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Date: Wednesday, April 3, 1996 FOR IMMEDIATE RELEASE Contact: Contact: Bill Hall, (301) 496-4819 or Caroline McNeil, (301) 496-6641
The 13-member panel urged special efforts to reach several groups of women who have lower rates of screening and higher rates of cervical cancer--the uninsured; women over 65; ethnic minorities, especially Hispanic and older African American women; and rural and poor women. "Cervical cancer is a disease of the economically disadvantaged," said panel co-chair Patricia S. Braly, M.D., Professor and Chief of the Section of Gynecologic Oncology at Louisiana State University Medical Center in New Orleans. "Thousands of women continue to die needlessly from this disease," she said.
Half of all women newly diagnosed with cervical cancer have never had a Pap test and another 10 percent have not been screened in the past 5 years. "If we could reach all the women in this country who are not getting regular Pap tests, we could eradicate this form of cancer," said the panel's other co-chair Allen S. Lichter, M.D., Professor and Chair of the Department of Radiation Oncology at the University of Michigan Medical Center in Ann Arbor.
Based on an overwhelming body of scientific evidence, the panel concluded that a principal cause of cervical cancer is the human papillomavirus (HPV), which is transmitted sexually. While many women and men are infected with this virus, most infections resolve without treatment. Only a small percentage of women infected with HPV eventually develop invasive cancer.
To prevent HPV infection, the panel emphasized the importance of educating adolescents and health care providers about the strong causal link between HPV and cervical cancer; discouraging early sexual intercourse; encouraging the use of barrier contraceptives; and developing a preventive vaccine.
Cervical cancer is one of the most common malignancies in women in the United States accounting for nearly 5,000 deaths each year and for 6 percent of all cancers in women. Worldwide, cervical cancer is the second most common malignancy in women, after breast cancer, with more than 437,000 cases diagnosed annually. In developing countries, it is the most common cancer in women.
When detected at the earliest stage, cervical cancer is highly curable. The panel found that a procedure called a cone biopsy in which only the tumor is removed is a treatment option for some women, especially those wishing to preserve fertility; a hysterectomy is also an option that can cure the disease at this stage.
In more advanced cancers that have not yet spread beyond the cervix, treatment with surgery or radiation therapy is equally effective, curing 70 to 85 percent of cases. The panel emphasized the need to carefully select patients to receive either one treatment or the other, but not both.
For patients in the later stages of cervical cancer, the panel concluded that radiation therapy is the treatment of choice. If disease recurs, women who have already undergone surgery should receive radiation therapy, and vice versa. In women with advanced cervical cancer, radiation therapy may ease symptoms. Studies are currently evaluating the use of chemotherapy in several stages of the disease.
The panel stressed the need for further basic and behavioral research to improve the detection and treatment of cervical cancer as well as the quality of life in women with this disease. Important areas for study include methods to broaden participation in screening, new technologies to collect and interpret Pap tests, and new surgical techniques such as laparoscopy.
Finally, the panel underscored the importance of vaccine research to prevent HPV infection and treat cervical cancer, an area of investigation that holds promise of profoundly reducing the impact of this disease.
The panel made their recommendations at the conclusion of the 3-day NIH Consensus Development Conference on Cervical Cancer. The conference was convened by the National Cancer Institute and the NIH Office of Medical Applications of Research.
The conference was cosponsored by the National Institute of Nursing Research, the National Institute of Allergy and Infectious Diseases, the Office of Research on Minority Health, and the Office of Research on Women's Health, all of the NIH; and the Centers for Disease Control and Prevention.
Bill Hall: National Institutes of Health Bethesda, MD, USA Phone: (301) 496-4819 Fax: (301) 402-0420E-mail: billhall@nih.gov