they can transmit HPV to others.

That's one reason why January has been designated Cervical Health Awareness Month.

In November, researchers reported in the New England Journal of Medicine that they had developed a vaccine that had achieved a 100 percent success rate against the version of the virus responsible for 50 percent of all cases of cervical cancer. Despite these encouraging results, a workable vaccine is still several years away.

For now, the best weapon against cervical cancer is screening in the form of a Pap smear. And it's very effective.

"If you look at mortality from cervical cancer from the 1940s before we had the Pap smear until the 1990s, there's a dramatic decrease," says Dr. Carolyn D. Runowicz, vice chairman of the department of obstetrics and gynecology at St. Luke's Roosevelt Hospital in New York City.

"The line is just a sharp drop, so the Pap smear is absolutely, unequivocally a good example of screening if done correctly," adds Runowicz, who is also one of the authors of the American Cancer Society's cervical cancer guidelines.

A Pap smear involves gently scraping cells from the outside and the canal of the cervix. The cervix is actually the "neck" of the uterus that protrudes into the vagina and through which sperm and menstrual blood flow. The test is easily done in a gynecologist's office as part of a routine visit.

The problem is that not enough women are getting screened, and most cases of cervical cancers occur in unscreened women, Runowicz says.

"If we could get every woman screened, we could eliminate this disease like polio," she says. "Women sometimes think after their last baby, they don't need to go to the gynecologist anymore. And they really couldn't be more wrong -- and cervical cancer screening is one reason among many."

Runowicz advises women to start getting regular Pap smears within three years of becoming sexually active but no later than age 21.

"Invasive cervical cancer in this country is virtually unheard of before the age of 20, but the individual woman needs to speak with her health-care provider to determine what is an appropriate screening interval for her," she says.

"The cervix is a great organ," adds Goldstein. "You can Pap it, magnify it, biopsy it, cryo it, laser it, look at it. It's not like the lung. There's no excuse for any woman today to get cervical cancer."

So get screened.

More information

For more on cervical cancer, visit the National Cancer Institute or the American Cancer Society.

SOURCES: Carolyn D. Runowicz, M.D., vice chairman, department of obstetrics and gynecology, St. Luke's Roosevelt Hospital, and professor of obstetrics and gynecology, Columbia University College of Physicians and Surgeons, both in New York City; Steven R. Goldstein, M.D., professor of obstetrics and gynecology, New York University Medical Center, New York City; Nov. 21, 2002, New England Journal of Medicine
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