Carcinoma of the Cervix: Mortality Reduction

1. Wright Clarkson, M.D. and
2. Allen Barker, M.D.

1. ↵¹ Presented before the Fifth International Congress of Radiology, Chicago, Sept. 13–17, 1937.

Excerpt

CANCER of the cervix accounts for nearly 20 per cent of all deaths from cancer in women; and our observations agree with those of Norris (1), who thinks that a cross-section of all cases of carcinoma of the cervix will show five-year survivals of not over 10 per cent. When one considers the fact that five-year survivals of well over 50 per cent have been reported following proper radiological treatment of large series of moderately advanced cases, it becomes obvious that the number of deaths can be greatly reduced by more effective application of our modern methods of treatment.

Inadequate knowledge of cancer and geographic inertia afflict both the average physician and the general public. The only way to meet this condition seems to be to bring trained oncologists and facilities for treatment to as many localities as possible. This could well be accomplished by the formation of numerous small rotating clinics. Through close co-operation with the local medical societies everywhere, clinics can carry cancer control to the laity and to the physicians. These clinics should be conducted only by those who are thoroughly trained in the diagnosis and treatment of neoplastic diseases. The establishment of cancer clinics stimulates the demand for specialization in oncology and there is no field of medicine where intense specialization is more urgently needed.

A definite cancer diathesis is inherited by many persons, and this is one of the chief causes of the present death rate from this disease. Genetics, therefore, may eventually play an important rôle in the prevention of cancer. It is also possible that some day there will be discovered a way of increasing an individual’s resistance to this disease by inoculation or otherwise; but no material reduction of mortality seems likely to occur from either of these methods in the very near future.

Our present methods of prophylaxis and treatment of cancer of the cervix, however, are practicable and comparatively effective, and the mortality rate can be materially lowered if we combine the educational factors with the scientific aspects of the problem. Women everywhere must be taught to regard leukorrhea and any other unusual change in the character or amount of their vaginal discharge as significant of some abnormal condition which demands immediate investigation and treatment. Physicians must be impressed with the necessity for making frequent and careful examinations of the cervix as a routine procedure; and both laymen and physicians must be convinced of the fact that cancer patients can be properly treated only by those who are thoroughly trained in oncology. Since a benign disease of the cervix usually precedes actual cancer of the cervix, every physician should be on the outlook for abnormal conditions of this structure, and the lesions should be diagnosed accurately and treated promptly.