Genetic Links to Cervical Cancer
Dear OncoLink "Ask the Experts,"
I have some questions about the possibility of a cervical cancer being genetically linked. My grandmother died of cervical cancer (approx. 1947). Since then, 5 of 9 granddaughters have been diagnosed/treated for cervical cancer.
Do you know of anyone doing research on the possibility of a genetic link? Where can I get the most current information?
I've heard there is a new vaccine for cervical cancer. Is this true? where would I find out information about this?
Thanks for your help!
Ivor Benjamin, MD, Former co-Editor-in-Chief of OncoLink, responds:
Dear Ms. T,
In general it is not thought that there is a genetic basis for the development of cervical cancer. Almost all patients who develop cervical cancer have been infected with the Human Papilloma Virus (HPV). This infection may be "silent" (i.e. no visible changes on the cervix, vagina or vulva or may lead to the development of visible warts that may become quite large.
Another potential manifestation of HPV infection are pre-cancerous changes in the surface of the cervix. These pre-cancerous changes are known as dysplasia. There are two types of cells on the cervix that may become dysplastic (squamous cells and glandular cells). It is more common for the squamous cells to become dysplastic. Fortunately, squamous dysplasias are also easier to diagnose and treat. Anyone who has an abnormal Pap test should have a colposcopic examination by a skilled colposcopist. Gynecologic Oncologists are skilled in colposcopy as are some nurse-clinicians and some general Ob/Gyns.
There is much active research targeted at enhancing the immune response to the HPV virus via a vaccine. Specifically, these vaccines are directed against the E6 and E7 proteins produced by the HPV virus. E6 and E7 are two of the "early" proteins produced in the HPV replication cycle. Other vaccines are being developed against the p53 gene product that is also involved with the development of pre-cancerous changes and cervical cancer. These vaccines may ultimately lead to prevention of HPV infection and reduction in the incidence of cervical cancer. Also, these vaccines may help a patient with advanced cervical cancer fight their disease.
The National Cancer Institute currently has the following vaccine related trials listed in the PDQ® Database:
- Phase II Pilot Study of HPV16 E6 and E7 Peptide Vaccines for Advanced or Recurrent Cervical Cancer (IDs: NCI-95-C-0154, NCI-T94-0134N)
- Phase I Study of a Human Papillomavirus E7 Peptide Vaccine with Incomplete Freund's Adjuvant (IFA) Combined with an E7 Lipopeptide for the Treatment of Cervical/Vulvar Squamous Intraepithelial Neoplasia (IDs: LAC-USC-5C952, NCI-T96-0033)
- Phase II Adjuvant Study of the Recombinant Vaccinia Virus Vaccine Expressing the Human Papilloma Virus 16, 18, E6 and E7 in Early Cervical Cancer (ID: EORTC-13961)
- Phase II Pilot Study of Tumor-Specific p53 or ras Vaccines with or without Cellular Immunotherapy with Peptide-Activated Lymphocytes plus Interleukin-2 (IDs: NCI-95-C-0105A, NCI-T94-0096N)