A Primer on Cervical Cancer

Cervical cancer is a major killer of women worldwide, killing over 250,000 annually.  It is the fifth most deadly cancer and one that could potentially be prevented in a vast majority of cases.  The reason for this is two-fold:  First, cervical cancer has an effective screening test known as the Pap smear and second, cervical cancer is sexually transmitted.

The Pap smear was invented by the Greek physician George Papanicolaou while working in the United States in 1928.  The Pap smear involves scraping cells from the cervix and looking at them under a microscope to detect potentially pre-cancerous changes.  It has been estimated that routine screening of sexually active women with the Pap smear has reduced the number of deaths from cervical cancer by at least 50%.

Epidemiologists noted certain characteristics about cervical cancer noting that it was common in female prostitutes, rare among nuns, and more common among men whose first wives had died from cervical cancer.  This led them to believe that cervical cancer might be transmitted sexually.  In the 1970’s, human papillomavirus (HPV) was discovered and was later found to be the cause for virtually all cervical cancers.

After a positive Pap smear result, a biopsy of the cervix is required to confirm the diagnosis of pre-cancerous changes or cervical cancer.  As with most cancers, the earlier the cancer is detected, the more effective the treatment.  Depending upon the extent of the cancer, treatment may range from hysterectomy plus or minus removal of the lymph nodes or radiation therapy to radical hysterectomy plus chemotherapy.

The first step in prevention is education. In a 2005 survey, only 40% of American women had even heard of HPV infection and only 20% knew of its link to cervical cancer. Knowing that HPV and cervical cancer is sexually transmitted means that safe practices and use of a condom is an important means of prevention. Early detection via regular Pap smear screening is also vital in early detection which can allow for early treatment and higher cure rates.

There has recently been a vaccination for the 2 strains of HPV which are responsible for 70% of the cases of cervical cancer. It has been approved in both Europe and the United States and is manufactured by Merck under the trade name Gardasil. There is also a vaccine made by GlaxoSmithKline.

There is also some evidence that certain aspects of a woman’s nutrition can help the body’s natural defenses clear HPV infection. High levels of vegetable consumption and papaya have been shown to be beneficial as have higher levels of consumption of vitamin C, vitamin E, folic acid, and coenzyme Q10.

Great strides have been made in recent years in decreasing the incidence and impact of cervical cancer. Increased efforts at education, prevention, vaccination, and early detection can continue to reduce the adverse effects of this killer of otherwise young, healthy women.