Cervical Cancer

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Cervical Cancer

NIH - Medical Encyclopedia Cervical Cancer

"Cervical cancer is cancer that starts in the cervix, the lower part of the uterus (womb) that opens at the top of the vagina. … Worldwide, cervical cancer is the third most common type of cancer in women. … Cervical cancers start in the cells on the surface of the cervix. There are two types of cells on the cervix's surface: squamous and columnar. The majority of cervical cancers are from squamous cells. The development of cervical cancer is very slow. It starts as a pre-cancerous condition called dysplasia. This pre-cancerous condition can be detected by a Pap smear and is 100% treatable. That is why it is so important for women to get regular Pap smears … Undetected, pre-cancerous changes can develop into cervical cancer and spread to the bladder, intestines, lungs, and liver. … Almost all cervical cancers are caused by HPV (human papillomavirus). … Other risk factors for cervical cancer include: • Having sex at an early age • Multiple sexual partners • Sexual partners who have multiple partners or who participate in high-risk sexual activities • Women whose mothers took the drug DES (diethylstilbestrol) during pregnancy in the early 1970s to prevent miscarriage • Long-term use of birth control pills (more than 5 years) • Weakened immune system • Infections with genital herpes or chronic chlamydia infections • Poor economic status (may not be able to afford regular Pap smears)."

Highlighted Articles

[Clearance, persistence and recurrence of HPV infection.] (Gynecol Obstet Fertil. 2008) “The longitudinal studies show that "recurrent" HPV infections offer no evidence that the recurrent episode is correlated with reemergence of the same strain or another strain of the same genotype (wild or variant), but the sequential detection of other HPV type is common. The studies offer no evidence of competition between HPV types but frequently show an increased risk of acquisition of new HPV types in patients already infected compared with those who are HPV-negative.”

Prevalence of HPV Infection Among Females in the United States (JAMA. 2007) "Results The overall HPV prevalence was 26.8% … among US females aged 14 to 59 years … HPV prevalence was 24.5% (19.6%-30.5%) among females aged 14 to 19 years, 44.8% (36.3%-55.3%) among women aged 20 to 24 years, 27.4% (21.9%-34.2%) among women aged 25 to 29 years, 27.5% (20.8%-36.4%) among women aged 30 to 39 years, 25.2% (19.7%-32.2%) among women aged 40 to 49 years, and 19.6% (14.3%-26.8%) among women aged 50 to 59 years. There was a statistically significant trend for increasing HPV prevalence with each year of age from 14 to 24 years … followed by a gradual decline in prevalence through 59 years … HPV is common among females in the United States. Our data indicate that the burden of prevalent HPV infection among females was greater than previous estimates and was highest among those aged 20 to 24 years."

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Cervical Cancer

General Information

NEWS:

Abnormal cells in cervix raise cancer risk: study “A woman's age and the type of treatment she gets may play a big role in the risk that abnormal cells on the cervix will return or develop into cervical cancer, U.S. researchers said on Tuesday. The said older women and women treated with a freezing procedure known as cryotherapy have the highest risks of having the abnormal cells come back or progress to cervical cancer. How severe the abnormal changes in cells were in the first place also plays a role. "We now have a much more clear idea of the risks of recurrent abnormal cells and invasive cervical cancer over time after treatment of these cells," said Joy Melnikow of the University of California Davis, whose study appears in the Journal of the National Cancer Institute. The condition, known as cervical intraepithelial neoplasia (CIN), can progress to cancer. The main cause is the human papillomavirus or HPV, a common sexually transmitted disease. Pap smears, which women in most developed countries undergo regularly, sample the cervix for these abnormal cells. CIN is grouped into three stages, ranging from mild or grade 1, with just a few abnormal cells, to severe or grade 3, in which there are precancerous cells on the top layer of the cervix. … The researchers found the risk of cervical cancer and recurrence of grade 2 or grade 3 abnormal cells was highest for women who were over 40, who were previously treated for grade 3 or for those who whose cells were frozen using cryotherapy. Women treated with cone biopsy, a way of surgically removing the cells, were the least likely to have CIN again later. In general, they found most recurrences of CIN happened in the first six years after treatment, Melnikow said in an e-mail. She said women who have had treatment for the condition in the past have "a low, but higher-than-average risk of invasive cancer, so they need regular screening over an extended period of time." Melnikow said women treated surgically have higher risks of bleeding and preterm labor if they become pregnant after treatment. "Younger women planning later pregnancies may prefer cryotherapy; their risk of recurrence is lower and a recurrence can be treated again," she said.”

ARTICLES:

What Is Cervical Cancer? What Causes Cervical Cancer?

JOURNAL ARTICLES:

Association between bacterial vaginosis and cervical intraepithelial neoplasia. (J Gynecol Oncol. 2009) “CONCLUSION: There was significant correlation between BV and the presence of CIN, regardless of the severity of CIN. In addition, there was no significant association between the presence of BV and HPV infection.”

Gynecological cancer in Indonesia. (J Gynecol Oncol. 2009)

High frequency of multiple HPV types in cervical specimens from Danish women. (APMIS. 2009) “Using microarray technology, we found that 49% of the HPV-positive patients were infected with multiple HPV types. Among the CIN2+ diagnosed women, this frequency was 41%. The most frequently found high-risk HPV type was HPV-16, which was found in 25% of the HPV-positive cervical specimens. Among the HPV positive CIN2+ diagnosed women, 48% were HPV-16 positive. Women younger than 30 years of age had a higher frequency of multiple infections (61%) than women older than 30 years (39%). We conclude that cervical infection with multiple HPV types is common among women in all age groups and among women with or without the diagnosis of CIN2+.”

Prevalence and type distribution of human papillomavirus in 5,000 British Columbia women-implications for vaccination. (Cancer Causes Control. 2009)

Smoking behavior in women with locally advanced cervical carcinoma: a Gynecologic Oncology Group study. (Am J Obstet Gynecol. 2009)

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