Roanoke Times
Copyright (c) 1995, Landmark Communications, Inc.
DATE: WEDNESDAY, June 7, 1995 TAG: 9506070070
SECTION: NATIONAL/INTERNATIONAL PAGE: A-4 EDITION: METRO
SOURCE: Associated Press
DATELINE: WASHINGTON LENGTH: Medium
A study of 481 women diagnosed with cervical cancer after the disease became advanced found almost 29 percent had never had a Pap smear, a test recommended every one to three years.
The average age of these women was 64 - 20 years older than the average woman who is properly tested, researchers report in the June edition of the American Journal of Public Health.
``Every case of invasive cervical cancer is preventable,'' said study author Dr. Dwight Janerich of the University of Utah. ``My hope is that this study kicks off a new chapter of concern about the Pap test.''
The Pap smear is a simple test in which cervical cells are scraped off and checked for malignancies and for precancerous changes in cells that, if removed, can prevent cervical cancer. It is recommended annually once women reach age 18 or become sexually active. After three consecutive normal tests, doctors may recommend low-risk women have the test as seldom as every three years.
``This study shows we could be doing much better,'' said Dr. S.B. Gusberg, past president of the American Cancer Society. ``Many doctors, especially family practitioners, don't suggest this screening for patients as often as they should ... and women themselves are failing.''
The Pap smear is credited with causing decades of steady decline in the rates of invasive cervical cancer, but those declines suddenly leveled off in the 1980s. To discover why, Janerich and colleagues at Yale University studied 481 Connecticut women diagnosed with invasive cancer between 1985 and 1990.
Older women who had never been tested were most at risk, the study found.
But they weren't the only problem. Of women who had had at least one Pap smear in their lifetime, 32.8 percent had not sought one in at least five years, much too long an interval to detect early cancer, Janerich said. Another 15 percent didn't return for proper follow-up care after an abnormal or inconclusive Pap.
And laboratory workers missed some evidence of cancer or precancerous abnormalities in at least 6.9 percent of the cases, Janerich said.
Meanwhile, a sexually transmitted virus has been linked in 22 countries to cervical cancer, suggesting a vaccine could be a key to reducing the death toll from the disease.
A study of more than 1,000 cervical cancer specimens from 22 countries found evidence for 25 different types of the human papillomavirus. The virus was found in 93 percent of the specimens tested.
``This is the final, definitive proof that there is a worldwide linkage between cervical cancer and this sexually transmitted virus,'' said Dr. M. Michele Manos of the Johns Hopkins School of Public Health.
``It is very clear now that sexual behavior has a direct relationship on the occurrence of cervical cancer,'' she said.
by CNB