Health topic

Cervical cancer

Human papillomavirus (HPV), the link to cervical cancer

Cervical cancer is one of the most common cancers in women with more than 14,000 new cases estimated in the US in 2021.1 The link between cervical cancer and HPV has become clear over the past few decades. It is well known that a persistent HPV infection with specific high-risk genotypes account for nearly all cases of cervical cancer.2

 

Cervical cancer is nearly preventable with proper vaccination, screening, and treatment

Cervical cancer is most frequently diagnosed in women between the ages of 35 and 44 with the average age at diagnosis being 50.2 It is important to screen for high-risk HPV

infections that are at the greatest risk of progressing to cervical pre-cancer and cancer. Identifying women at risk, before disease develops, is an important part of prevention.

Roche is committed to helping identify the best possible treatment for each patient by accurately identifying the type of cancer and the likely course of the illness

Our commitment to cervical cancer covers the entire spectrum of screening, triage, and diagnostic solutions to deliver accurate results with confidence. With this knowledge, doctors can identify more patients for the right therapy at the right time.

The progression to cervical cancer

While most HPV infections resolve on their own, some HPV infections can progress to high-grade cervical intra-epithelial neoplasia, CIN2 or CIN3. If left untreated, CIN2 or CIN3

can progress to cervical cancer years or decades after the initial infection.3 Early detection and treatment of precancerous lesions may prevent progression to cervical cancer.4

Squamous cell carcinoma3

Squamous cell carinoma is the most common subtype of cervical cancer, representing up to 90% of cases.5 It develops from cells in the exocervix and most often begins in the transformation zone.

Adenocarcinoma5

Adenocarcinoma is the second most common cervical cancer with around 20% of cases. This is a cancer of the glandular cells that produce mucus within the endocervix.

Adenosquamous carcinomas5

Adenosquamous carcinomas are the cause of only 5-6% of cervical cancers, but have become more common in recent years. This subtype shares features of both squamous and adenocarcinomas.

Cervical cancer data

cervical-cancer
cervical-cancer

Biomarkers pave way for new advances

Today’s cervical cancer assays were built on decades of research on gene and protein expression. These tests can detect high-risk HPV types, including HPV-16 and HPV-18, which are attributed to 70% of cervical cancer cases.6 Yet research continues to improve diagnosis and outcomes for women the world over.7

New advances in biomarker technology can help detect changes at the cellular level, providing an objective interpretation of whether or not the HPV infection is putting the woman at a higher risk of cervical disease. For example, p16 is a biomarker that occurs in normal cells and signifies cell cycle arrest. Ki-67 is also a biomarker that occurs in normal cells and signifies cell cycle division. A new test can identify when both biomarkers are present at the same time, indicating that HPV is disrupting the cell cycle and the cell has started to transform.

Advances are sure to include refinements to how cancer is staged. For example, a technique called sentinel lymph node biopsy can be used to target just the few lymph nodes most likely to contain cancer if it has spread. Removing fewer lymph nodes may lower the risk of complications, such as lymphedema.8

 

Genetic targets are plentiful for new therapies

Vaccines produce immunity to the most dangerous types of high-risk HPV that are associated with cervical cancer. Other vaccines are being studied in advanced cervical cancer that may produce an immune reaction to the E6 and E7 proteins that make the cervical cancer cells grow abnormally.8

Clinical trials are underway to find out if immune therapies, such as immune checkpoint inhibitors, can be used to “reset” the immune system as in a number of other cancers. Targeted therapies that seek out gene changes in cells that cause cancer also show promise.8

Now, 3 clinically validated tests bring greater diagnostic certainty

The molecular and biomarker-based tests in the Roche Cervical Cancer Portfolio bring greater diagnostic certainty to cervical cancer screening to guide clinicians and women along each step, removing ambiguity that can arise in current testing approaches.

 

References

  1. National Cancer Institute Cancer Stat Facts: Cervical Cancer. Accessed August 16, 2021. Available at: https://seer.cancer.gov/statfacts/html/cervix.html
  2. Key Statistics for Cervical Cancer. American Cancer Society. Accessed August 13, 2021. https://www.cancer.org/cancer/cervical-cancer/about/key-statistics.html
  3. American Cancer Society. What is cervical cancer? Accessed August 14, 2021. https://www.cancer.org/cancer/cervical-cancer/about/what-is-cervical-cancer.html
  4. Khan MJ, Castle PE, Lorincz AT, et al. The elevated 10-year risk of cervical precancer and cancer in women with human papillomavirus (HPV) type 16 or 18 and the possible utility of typespecific HPV testing in clinical practice. J Natl Cancer Inst. 2005;97(14):1072-1079.
  5. Cancer Research UK. Types and Grades. Accessed August 14, 2021. https://www.cancerresearchuk.org/about-cancer/cervical-cancer/stages-types-grades/typesand-grades
  6. National Cervical Cancer Coalition. Cervical cancer overview. Accessed September 10, 2021. https://www.nccc-online.org/hpvcervical-cancer/cervical-cancer-overview/
  7. World Health Organization. A cervical cancer-free future: first ever global commitment to eliminate a cancer. Accessed August 14, 2021. https://www.who.int/news/item/17-11-2020-a-cervical-cancer-free-future-first-ever- global-commitment-to-eliminate-a-cancer
  8. American Cancer Society. What's new in cervical cancer research. Accessed August 14, 2021. https://www.cancer.org/cancer/cervicalcancer/about/new-research.html
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