Cancer Headlines
CHICAGO (AP) - Low-income American women and women in developing countries
who are tested for cervical cancer could benefit from faster, more aggressive
treatment, two studies suggest.
Some of those women would be treated unnecessarily, but some experts believe
the trade-off might save lives in impoverished countries where women often
die from a cancer that can be treated if caught early.
"We may have to decide what's feasible, what we can afford and what's the
best care for different groups," said University of California, Irvine,
researcher Dr. Wendy Brewster, co-author of one of the studies. Both studies
appear in Wednesday's Journal of the American Medical Association.
Cervical cancer is preventable and mostly afflicts the world's poorest women.
Eighty per cent of the 230,000 cervical cancer deaths worldwide each year
are in developing countries, according to the International Agency for Research
on Cancer. In the United States, black and Hispanic women have the highest
death rates for cervical cancer.
Many women in affluent countries get screened annually with a Pap smear,
a test in which cells are scraped from the cervix and examined under a microscope
in a lab. If the test is abnormal, the patient is called back for a biopsy.
If the biopsy shows signs of cancer, the woman and her doctor discuss treatment
choices.
In poor countries, however, lab testing and biopsies are rare. In poor U.S.
neighbourhoods, patients might not get regular Pap tests, or might fail to
return for follow-up exams, Brewster said.
The new studies, which explore ways to get more poor women tested and treated,
were done in South Africa and in largely Hispanic neighbourhoods in Orange
County, Calif.
In the California study, 3,521 women were given Pap smears. One group of
women stayed at the clinic to await results. If their tests indicated high-grade
precancerous lesions, the women had a procedure that day to remove a layer
of the cervix. The cervix is the lower part of the uterus that opens into
the vagina.
In the comparison group, women with abnormal tests were referred for later
follow-up care.
Checking back six months and 12 months later, researchers found that the
women in the single-visit group were significantly more likely to have completed
their care than women in the comparison group.
Samples for biopsies were taken before treating the women. Those indicated
that two out of 14 women had had the procedure unnecessarily because their
biopsies were negative. The procedure is considered safe but still carries
risks.
In the South Africa study, 6,555 women got two screening tests: one for human
papilloma virus, HPV, a common sexually transmitted virus that causes most
cervical cancer, and the other a simple, cheap test for precancerous lesions.
The women then were divided into three groups. In the first group, only the
women testing positive for HPV were given cryotherapy, a procedure that destroys
cells on the cervix by freezing them with nitrous oxide. In the second group,
only the women who tested positive for precancerous lesions had cryotherapy.
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