Excess Pounds Boost Risk of
Cervical Cancer
September Is Gynecologic
Cancer Awareness Month
Being overweight doubles
the risk of cervical cancer, according to a new study reported
in the medical journal Cancer.
"Our study is not
the first to look at obesity [and cervical cancer]," says Dr.
James V. Lacey Jr, an epidemiologist at the National
Cancer Institute (NCI) and the lead author of the study.
"But by controlling
for human papilloma virus [a sexually transmitted virus that
causes genital warts and is considered the primary risk factor
for cervical cancer], we got a better picture of what role obesity
might also play," Dr. Lacey says.
"It showed us that
when taking into account the role of HPV, obesity might be an
important co-factor for cervical adenocarcinoma," Dr. Lacey
says.
Exactly how excess
weight may increase the risk of cervical cancer is not known.
But some experts believe that excess fat tissue can influence
levels of estrogen and other sex hormones, and that, in turn,
can increase susceptibility to cancers.
Other risk factors
for cervical cancer include intercourse before age 18, multiple
sex partners, or a partner with many previous partners.
Body
Mass Index Measured
Cervical adenocarcinomas
account for about 10 percent to 15 percent of all cervical cancers, Dr.
Lacey says.
The American
Cancer Society (ACS) estimates that in 2003, about
12,200 cases of invasive cervical cancer will be diagnosed in
the United States. Some researchers estimate that noninvasive
cervical cancer (carcinoma in situ) is about four times
more common than invasive cervical cancer.
About 4,100 women
will die from cervical cancer in the US during 2003, the ACS
states. Cervical cancer was once one of the most common causes
of cancer death for American women.
Between 1955 and 1992,
the number of cervical cancer deaths in the US declined by 74
percent. The main reason for this change is the increased use
of the Pap test, which is a screening procedure that permits
diagnosis of preinvasive and early invasive cancer.The death
rate continues to decline by about 2 percent a year.
September is national
Gynecologic Cancer Awareness Month, an observance
supported by the Gynecologic Cancer Foundation.
In the study, Dr.
Lacey and his team evaluated 124 women with adenocarcinoma,
139 with squamous cell cancer, and 307 healthy controls, ranging
in age from 18 to 69. The women gave their height and weight,
and researchers measured their waist-to-hip ratio, another measure
of obesity.
Women with a Body
Mass Index (BMI) above 30, which is considered obese, were 2.1
times more likely to have adenocarcinoma, compared with women
who had BMIs in the healthy range, under 25. Less consistent
results were found for squamous cell cancers, Dr. Lacey says.
A woman who is 5 feet,
3 inches tall and weighs 135 pounds has a BMI of 24; if a woman
weighs 170, her BMI is 30.
The link to cervical
cancer was found "not just for obese women, but also for overweight
women," Dr. Lacey says.
Experts
Say New Study Confirms Link
The new study strengthens
the argument for the role of hormones in the development of
some cancers, says Dr. Margaret M. Madeleine, an epidemiologist
at the Fred Hutchinson Cancer Research Center in Seattle.
Dr. Jonathan Berek,
of the University of California Los Angeles Jonsson Cancer Center,
agrees, calling the new research "a good study."
A high BMI is already
a known risk factor for endometrial cancers, so it is feasible
that the same may hold true for cervical cancers, Dr. Berek
says.
Exactly how excess
pounds can boost the risk isn't certain. But it might be that
the higher levels of circulating estrogen in a heavy woman's
body stimulate normal cells to become malignant cells, he says.
Always consult your
physician for a diagnosis.
Online
Resources
(Our Organization
is not responsible for the content of Internet sites.)
American
Society for Reproductive Medicine (ASRM)
Centers
for Disease Control and Prevention (CDC)
Gynecologic
Cancer Foundation
HealthierUS.Gov
National
Institutes of Health (NIH)
National
Women's Health Information Center
Office
of Research on Women's Health
|
September
2003
Excess
Pounds Boost Risk of Cervical Cancer
Body
Mass Index Measured
Experts
Say New Study Confirms Link
What
Is a Pap Test?
Online
Resources
What
Is a Pap Test?
A Pap test (sometimes
called a Pap smear) is a way to examine cells collected from
the cervix, or the "mouth" of the womb (located at the top of
the vagina), for the presence of:
-
infection
-
inflammation
-
abnormal cells
-
cancer
A Pap test, along
with a pelvic examination, is an important part of a woman's
routine healthcare because it may detect abnormalities that
can lead to invasive cancer.
Most invasive cancers
of the cervix can be detected early if women have Pap tests
and pelvic examinations regularly.
As with many types
of cancer, cancer of the cervix is more likely to be successfully
treated if it is detected early.
The Pap test is useful
for detecting not only cancerous cells, but also other cervical
and vaginal abnormalities including dysplasia (precancerous
cells) and inflammation. Inflammation may be caused by:
According to the
National Cancer Institute (NCI), cervical cancer
screening should begin approximately three years after a woman
begins having sexual intercourse, but no later than at 21 years
old.
Experts recommend
waiting approximately three years following the initiation of
sexual activity because transient HPV infections and cervical
cell changes that are not significant are common and it takes
years for a significant abnormality or cancer to develop.
Cervical cancer is
extremely rare in women under the age of 25.
Women should have
a Pap test at least once every three years.
Women 65 to 70 years
of age who have had at least three normal Pap tests and no abnormal
Pap tests in the last 10 years may decide, upon consultation
with their healthcare provider, to stop cervical cancer screening.
Women who have had
a total hysterectomy (removal of the uterus and cervix) do not
need to undergo cervical cancer screening, unless the surgery
was done as a treatment for cervical precancer or cancer.
Women should seek
expert medical advice about when they should begin screening,
how often they should be screened, and when they can discontinue
cervical screenings, especially if they are at higher than average
risk of cervical cancer due to factors such as HIV infection.
Always consult your
physician for more information. |
