Virus linked to cervical cancer

Treatment hope: Finnish discovery prompts search for vaccine that could 'eliminate disease'

Cervical cancer could be drastically reduced by routine testing for a virus when smears are taken, doctors said yesterday.

The virus, which is a common one, infects about one in 20 women, has no symptoms and is generally transmitted through sexual intercourse.

If a vaccine for the virus could be developed the deaths from cervical cancer, currently 500,000 worldwide each year, could be drastically reduced.

The human papillomavirus type 16 (HPV 16) - related to wart viruses - is said to be "the major factor" linked to cervical cancer according to a paper by researchers in Finland in the British Medical Journal today.

Dr Peter Sasieni, epidemiologist for the Imperial Cancer Research Fund, said the discovery had great implications for the treatment of the cancer.

"There are both short-term and long-term things we could do which would aid us. We could put a test for the virus into the cervical screening programme.

"We know that the cervical smear test is not perfect, but if we were testing for the virus we would not miss the proportion that we miss at the moment."

About 4,000 cases of cancer and 18,000 cases of pre-cancer are detected annually in Britain. There were 1,369 deaths from cervical cancer in 1994, most among women who had never been screened. A scheme set up in 1988 and offering a three or five-yearly test to women aged 25 to 64, is estimated to save 1,000 to 2,000 lives a year.

More than 18,000 women in Finland were invited to a health examination between 1966 and 1972 which included asking about medical history, smoking and taking a blood sample.

All those who had given blood and were free of cancer at the time were followed by public health researchers.

In the study, between 65 and 95 per cent of cervical cancers contained the human papillomavirus DNA. About half of the patients with cervical cancer tested positive for antibodies to HPV16.

Nearly a quarter of the women found to have developed cervical cancer by 1991 had detectable antibodies when the survey started, and additional women may have become infected during the average time gap of 10 and 23 years between taking the sample and development of the cancer.

If a woman was found to have the virus then, as happened with a positive smear test, she was sent to a gynaecologist for a colposcopy which identifies precancerous tissue by examining the cervix. If pre-cancerous cells were found a small biopsy or laser treatment was be carried out.

Although there was thought to be a link between herpes and cancer of the cervix, the study showed that women with herpes only developed the cancer when the papillomavirus was present.

"The public health impact of controlling precursor cervical lesions and cancer is potentially huge, especially in developing countries where the incidence of cervical cancer approaches 40 per 100,000 women," an editorial in the BMJ said.

Dr Sasieni added: "The long-term implication would be if we could develop a vaccine for the virus. Then it would be possible to eliminate cervical cancer altogether."