Dr. Michael Herfs at the University of Liege in Belgium and Dr. Christopher P. Crum of Brigham and Women’s Hospital in Boston, Massachusetts recently published a review on a potential new strategy against the development of cervical cancer based on a specific cell population in the cervix. The study is entitled “Cervical cancer: Squamocolumnar junction ablation—tying up loose ends?” and was recently published in the journal Nature Reviews Clinical Oncology.

Cervical cancer is characterized by an abnormal cell growth in the cervix, the lower part of the uterus. This cancer can be successfully treated when detected at an early stage, usually through a Papanicolaou (Pap) smear test, where the doctor scrapes a small sample of cervical cells to look for abnormal cell changes. The majority of the cervical cancer cases are caused by the human papillomavirus (HPV), which can be transmitted by sexual contact.

The Advisory Committee on Immunization Practices (ACIP) recommends routine vaccination of girls and boys, aged 11 or 12 years, with the HPV vaccine. However, despite these efforts, cervical cancer still remains a major cause of mortality, affecting more than 500,000 women worldwide and resulting in almost 250,000 deaths each year. Cervical cancer incidence is estimated to be around five times higher in developing countries when compared to the United States and Western Europe.

According to the researchers, a recent study in which both researchers are co-senior authors suggests that a particular population of cells is involved in the development of cervical precancerous lesions. These cells are found within the cervical squamocolumnar junction, the region of the cervix in which the squamous lining of the vagina is replaced by the columnar epithelium of the uterus; the cervical squamocolumnar junction is known to be a common site of abnormal cell growth (neoplasma). Researchers now present, for the first time, direct evidence that these unique cells can be infected by the carcinogenic HPV. The study is entitled “Carcinogenic HPV infection in the cervical squamo-columnar junction” and was recently published in the Journal of Pathology.

Researchers state that the risk of developing cervical cancer seems to be strongly linked to this HPV-vulnerable cell population in the cervical squamocolumnar junction, and suggests that removal of these unique cells could potentially reduce cervical cancer rates in high-risk populations. This novel and affordable strategy could be implemented in vulnerable populations at specific times (like post-partum or in cases of asymptomatic HPV infection), using a widely available portable apparatus designed to target the cervical squamocolumnar junction.

Researchers also suggest that it would be interesting to study whether the lowering rate of HPV infection through squamocolumnar junction removal would have an impact in infection with the human immunodeficiency virus (HIV), a virus often present in populations in developing countries.