Cervical Cancer & HPV
Adenocarcinoma Rates are Rising
Cervical cancer deaths are steadily declining, due to the widespread use of routine pap testing. But even as cervical cancer deaths continue to decline, rates of adenocarcinoma — a specific type of cervical cancer, are increasing — especially in younger women.
Adenocarcinoma rates have increased by almost 50% over the past 30 years1
What is the cause of the increase?
The cause of the increase in adenocarcinoma rates is unclear, but the risk factors probably include:
- HPV (human papillomavirus) infection3-5
- Sexual history3
- History of uterine disease6
Adenocarcinoma is more difficult to detect
Another reason why adenocarcinoma is on the rise may simply be that it is harder to find. The glandular cells that can give rise to adenocarcinoma are located deeper within the uterus, behind the "transformation zone" — a narrowing of the cervix where glandular cells transform themselves into squamous cells. The ThinPrep Pap Test is the only pap test with FDA-approved labeling that is supported by multiple peer-reviewed publications reporting increased detection of adenocarcinoma (glandular disease).7-12
1. Smith HO, Tiffany MF, Qualls CR, Key CR. The rising incidence of adenocarcinoma relative to squamous cell carcinoma of the uterine cervix in the United States — a 24-year population-based study. Gynecol Oncol. 2000;78:97-105.
2. Surveillance, Epidemiology, and End Results (SEER) Program (www.seer.cancer.gov) SEER*Database: Incidence – SEER 9 Regs Public-Use, Nov. 2004 Sub (1973-2002), National Cancer Institute, DCCPS, Surveillance Research Program, Cancer Statistics Branch, released April 2005, based on November 2004 submission.
3. Altekruse SF, Lacey JV Jr, Brinton LA, et al. Comparison of human papillomavirus genotypes, sexual, and reproductive risk factors of cervical adenocarcinoma and squamous cell carcinoma: Northeastern United States. Am J Obstet Gynecol. 2003;188:657-63.
4. Derchain SF, Rabelo-Santos SH, Sarian LO, et al. Human papillomavirus DNA detection and histological findings in women referred for atypical glandular cells or adenocarcinoma in situ in their Pap smears. Gynecol Oncol. 2004;95:618-23.
5. An HJ, Kim KR, Kim IS, et al. Prevalence of human papillomavirus DNA in various histological subtypes of cervical adenocarcinoma: a population-based study. Mod Pathol. 2005;18:528-34.
6. Chhieng DC, Gallaspy S, Yang H, Roberson J, Eltoum I. Women with atypical glandular cells: a long-term follow-up study in a high-risk population. Am J Clin Pathol. 2004;122:575-79.
7. Ashfaq R, Gibbons D, Vela C, Saboorian MH, Iliya F. ThinPrep Pap Test. Accuracy for glandular disease. Acta Cytol. 1999;43:81-5.
8. Bai H, Sung CJ, Steinhoff MM: ThinPrep Pap Test promotes detection of glandular lesions of the endocervix. Diagn Cytopathol. 2000;23:19-22.
9. Carpenter AB, Davey DD: ThinPrep Pap Test: Performance and biopsy follow-up in a university hospital. Cancer Cytopathology. 1999;87:105-12.
10. Guidos BJ, Selvaggi SM. Detection of endometrial adenocarcinoma with the ThinPrep Pap test. Diagn Cytopathol. 2000;23:260-5.
11. Schorge JO, Hossein Saboorian M, Hynan L, Ashfaq R. ThinPrep detection of cervical and endometrial adenocarcinoma: A retrospective cohort study. Cancer Cytopathology. 2002;96:338-43.
12. Wang N, Emancipator SN, Rose P, Rodriguez M, Abdul-Karim FW. Histologic follow-up of atypical endocervical cells. Liquid-based, thin-layer preparation vs. conventional Pap smear. Acta Cytol. 2002;46:453-7.