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Researchers Report Big Gains Against Cervical Cancer

Death rates are down, and an experimental vaccine holds great promise

SATURDAY, Feb. 4, 2006 (HealthDay News) -- Cancer of the cervix was once a dreaded disease, one of the most common causes of cancer death in American women.

But from 1955 to 1992, the number of cervical cancer deaths in the United States dropped by 74 percent, as more and more women underwent regular screenings using the Pap test.

Now, it is one of the most survivable forms of cancer, with the death rate continuing to decline about 2 percent every year, according to the American Cancer Society.

And the news continues to get better: Scientists believe they have developed a vaccine that prevents nearly all cervical cancers caused by human papillomavirus, or HPV, the disease's main risk factor.

"How exciting is it, that we can have a win against a potential cancer with the vaccines that are coming out?" said Alan Kaye, executive director and co-founder of the National Cervical Cancer Coalition.

Experts are reporting striking advances that have taken place in the fight against the disease. But they're also urging women to get regular Pap tests, which check cells wiped from the walls of the cervix for any pre-cancerous abnormalities.

"What's most important is to get screened," said Debbie Saslow, the American Cancer Society's director of breast and gynecological cancer. "Cervical cancer is a leading killer of women worldwide, and that's because we don't have Pap tests in many of those countries."

More than 10,000 cases of invasive cervical cancer were diagnosed in the United States in 2005, according to estimates by the American Cancer Society. About 3,700 women died from the disease last year.

The five-year survival rate for invasive cervical cancer that is caught at its earliest stage is nearly 100 percent. More advanced cases that haven't spread to the lymph nodes or elsewhere have a 92 percent five-year survival rate, and the overall five-year survival rate for cervical cancer is 73 percent, according to the cancer society.

Women are most likely to get cervical cancer through infection by HPV, a group of viruses that causes warts and can be passed from person to person through sexual contact.

An estimated 20 million men and women in the United States are infected with HPV, but for the most part the viruses show no symptoms and go away on their own.

However, HPV can lead to cervical cancer in some women. The virus is also associated with abnormal Pap test results.

Scientists have discovered an experimental cervical cancer vaccine called Gardasil, developed by the drug company Merck, that cut the risk of cervical cancer by 97 percent in clinical trials. Researchers found that none of the women who received the vaccine developed either pre-cancer or invasive cervical cancer associated with HPV types 16 and 18.

Gardasil is still awaiting approval by the U.S. Food and Drug Administration, but doctors and medical experts are delighted at the prospect of being able to prevent most cases of cervical cancer.

Widespread use of the vaccine could prevent many cases of cervical cancer in women who aren't coming in for their regular Pap screenings, Kaye said.

However, the biggest public health benefit may be outside the United States, in other countries where Pap tests are not readily available, Saslow said.

Women should receive a Pap test every year, or every two years if they are getting the newer liquid-based Pap test. Beginning at age 30, women who have had three normal Pap test results in a row may get tested every two to three years with either the regular or liquid-based Pap test, according to the cancer society.

"A woman shouldn't get Pap tests less than every year unless she has three normal tests in a row," Saslow said. "Then she can get one every two or three years."

Women older than 65 who have had at least three normal Pap tests and no abnormal tests in the past decade may decide, after speaking with their doctor, to stop cervical cancer screening, the National Cancer Institute says.

There are a number of risk factors that can increase the chance of getting cervical cancer from HPV, Saslow said.

They include:

  • A weakened immune system. "If they have HIV or AIDS, it's important to get Pap tests more regularly," Saslow said. "Every year, and early on every six months."
  • Smoking.
  • Sexual history. "A lot of doctors believe girls are at risk if they've had a lot of sexual partners," Saslow said.
  • Use of birth control pills for longer than five years.
  • Giving birth to many children.

Testing is important because in its early stages, cervical cancer does not cause pain or other symptoms.

When the disease gets worse, women may notice abnormal vaginal bleeding, increased vaginal discharge, pelvic pain or pain during sex.

Saslow reiterated that it is an extremely treatable form of cancer.

"Cervical cancer grows extremely slowly," she said. "We're talking 10 or 20 years. Even if we miss it the first year, or three years later, we're still going to catch it in time."

More information

To learn more about cervical cancer, visit the American Cancer Society.

SOURCES: Alan Kaye, executive director and co-founder, National Cervical Cancer Coalition, Berkeley, Calif.; Debbie Saslow, the American Cancer Society's director of breast & gynecological cancer, Atlanta; the National Cancer Institute
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