Focusing On Patients

Cervical cancer: "preventable and curable"

Feared, misunderstood and invariably diagnosed too late, cervical cancer used to be a major killer of women. Sixty years ago the disease killed more women than lung or breast cancer combined. Between 1955 and 1992, however, the number of deaths from cervical cancer declined by more than 70 percent, thanks to a test for detecting abnormal cells developed by a physician named George Papanicolaou.

The Pap test or Pap smear, as it became known, identifies cells that have changed but are not yet cancerous. About 15,000 women are diagnosed annually with cervical cancer, but thanks to this test, many of these cancers are found when they are eminently treatable. The five-year survival rate for pre-invasive cervical cancer, for example, is nearly 100 percent. The five-year survival rate for early invasive cancer of the cervix is 90 percent. For all stages combined, it is 70 percent.

That's not to say women can take cervical cancer for granted. While the causes of cervical cancer not entirely known, doctors believe infection with a sexually transmitted disease called human papilloma virus (HPV) is a predisposing factor. More than 90 percent of women diagnosed with cervical cancer had HPV. Other risk factors include first intercourse at an early age, having many sexual partners or having sex with a man whom has had many partners. Smoking increases a woman's chances of developing cervical cancer, as does having a compromised immune system. Women who are HIV-positive have a much higher incidence of cervical cancer.

Women whose mothers took the synthetic hormone DES during pregnancy are also at risk, although it's not as common a problem today. Use of DES peaked in the 1950s and was phased out entirely more than 25 years ago.

Regardless of her risk factors, a woman can greatly reduce the danger of cervical cancer by getting regular Pap tests and pelvic exams.

"Cervical cancer is now a mostly preventable and curable disease, thanks to the Pap smear and early diagnosis," says John Dalrymple, an assistant professor of obstetrics and gynecology. "These measures make an enormous difference."