The CancerWeb Report, What's New In Cancer: October, 1996
Cervix Cancer

• The effects of screening on the stage of disease - The September, 1996 issue of the British Journal of Cancer contained an article from the University of British Columbia, Canada, comparing two groups of women, born 1914-1918 and 1929-1933, who had been screened for cervical cancer and had been followed-up for over 40 years. There was a false negative rate for screening of about 15%. The younger group who had been screened more frequently had lower rates of invasive disease; it appeared that they were reduced to between one-third and one-half of what they would have been without screening. Cervical cancer at the in situ stage frequently regresses spontaneously, and it appeared that this occurred more often among the younger (72% rate) than among the older women (47%). Overall rates of cervical cancer were higher for the younger group until they reached about 50 years of age, but rates were not as markedly age-dependent as had been thought. The pattern was consistent with exposure to a causative agent, probably infectious, during the late 1940s or early 1950s. (Morrison, Br J Cancer 74:814, 1996)

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• Human papilloma virus type as an indicator of poor prognosis - The role of certain types of human papilloma viruses (HPV) in the development of cervix cancer is well established. Although study results have been inconsistent, there is also suggestive evidence that the type of HPV may also affect how aggressive the cancer is in its growth behavior. A recent example of this was provided by doctors at the Irvine Medical Center and the City of Hope National Medical Center in California. They examined tissue from 291 patients with cervix cancer, publishing their findings in the October 2, 1996 issue of the Journal of the National Cancer Institute. The DNA of HPV was detected in 85% of tumors, with HPV16 in 52% and HPV18 in 20%. Patients who were 45 years of age or younger with a history of smoking cigarettes were most likely to be positive for HPV. Sixty-two percent of adenocarcinomas contained HPV18, versus 17% with HPV16 and 14% with other types, whereas most viral types were found in squamous cell cancers - 83% HPV16, 38% HPV18, and 86% others. In 171 women treated with hysterectomy and removal of pelvic lymph nodes, estimated 5-year survivals were 84% for those with HPV16-containing tumors, 77% for those without detectable HPV, but only 59% for those containing HPV18, indicating an adverse prognostic implication for this viral type. (Burger, J Natl Cancer Inst 88:1361, 1996)