Cervical Cancer Still Cutting Many Lives Short

Unlike in wealthy nations where cervical cancer deaths have plunged in the past 50 years, the disease remains a top killer of younger women in many parts of the world, according to new research. Study author Dr. Zuo-Feng Zhang of the University of California-Los Angeles said the findings demonstrate the need for more prevention and screening in developing nations.

Zhang and colleagues used the "years of life lost" measure to examine the impact of cervical cancer among women ages 25 to 64 in 2000. Unlike a simple death rate, this measure takes into account a woman's age at death versus her life expectancy. In the global analysis, AIDS was responsible for the most years lost by far, followed by complications due to pregnancy and childbirth, and tuberculosis.

In Latin America and the Caribbean, however, cervical cancer resulted in the most years lost. In sub-Saharan Africa and south-central Asia, women lost more years of life to cervical cancer than any other cancer. In most other world regions, breast cancer resulted in the most years lost.

Cervical cancer is most often caused by infection with certain strains of the sexually transmitted human papillomavirus (HPV). Women can lower their risk of HPV and cervical cancer by not having sex before age 18 and by limiting their number of sexual partners. In the developed world, routine Pap testing -- which can detect early cancer as well as precancerous cells -- is credited for the drop in cervical cancer deaths. But in poor countries, routine Pap tests are not feasible and education on cervical cancer risk factors is lacking. As a result, more than 80 percent of cervical cancer cases globally occur in these nations.

Poor countries, Zhang said, need help from wealthier ones and from international aid agencies to educate women about cervical cancer and to improve screening. While he acknowledged that many poor countries lack the laboratory resources to conduct and interpret Pap tests, he said one alternative is a simple visual inspection of the cervix. Though not as sensitive as the Pap test, "it's better than nothing," Zhang said.

The full report, "Cervical Cancer as a Priority for Prevention in Different World Regions: An Evaluation Using Years of Life Lost," was published in the International Journal of Cancer (2004;109(3):418-424).

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