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European cervical cancer week marked in Israel
By JUDY SIEGEL-ITZKOVICH
19/01/2014
A weakened immune system resulting from smoking, poor nutrition, and numerous sex partners can raise risk.
 

Although unprotected sex with a carrier of human papilloma virus is the main cause of cervical cancer – and killed 80 Israeli women last year – a weakened immune system resulting from smoking, poor nutrition or other infections can also be a cause.

So said the European Cervical Cancer Association, that called this week’s Cervical Cancer Awareness Week, which Israel is observing along with Europe.

A total of 200 women were diagnosed with cervical cancer here in 2013, but the morbidity (illness) and mortality (death) rates in this country are lower than the more than 40 countries in Europe. The morbidity rate for cervical cancer in Israel (per 100,000 women) is five and the mortality rate is 1.5, compared to close to 35 and 12, respectively, in the worst off country, Romania, the Israel Cancer Association reported.

The rates are lower among Arab (mostly Muslim) Israeli women (exactly one death per 100,000) than among Jewish Israeli women (1.4 per 100,000). Having sex partners who underwent circumcision is regarded as a major reason for lower rates here.

As both Muslim and Jewish men are routinely circumcised, the more conservative sexual habits (fewer partners) among Muslim Israeli women is thought to be the reason for the difference compared to Jewish Israeli women.

The more sexual partners one has, the more likely the virus will spread.

Most women are infected with the virus at some time in their lives, but in 90 percent of cases, the virus disappears without causing harm, destroyed by the host’s immune systems, often without even being noticed. Some strains of the virus can cause genital warts, while others can result in cervical intraepithelial neoplasia (also known as cervical dysplasia and cervical interstitial neoplasia). This is potentially pre-malignant, but it is not cancer and is usually curable.

A sexually active woman of ordinary risk between the ages 35 to 54, or a high-risk younger woman, can prevent most cervical cancer by undergoing regular Pap smears to look for irregular cervical cells. The European association recommended that young teenage girls and young women (and young males to prevent transmission) undergo vaccination against papillomavirus to reduce the risk of transference.

But opinion is not uniform. One of the experts who dispute the effectiveness of the treatment is Prof. Uzi Beller, a leading genital cancer gynecologist at Shaare Zedek Medical Center, declared that it had never been proven anywhere that the vaccine actually protects against cancer, but only against genital warts.

“We don’t have a serious problem of cervical cancer here; the whole campaign was premature and a waste of good money,” he told The Jerusalem Post on Sunday, “and routine Pap smears would have been more effective.”

In fact, although the Health Ministry offered the vaccine free for the first time last fall to over 10,000 girls, only about 60% of them (or their parents) agreed to the shots.

New research pointing to the positive link between cervical cancer and smoking was published in 2012 in the Asian Pacific Journal of Cancer Prevention.

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