The CancerWeb Report, What's New In Cancer: January, 1997
Cervix Cancer

• A new Danish estimate of how many early cancers and precancerous areas of the cervix progress or regress - Cancer of the cervix can now be detected by Pap smears even while still at the precancerous stage. Many precancerous areas on the cervix that shed the abnormal cells seen on smears will never progress to cancers even if left untreated. The medical literature contains widely different estimates, some in excess of 60%, of how frequently these abnormalities either do not progress or actually regress and disappear. Any abnormal areas of the cervix are nowadays likely to be identified early and treated. A study covering a single Danish county over the period 1966-1982, including screening data from scratch and complete registration, together with clinical cancer incidence before and after initiation of the screening program, was published in the January, 1997 issue of the British Journal of Cancer. Of preclinical cervical abnormalities in women aged 25-50, 24% progressed to cancers, 38% remained unchanged, and 39% regressed. The researchers estimated that preclinical abnormal lesions last for an average of about 16 years, and that 48% of these cervix lesions would not progress to cancer within a women's lifetime. These findings are somewhat reassuring, and are relevant to controversies over the optimal frequency for obtaining cervical smears. (Bos, Br J Cancer 75:124, 19997)

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• Cisplatin plus ifosfamide for cervix cancer, better response but no improved survival - Although it is readily curable at an early stage, advanced cervix cancer is difficult to treat, which is why early detection is so important. The US Gynecology Oncology Group compared cisplatin, cisplatin plus mitolactol (C + M), or cisplatin plus ifosfamide (CIFX) and mesna in patients with advanced cervix cancer. The results were published in the January, 1997 issue of the Journal of Clinical Oncology. CIFX gave a higher response rate (31% versus 18%) and longer progression-free survival than cisplatin alone. C + M showed no improvement over cisplatin alone. However, overall survival did not differ between the three treatments, and toxicity - low white cell counts, kidney and nervous system toxicity - was more frequent with CIFX. (Omura, J Clin Oncol 15:165, 1997)