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J Reprod Med. 1974 May;12(5):173-85.

Cervical cancer epidemiology in historical perspective.

Abstract

PIP:

In 1846, uterine cancer was the most frequently observed malignant tumor in western Europe. It accounted for nearly 1/3 of all reported deaths in Paris. The cervix was regarded as the primary source in most cases. Several etiological theories in vogue today were discussed then. The relative infrequency of cervical cancer among Jewish women was reported by numerous writers. The possible role of circumcision of husbands was not seriously considered until 1935. More recent such studies have been inconclusive. A definite reduction in the death rate from cervical cancer has been evident since 1950. The parallel rise in incidence is accounted for by the more numerous in situ cases detected through cytologic screening. Nonwhite women in America above age 60 as well as the elderly in England and Wales have not shown equally improved rates. The hypothesis that the genital strain of herpes simplex virus (HSV-2), a venereally transmitted virus, is associated with cervical cancer has been advanced and much new evidence has recently been reporte d. A positive association between cervical cancer and HSV-2 antibodies is evident. Progression of dysplasia and carcinoma in situ is of uncert ain occurrence. Prolonged periodic check-up studies are needed to deter mine this. If the facts warrant, follow-up by aggressive therapy is indicated. Observer variability has been a problem. 1 pathologists' interpretation of dysplasia may be another's carcinoma in situ. The more severe dysplasias have been more likely to progress. Periodic cytological screening has reduced the percentages of cases 1st diagnosed in the invasive stage to 1/2 on 1/3 of the former incidence. Increases in survival rates have followed. Patients with regional spread have experienced little gain. Women at highest risk have tended to elude examinations.

PMID:
4599289
[Indexed for MEDLINE]

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