Smoking and Cervical Cancer: Beating the Odds  

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Posted: 9/1/2004

COLUMBUS, Ohio – A large team of investigators from The Ohio State University Comprehensive Cancer Center (OSUCCC) has launched a major research project to find the best way to help women beat the odds of getting cervical cancer. Surprisingly, they say one of the best first steps may be to stop smoking.

The program, one of several large population studies funded by a $7.5 million grant from the National Cancer Institute, will compare two different approaches to helping women quit smoking and increase their use of Pap smears, a way of detecting the presence of any cervical cancer cells, or any suspicious looking tissue that might lead to the development of cervical cancer.

The OSU team, including Dr. Mary Ellen Wewers, a professor of nursing and co-director of the project, along with collaborators from the University of Michigan, the Fred Hutchinson Cancer Research Center and the Centers for Disease Control and Prevention, are targeting their efforts to women in Ohio’s 29-county Appalachian region, but the project has implications for women everywhere.

“We hope to help women understand risk appropriate use of Pap smears,” says Dr. Electra Paskett, associate director of population sciences for the OSUCCC and lead investigator of the project.

Recently, public health guidelines changed: Women with no risk factors for cervical cancer are now told they need Pap smears only every three years, not yearly.

But that’s got Paskett worried. She says there are three known risk factors for cervical cancer – smoking, the presence of the human papilloma virus (HPV) and the lack of appropriate Pap testing. Paskett, who is also a professor in the OSU School of Public Health and the Marion N. Rowley Designated Chair in Cancer Research, says women who smoke, who have multiple sexual partners, or who are infected with HPV need Pap tests every year, no matter how old they are. She is afraid women might not have heard that addendum to the recent change in the guidelines, and may be neglecting to get their Pap tests, a key cancer prevention tactic.

The incidence and death rates from cervical cancer are higher in Appalachia than the national average, but the use of Pap testing is slightly lower than average. “We don’t know much about the incidence of HPV infection; that’s one of the things we hope to find out,” says Paskett.

Paskett says the relationship between smoking and the development of cervical cancer is not entirely clear, but scientists do know that carcinogens from smoke can actually be found in cervical mucous. There, they are able to damage cells and allow HPV to infect cells of the cervix. Still other studies have found that smoking can depress the immune system.

“One of our goals is to help women understand these things, and to offer them a strategy that can help them quit tobacco altogether.”

Paskett says part of the research project will use lay health educators – respected and well-known members of the Appalachian community – to drive those messages home.

“Quitting smoking has well-documented health benefits, and we know that worldwide, the incidence of cervical cancer has plummeted where Pap screening is used appropriately,” says Paskett. “No one should die of cervical cancer in 2004. We hope this project is a win-win for everyone.”

The Ohio State University Comprehensive Cancer Center is a network of interdisciplinary research programs with over 200 investigators in 13 colleges across the OSU campus, the Arthur G. James Cancer Hospital and Richard J. Solove Research Institute and Children’s Hospital, in Columbus. OSUCCC members conduct research on the prevention, detection, diagnosis and treatment of cancer, generating over $95 million annually in external funding.

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Michelle Gailiun
Medical Center Communications

Tags: Cancer; Clinical/Translational Research; Gynecologic Cancer; James Cancer Hospital; OSU Medical Center; Prevention Research; Smoking Cessation; Women's Health

The Ohio State University Comprehensive Cancer Center – Arthur G. James Cancer Hospital and Richard J. Solove Research Institute (OSUCCC – James) 460 W. 10th Avenue, Columbus, OH 43210 Phone: 1-800-293-5066 | Email: