PAP SMEARS, SAFE SEX MAY PREVENT CERVICAL CANCER, PANEL CONCLUDES.

Byline: Paul Recer Associated Press

Almost 5,000 American women die of cervical cancer annually, and virtually all the deaths could be prevented by routine Pap smears and by safe sex, a National Institutes of Health panel of experts concluded Wednesday.

``In theory, cervical cancer is a cancer that we can completely prevent,'' said Dr. Patricia S. Braly, a gynecological cancer specialist at Louisiana State University and chairman of a panel of experts appointed by the NIH.

``If we could reach all the women in this country who are not getting regular Pap tests,'' she said, ``we could eradicate this type of cancer.''

The committee of nongovernment scientists issued a report Wednesday evaluating the current methods of preventing, detecting and treating cervical cancer.

About 15,700 new cases of cervical cancer, about 6 percent of all cancers, are diagnosed annually in the United States. Worldwide, 470,000 cervical cancer cases are diagnosed every year. It is second to breast cancer as the most common malignancy.

The committee of experts found that about half of the women diagnosed with cervical cancer in the United States have never had a Pap test, an office procedure in which cells are scraped from the cervix and then analyzed for abnormality. Properly performed, the test can detect abnormal cells before they become cancers and can lead to early treatment that can preserve both life and fertility.

``Use of the Pap smear is effective in reducing morbidity and mortality from cervical cancer,'' the panel concluded.

Among the population groups least often receiving Pap tests are older women, the uninsured, ethnic minorities, especially Latinas and older African-Americans, and the poor, particularly those in rural areas.

Many elderly women see doctors frequently, but the panel said that many physicians do not emphasize to their patients the importance of Pap test screening.

The committee also concluded that virtually all cervical cancers are related to infection, at some point in life, by the human papilloma virus, or HPV, a sexually transmitted disease.

``Cervical cancer is unique in that it is the first major solid tumor to have been shown to be virally induced in essentially every case,'' the report said.

There are 70 types of HPV, but only six are associated with cervical cancer. About 30 million Americans, about half women, are infected with HPV. About 1 percent of the infected women will actually develop cervical cancer, said Dr. Richard L. Sweet, a committee member and a professor at the University of Pittsburgh, Magee Women's Hospital.

Spread of HPV can be prevented by the use of condoms, the panel said. It also strongly recommended that young people delay the start of sexual activity as long as possible and limit the number of partners.

Sweet said adolescent females who start sexual activities before the age of 18 are more likely to develop cervical cancer from an HPV infection than are women who delay the start of sexual intercourse.

The greater the number of sexual partners, the greater is the chance of contracting HPV, said Dr. Braly.

So common is the infection, she said, that one study of women who first became sexually active in college found that 25 percent had some form of HPV within one year, even though the women averaged only two male partners.

``Typically, most every young woman now fits into the high-risk category for cervical cancer'' because of sexual activity and the common spread of HPV, said Dr. Braly.

``The only women who aren't (at high risk) are those who didn't have sex until after 18 and never with more than two (lifetime) partners, and those partners must not have had sex with more than two partners,'' she said.