CLASS NOTES Alumni Profile
Papillo
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CANCER WITH A CURE
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Written by DOUG MCINNIS
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ervical cancer is the only major cancer for which there is only one can cause the virus to persist. But often, the reason the virus lingers
known cause—the human papillomavirus. For that reason, it may in the body is not known. “That’s a very important question for which we don’t
be possible to wipe out the disease through a joint global vaccina- have very good answers.”
tion and screening program. There is precedent for wiping out a virus through a well-planned vaccina-
“I think this cancer is one-of-a-kind to some extent,” said Jack tion program; the World Health Organization instituted worldwide vaccina-
Cuzick ’70, who outlined the concept for an eradication program at tions that eradicated smallpox in the general populace. The program began in
the 15th Congress of the European Cancer Organization this fall. the mid 1960s, and the last known naturally transmitted case of the disease
Eradication by vaccination alone would take decades because of was found in 1977 in Somalia.
the large numbers of women still infected worldwide, said Cuzick, It could take much longer to wipe out cervical cancer. Currently, cervical
head of the UK Centre for Epidemiology, Mathematics, and Statis- cancer vaccines are not widely used in much of world. And they are expensive
tics at the Wolfson Institute for Preventive Medicine in London. For —in the U.S., a three-shot regiment costs $360. In addition, the vaccine now
that reason, Cuzick proposes a two-pronged attack on the disease— in use doesn’t treat all types of the human papillomavirus that are known to
vaccinations for girls when they reach age 12 or 13, and testing for cause cancer, though a broad-spectrum vaccine is being tested.
women who may already have the cancer or be in a precancerous Even if the vaccine were widely used it would only prevent new cases.
stage of the disease. “There will be a group of infected individuals who will cause the disease to
Cuzick has worked on cervical cancer since the mid 1980s. His in- persist for many decades,” said Cuzick. “So we want to do both screening
terest in the field evolved gradually. He studied pure math and physics and vaccinations. The payback for screening comes within a few years. The
at HMC, did graduate work in probability theory, and then took a job at payback for vaccinations will take 20 to 30 years.
Columbia University in mathematical statistics. This led to an interest “We suggest a mother-daughter approach. The daughter will get a vaccine,
in the mathematical issues involved in clinical trials. Later, at Oxford the mother will undergo screening.” He added that the vaccinations should be
University, he became interested in cancer epidemiology, which fo- school-based, as they are in the United Kingdom where coverage reaches 85
cuses on the causes of the disease. That evolved into an interest in to 90 percent of school girls. “The coverage will be very low if it’s left to girls
the human papillomavirus, cervical cancer, and programs to control it to go to their doctor to get the vaccine.”
through screening and vaccination. Cuzick also wants to see universal use of tests which screen for the virus,
Cervical cancer is the third leading cause of cancer deaths in rather than the traditional pap smear, which looks for abnormal cells. The
women, behind breast and lung cancer. However, cervical cancer is pap smear has a detection rate of only 60 to 70 percent. “The better method
virtually 100 percent preventable if abnormal pre-cancerous cells are is to look for the virus,” Cuzick said. “It would be somewhat more expensive
detected in screening tests, and it is highly treatable if detected in the per test, but because it needs to be done less often, the overall cost would
early stages of the disease. potentially be less in the long run.”
Sex is the primary vehicle for the spread of the virus. “It’s esti- Cuzick believes that governments must get involved in screening and vaccina-
mated that 70 percent of the female population will be infected at tion programs. “The solution is now political. The science has largely been done.”
some point,” said Cuzick. “In most cases, the immune system clears
the virus from the body.” But in a small percentage, the virus persists. Doug McInnis is a freelance writer based in Casper, Wyo.
Several factors, including smoking or a damaged immune system,
FALL/WINTER 2009 Harvey Mudd College 2 9
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