Much of the world's cervical cancer problem can be solved with existing or soon-to-be-available technology, sufficient will, and modest resources, say authors of a Seminar in this week's edition of The Lancet.
Professor Mark Schiffman, National Cancer Institute, National Institutes of Health, Maryland, USA and colleagues say: "There is an enlarging repertoire of options for cervical cancer prevention for regions with varying needs and values, based on innovative technology and clear understanding of cervical carcinogenesis."
There were around 500000 incident cases and 275000 deaths due to cervical cancer in 2002, equivalent to about a tenth of all deaths of in women due to cancer. It is the second most common cancer in women worldwide, and the burden of the disease is disproportionately high in the developing world (>80%).
The authors say: "Not only in cervical cancer the most prevalent and important cancer in women in several developing countries, but also the societal importance of the disease is accentuated even further by the young average age at death, often when women are still raising families."
They add: "Promising approaches to cervical cancer prevention have resulted from our new understanding that almost all cases are caused by persistent infection with about 15 genotypes of human papillomavirus (HPV)."
The seminar reviews the histopathology of cervical cancer and transmission of the HPV virus, progression to pre-cancer and cancer. The strengths and weaknesses of screening and diagnostic options are highlighted. Prevention strategies including vaccination are also discussed in detail.
The authors conclude: "Because of the importance of the [cervical cancer] problem and the feasibility of ameliorating it, we hope to see a major decrease in the numbers of women affected with this cancer within our lifetimes."
For accompanying seminar: http://multimedia.