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 some women at long term cervical cancer risk

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PostSubject: some women at long term cervical cancer risk   Fri Oct 26, 2007 1:19 am

By Michael Kahn


LONDON (Reuters) - Women treated for pre-cancerous lesions are at
increased risk of developing cervical or vaginal cancer for at least
another 25 years, according to a study suggesting that follow-up tests
fall dangerously short.


Using data from Sweden's national cancer registry, the researchers
said on Friday women who have had severe lesions in the cervix are more
than twice as likely to develop one of the two cancers than women in
the general population.


The findings underscore the need for follow-up tests to continue for
at least 25 years after treatment, far longer than the current five or
10 years standard in most European countries, said Bjorn Strander, a
gynaecologist at Sahlgren's University Hospital in Sweden, who led the
study.


"This is a warning to the healthcare system to keep track of these
women," he said in a telephone interview. "It has not been known these
women remain at risk for such a very long time."


Most cases of cervical cancer are caused by the sexually transmitted
human papilloma virus and is the second most common type of cancer in
women. Vaginal cancer is far more rare, with about 13,000 women
diagnosed each year.


Women in many countries have an annual Pap smear to check for early
signs of these lesions, which are easily removed if caught before they
develop into cancer.


Nonetheless cervical cancer kills 300,000 each year, mostly in
developing countries. Merck and Co's Gardasil and GlaxoSmithKline's
Cervarix vaccines protect people against certain strains of HPV, but
not all.


In their study, the researchers mined the National Swedish Cancer
Register for information recorded from 1958 to 2002 on more than
132,000 women diagnosed with pre-cancerous lesions.


They found that 881 women had developed cervical cancer and 111
women had vaginal cancer more than one year following their diagnosis
-- even after they had their lesions removed.


And the risk remained high for a long time, they said.


"We haven't investigated why but there are indications it could be
because a lack of surveillance," Strander said." The risk is quite
steady . It does not decrease."


A woman's risk also rose if she was older at diagnosis, also
possibly due to the healthcare system letting down its guard during
follow-up care, Strander said.


The Swedish study, published in the British Medical Journal, did not
look at whether a Pap smear or DNA test represented the best way to
screen these women but said it merits further study, Strander added.


Two Italian researchers writing in a related editorial agreed the
findings should spark further study and said they clearly show current
testing guidelines are not sufficient.


"One clear indication is that women treated for (severe
pre-cancerous lesions) should continue surveillance beyond the age
limit of regular screening," they wrote.









Reuters2007All rights reserved

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