Cervical cancer deadlier than revealed

Cervical cancer is deadlier than previously thought, concluded research published in the journal Cancer. Previous estimates of cervical cancer death rates did not account for women who had their cervixes removed in hysterectomy procedures, which eliminates the risk of developing this cancer.

The study used 2002-2012 data from the National Center for Health Statistics and the NCI Surveillance, Epidemiology, and End Results Mortality Database and discovered:

• The mortality rate for white women in the U.S. is 4.7 per 100,000, which is 47 percent higher than the 3.2 per 100,000 previously estimated.
• Among black women, the mortality rate is estimated to be 10.1 per 100,000 — 77 percent higher than the previous estimate of 5.7 per 100,000.
• Previous estimates of differences in cervical cancer mortality between black and white women were underestimated by 44 percent.

“Prior calculations did not account for a hysterectomy because the same general method is used across all cancer statistics,” said Anne Rositch, assistant professor of epidemiology at Johns Hopkins Bloomberg School of Public Health in Baltimore and lead author of the study.

“This shows that our disparities are even worse than we feared,” said Dr. Kathleen M. Schmeler, an associate professor of gynecologic oncology at the University of Texas M. D. Anderson Cancer Center. “We have screenings that are great, but many women in America are not getting them. And now I have even more concerns going forward, with the” — expected — “repeal of the Affordable Care Act, which covers screening, and the closing of family planning clinics, which do much of that screening.” [1]

According to the National Cancer Institute, there were about 12,990 new cases of cervical cancer in the United States last year and 4,120 cervical cancer deaths. Worldwide, cervical cancer accounts for more than 500,000 new cases of cancer and more than 250,000 deaths each year.

The most common types of cervical cancer are:

• Squamous Cell Carcinoma — starts in the squamous cells which cover the ectocervix (outer lining of the cervix).
• Adenocarcinoma — starts in the glandular cells (mucous-making) that line the inside of the cervix.

Other types of cervical cancer are rare and include adenosquamous carcinoma, glassy cell carcinoma, and mucoepidermoid carcinoma.

You might be at an increased risk for cervical cancer if you are a woman who:

• Has the human papillomavirus (HPV), a common sexually transmitted virus
• Began having sex at an early age
• Has had multiple sexual partners
• Does not have a regular Pap test
• Smokes or uses tobacco
• Has used birth control pills for a long time
• Has a weakened immune system, such as those who have human immunodeficiency virus (HIV)
• Is overweight or obese
• Has a close relative (sister or mother) who has had cervical cancer
• Has been exposed to diethylstilbestrol (DES) before birth

“The vast majority of cases of cervical cancer are caused by persistent infection with oncogenic types of HPV. Effective preventive vaccines against the most oncogenic forms of HPV have been available for a number of years, with vaccination having the long-term potential to reduce the number of cases of cervical cancer,” said NCI Acting Director Douglas Lowy, M.D.

“However, most women who will develop cervical cancer in the next couple of decades are already beyond the recommended age for vaccination and will not be protected by the vaccine,” Dr. Lowy said. “Therefore, cervical cancer is still a disease in need of effective therapies, and this latest TCGA analysis could help advance efforts to find drugs that target important elements of cervical cancer genomes in addition to the HPV genes.” [2]