Cancer can be a scary topic, but one type – cervical cancer – represents a real clinical success story. Over the millennia, we’ve graduated to a fuller understanding of how the immune system figures in this disease, which was once the second most common cancer in women.

The cervix is the bottom part of the uterus – and we’ve known about cervical cancer since Hippocrates first described it in 400 B.C. We’ve also known that this type of cancer has been associated with sexual contact since 1842, when a physician in Italy described a difference in cervical cancer incidence between abstinent nuns and other women. (This was before we knew even what caused the sexual infection.)

Thanks to the development of the Pap smear (for Papanicolaou), the 1950s and 1960s showed a decrease in the incidence of cervical cancer. We still didn’t know what caused the sexually- transmitted infection, but we could screen for pre-cancer stages and treat it before it became cancer. Thanks to this strategy, by 1994 the incidence was down to 8 cervical cancer cases per 100,000 women in the U.S.

And now another huge breakthrough is the identification of HPV (human papilloma virus) types as the major cause of cervical cancer. The viral types were first isolated in the 1980s; we can now screen for HPV types which are responsible for both cervical cancer (called high risk HPV types) and genital warts (called low risk HPV types). Most people with healthy immune systems can fight off the virus within two years. But when the immune system is already compromised, the body has limited ability to fight off infection, and cancer may develop. A lifetime use of condoms will decrease the risk of cervical HPV infection by 70 to 80% but will not affect the risk to infection elsewhere on the body.

Although we know a lot about the life cycle of the HPV virus, we are still isolating more and more types of the virus and understanding where it chooses to infect both men and women. Three vaccines are also available. One is a “bivalent” vaccine that protects against the two most common high risk HPV types. One is a “quadrivalent” vaccine that protects against the two most common high risk HPV types and also protects against two HPV types that are responsible for 90% of external genital warts. A newer vaccine targets nine different HPV types – hoping to expand the effectiveness of the vaccine. The key to success with these vaccines is to administer the doses before sexual activity begins, which is one reason it is recommended for girls and boys ages nine to 26.

In addition, to keep the immune system strong on a daily basis, it’s smart to live a healthy lifestyle, including good nutrition, regular exercise, good sleep patterns and taking nutritional supplements if needed.

 

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