Cervical cancer's slow, noticeable growth makes it "an ideal
disease" for screening, but poor choices--like not getting
a Pap smear or having unprotected sex as young adults--give the
disease a disastrous head start, a University of Wisconsin Medical
Center cancer specialist says.
Simply changing these behaviors could go a long way toward preventing
the disease altogether or allowing its diagnosis at an early,
treatable stage, according to Dr. Daniel Petereit, a UW Hospital
radiation oncologist who recently took part in a national roundtable
on cervical cancer. Each year 5,000 American women die of cervical
cancer and nearly 15,000 others are diagnosed with the disease.
Petereit treats cervical cancer with high-dose-rate brachytherapy,
a technique he described at the National Institutes of Health
(NIH) Consensus Development Conference on Cervical Cancer on April
After extensively studying the disease's prevention and treatment,
Petereit came away convinced that increased awareness--especially
among rural elderly women and women in their 20s--could go a long
way toward keeping women from becoming his patients.
"'This disease is highly preventable and highly curable when
caught early, but substantial numbers of women are either not
being screened (with Pap smears and pelvic exams) or are not being
screened routinely," Petereit said.
Despite the recognized benefits of Pap smear screening, half of
the women with newly diagnosed cervical cancer have never had
a Pap smear and another 10% have not had one within 5 years, according
to the NIH panel's report.
"'Most alarming to me, since I see many women from small
communities, is the large number of rural, elderly women who do
not get screened," he said.
Nearly one-fourth of cervical cancer cases and 40% of deaths from
the disease are in women 65 and older who live outside metropolitan
areas, according to the panel's report. Groups of women with low
rates of screening and high rates of cervical cancer include women
over 65, the uninsured, ethnic minorities, and people with low
A Key Step Toward Prevention
Another key step toward preventing cervical cancer is conscientious
sexual behavior, Petereit said.
"Cervical cancer is the first solid tumor shown to be caused
by a virus in virtually every case (up to 93%)," Petereit
said. "'Much of the disease can be prevented by avoiding
high-risk sexual behaviors like sex at a young age or especially
unprotected sex," he said.
Genetic traces of human papillomavirus (HPV), a sexually transmitted
disease, are found in virtually every case of cervical cancer
and its precursors worldwide, Petereit said. Women are most likely
to contract HPV in their early to mid 20s.
Researchers, including several at the University of Wisconsin-Madison,
are working toward developing an HPV vaccine. The NIH panel said
that this research "should be given the highest priority."
In addition to emphasizing prevention, Petereit said the conference
clearly showed that "we have very effective therapies to
treat the disease." Cervical cancer in its early stages can
be cured with radiation therapy or surgery in up to 85% of cases.
For more advanced cancers, treatment with radiation therapy is
the best option, providing cure rates of 40% to 60%.
The panel said improved radiation techniques, including increased
use of brachytherapy, has led to "improvement in tumor control
and long-term survival" for women with advanced tumors.