Holden Comprehensive Cancer Center
David Bender, MD, a specialist in gynecologic cancer with University of Iowa Hospitals and Clinics, says there is a lot to talk about because of recent advances against the disease. He has these comments:
What is probably the single biggest recent development regarding cervical cancer?
We now have available an FDA-approved vaccine that targets the human pappiloma virus, a sexually transmitted infection that's linked to the development of most cervical cancers. The vaccine, known as Gardasil, is effective against four HPV types; 6 and 11 which cause genital warts, and 16 and 18 which are linked to 70 percent of the cervical cancers in the United States.
While there are a number of different HPV strains now reported, protection against these two alone will make an enormous impact on the prevention of cervical cancer.
What will be the impact of Gardasil?
Gardasil is expected to have a significant impact on the prevention of cervical disease and genital warts. Where our push for education on the practice of safe sex with barrier methods and the need to pursue regular cervical screening exams has helped many women avoid cancer, we still faced nearly 10,000 new cases of cervical cancer this past year. The HPV-directed vaccine will provide another means of protection for women against a virus that is often clinically silent at the time of transmission. The vaccine is approved for administration to women between nine and 26 years of age.
Is there an updated version of the traditional Pap smear?
The conventional Pap smear, a Pap smear on a glass slide, is a thing of the past for most institutions. Liquid-based Pap tests have become more and more common since their FDA approval 10 years ago. Cervical cells are easier to visualize in the liquid-based cytology studies and have reduced the number of false negative studies. Clinicians are able to definitively follow patients with cells of varying degrees of abnormality, targeting those with high grade lesions for interventions to prevent invasive cancer.
Are there other promising efforts on the horizon?
There are some very exciting efforts on the horizon, all with the focus to prevent gynecologic disease. A new vaccine covering a broader spectrum, or more HPV types, is being developed. Investigations into the detection of cervical glandular lesions, or ateneo carcinomas, and their relationship to this infection are underway. And then we continue to debate over the timing of the administration of Gardasil, the duration of protection for the vaccine, and the role of the HPV vaccine in terms of revaccination.
Are there other steps women can take to reduce their risk for cervical cancer?
Women should still take the more traditional measures to reduce the risk of developing cervical disease. Eliminating smoking or tobacco use will decrease a woman's risk for getting cervical cancer. Barrier protection with condoms, as we talked about, will help decrease the transmission of sexually transmitted diseases, which can alter the cervical cells.
And, finally, the annual gynecologic evaluation will help clinically screen patients for cervical abnormalities and keep them informed on the latest means of protection with the increasingly popular HPV vaccine.
What are the most important facts about cervical cancer you'd like people to remember?
The single most important fact about cervical cancer that people should remember is that this is a preventable disease. We can vaccinate and educate in the hopes of eliminating this disease. For patients already diagnosed with cervical abnormalities, regular follow-up and treatment of pre-invasive disease will help eliminate the majority of invasive cancer cases. If invasive cancer is detected, the earlier we have an opportunity to intervene, the better the chance for cure. |
