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Virus Studies Help Prevent Cervical Cancer | |
By DR. BRUCE A. BARRON One of the most common tests in medicine is the Papanicolaou - Pap test - used to detect cancer of the cervix and its precursor lesions. The smear technique was developed in the 1950s by Dr. George Papanicolaou. It has contributed substantially to the reduction of cervical cancer deaths in the United States. The test consists of microscopic examinations of cells that are taken from the cervix of the uterus. Studies in the 1970s found that some women with abnormal cells detected by the Pap test developed cancer slowly or not at all, while others developed invasive cancer rapidly. Knowledge about the genetics of human papilloma virus (HPV) has helped explain why. In the past 15 years, more than 50 different strains of HPV have been identified. They are distinguished by slight differences in the genetic material of the viruses and are identified simply by number. A subset of these different strains are commonly found in the cervix. A few of these strains appear to be associated with the rapid progression of precancerous lesions into cervical cancer. It now is possible not only to identify precancerous growths, but also to determine whether the high-risk strains of HPV associated with rapid progression to cancer are present in a given women. The treatment of high-risk and low-risk lesions does not differ. But after treatment, women who are infected with a virulent type of HPV require close supervision to minimize their risk of developing cervical cancer. The incidence of the disease appears to be increasing, in part because of increased sexual activity by younger people. In addition, it is one of the cancers that occurs in women with AIDS. Because HPV is sexually transmitted, sexually active women with multiple partners are advised to have Pap tests at least once a year. All sexually active women are advised to start with once-a-year Pap tests. The interval between tests can be increased for women who have three negative Pap smears and who have only one sexual partner. The Pap test is expensive, since it requires the services of a highly trained cytology technician to examine each sample. New technologies to automate the test and reduce its cost are being developed, but their cost-effectiveness has not yet been proved. --- Dr. Bruce A. Barron is Professor of Obstetrics and Gynecology at New York University School of Medicine. Copyright 1996 Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed. | |