131-AP-98
FOR IMMEDIATE RELEASE
UC IRVINE RESEARCHERS TO STUDY NEW TREATMENT APPROACH TO HELP REDUCE RATE OF CERVICAL CANCER
Researchers Receive $2.7 Million Award from National Institutes of Health to Study Effectiveness of Same-Day Pap Smear Screening, Therapy
Irvine, Calif., Oct. 27, 1998 - Researchers at UC Irvine's College of Medicine have been awarded $2.7 million by the National Institutes of Health (NIH) to study a new approach for the early detection and prevention of cervical cancer that involves screening, diagnosing and treating patients all in one visit.
The researchers hope this new approach will reduce the incidence-and the death rate-of one of the most common cancers affecting women.
In addition, because the study will involve as many as 3,500 women, the researchers will have an unprecedented opportunity to examine whether environmental and genetic factors increase the risk of getting cervical cancer.
Currently, women are screened for cervical cancer during an initial visit, using a Pap smear. If the test finds something abnormal, they must come in again for a more detailed assessment. If this assessment reveals a pre-cancerous condition or the early stages of cancer, they must make a third visit for treatment. In some cases, a fourth visit may be required. While most treatments involve a simple office procedure, this series of visits leading to treatment can be disruptive to patients' schedules and take months to complete, says Dr. Alberto Manetta, senior associate dean at the UCI College of Medicine and a researcher on the project. Manetta is working with Dr. Hoda Anton-Culver, head of the College of Medicine's cancer epidemiology division, and Dr. Alan Hubbell, head of its primary care division.
Manetta estimates that 20 percent to 40 percent of patients with abnormal Pap smear readings don't return for further testing and treatment, and he suspects that one reason may be the multiple visits required for the tests and treatment.
"Cervical cancer affects about 500,000 women worldwide, and an enormous number of women are missing needed treatment because they don't return for follow-up care after receiving a Pap smear with an abnormal reading," Manetta said.
Cervical cancer is deadly: 16,000 women are diagnosed with the disease and 4,500 die each year in the United States, according to the National Cancer Institute. In developing countries, these numbers can run much higher.
With the NIH award, Manetta, Anton-Culver and Hubbell will conduct a five-year study. Half of the 3,500 women in the study will undergo Pap smear screening and receive a diagnosis and treatment, if necessary, during the same visit to the clinic. The other half will receive traditional care with multiple visits. The researchers will compare levels of compliance and cost-effectiveness of the two programs. The researchers will recruit volunteer patients from the UCI Family Health Centers in Anaheim and Santa Ana. Women interested in volunteering for the study should contact either the Anaheim center at (714) 774-9795 or the Santa Ana center at (714) 541-6545.
Because the study involves a large number of women, the researchers will be able to measure whether such factors as race, ethnicity or genetic makeup play any role in cervical cancer. While the disease is linked closely to an infection by what is known as the Human Papilloma Virus, the researchers will look at other factors that have not been studied closely and may increase the risk of getting cervical cancer.
Anton-Culver explained: "Some risks, like smoking, multiple sexual partners and pregnancy at an early age, already are well-known. But in this study, we can now look at other areas, like genetic predisposition to cancer and metabolic differences between people.
"Also, we'll examine Pap smear specimens from the patients to look for different types of cancerous growth in cells, to see if the cancer occurs at different rates among people depending on their ethnic or genetic background."
Establishing a single-visit treatment program for cervical cancer is possible only at large clinics that have pathology laboratories located nearby. "You need a laboratory close to the doctors' office in order to make this work," Manetta said. The study will explore ways that clinics can be reorganized to make immediate laboratory testing possible.
Why do so many patients with abnormal Pap smear readings avoid treatment? Patients could be afraid of the diagnosis of cancer and may not understand fully the consequences of getting an abnormal Pap smear reading, but there may be other reasons for not coming back.
"People may have problems with the cost of multiple visits, or with transportation and child care, or they may not have access to a telephone," Manetta said, noting that the study will try to determine whether the one-visit system is cost-effective.
The one-visit system may appeal not only to low-income patients, but also to affluent executives with little time for doctor visits, Manetta added.
The research could prove useful worldwide. While the percentage of patients in the United States who fail to follow up after receiving abnormal Pap smear results is significant, the follow-up failure rate is even higher in other countries. For example, it's closer to 60 percent among women in Mexico and other Central American countries.
Eventually, the researchers will concentrate on how to deliver the service to remote areas that don't necessarily have access to modern diagnostic and treatment facilities. "We will want to see how we can make this system available to people who don't live or work close to a large medical clinic," Manetta said.
Future studies also will focus on whether the single-visit program works in other countries, especially those with low follow-up rates. "We think the information we develop will be invaluable to health departments throughout the world," Anton-Culver said.
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Contact:
Andrew Porterfield
(949) 824-3969
[email protected]
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