Talk:Cervical cancer

Interest in creating a page dedicated to women's cancer disparities in the U.S.

Hello, I am a student from Rice University interested in writing a page on women's cancer disparities in the U.S. and I hope to elaborate more on cervical cancer disparities based on socioeconomic status, race, sexual orientation, geographical factors, and more. Please feel free to check out my talk page for my page proposal or to provide me any feedback or suggestions. Thank you! Mtran99 (talk) —Preceding undated comment added 16:39, 28 February 2017 (UTC)

Prognosis - should add for Pap results

Since many women assume that if they have an abnormal Pap result that means they have cancer, it might be well to add brief coverage of the prognosis for various abnormal Pap results. (e.g. if have LSIL or HSIL result what are the chances that have Cancer/likelyhood to develop.) Castle would probably be a good reference for this. (Have to look up the rest of the citation.) Zodon (talk) 09:14, 5 October 2010 (UTC)

Suggested external link

I would like to add an external link to the cervical cancer section landing page on the Macmillan Cancer Support website. This section contains a thorough range of directly related content which has been rigorously written by information nurses, edited by a clinical advisory board and specialist advisory panel, and audited/certified by the Information Standard (owned by the Department of Health in the UK). Macmillan's cervical cancer pages include valuable post-treatment information.

Many thanks. Macmillancancer 15:05, 24 April 2011 (UTC) — Preceding unsigned comment added by Macmillancancer (talk • contribs)

Don't think this is really legit - Soapbox issue. I have rolled back your external links on breast cancer, anal cancer, and ovarian cancer, and someone else got you on brain tumor. Check with administrators on this issue please. Thank you.

Cliff L. Knickerbocker, MS (talk) 15:59, 24 April 2011 (UTC)

I hope I don't make this worse. When I saw Macmillancancer's change on brain tumor I felt a bit conflicted about reverting, and didn't. I think that opening up talk here when his/her first change was reverted they show the right intention to move in the right direction (although maybe they could have reverted the other changes him/herself).

Also as I live in the UK I am aware of how valued the organisation is, and as someone who sees far more health websites than she'd like - it does look useful.

Maybe it belongs better on a page for cancer support?

62.254.8.201 (talk) 16:19, 24 April 2011 (UTC)

I've added a couple of links to patient info and cancer stats from Cancer research UK - we have discussed this with the administrators and they are happy for us to add these links. KatArney (talk) 13:02, 15 June 2011 (UTC)

I would like to add an external link to this informative Infographic on Cervical Cancer http://www.mountsinai.org/patient-care/service-areas/obgyn-and-reproductive-services/infographic/cervicalcancerinfo ~Ejdjr — Preceding unsigned comment added by Ejdjr (talk • contribs) 19:02, 7 February 2013 (UTC)

Male circumcision and HPV transmission to female partners

A recent edit by an IP user added some material about possible association between circumcision and cervical cancer. I reverted the edit since it removed sourced content and the reference they provided was not clear. As far as I can tell "Male circumcision and HPV transmission to female partners" may have been the reference they intended. I could not add back appropriate coverage since I don't have access to the article at the moment. Zodon (talk) 06:14, 6 September 2011 (UTC)

Incidence rate by age?

I've just been told by someone that hers was caught at 15. Imagine Reason (talk) 01:40, 28 September 2011 (UTC)

Incidence of cervical cancer

The epidemiology section states that cervical cancer is the second most common cancer in women, then later in the paragraph states that it ranks behind endometrial cancer and ovarian cancer. This inconsistency needs to be addressed. Firewall62 (talk) 03:37, 6 March 2012 (UTC)

As far as I can see those are in different paragraphs. The first one says that worldwide it is the second most common cancer in women. The second paragraph is talking about the United States, where it is the 8th most common.

However the sentence about endometrial and ovarian cancers could definitely use improvement. It should indicate what ranking is being used in that case (incidence, mortality, prevalence, etc.). It also should indicate a source. Zodon (talk) 18:44, 6 March 2012 (UTC)

Merging back from Cervical cancer staging

I merged the content in cervical cancer staging back to this article, because apparently it doesn't seem to be able to develop acceptably as an independent article, and has gotten no other links to it from other articles. Therefore, having it as a separate article merely complicates the reading of this article, because the treatment-section is highly dependent on precise staging, so we need a detailed description in cervical cancer in order to make it complete. Mikael Häggström (talk) 15:49, 27 July 2012 (UTC)

Disagree. As this page is just a general overview having this sort of details is a little much. Doc James (talk · contribs · email) (if I write on your talk page please reply on mine) 23:38, 27 July 2012 (UTC)

Fraction of cases caused by HPV

The article which was cited previously only mentioned the 70% figure in the abstract and gave no reference to a proper study that established this figure. I could not find any such study on Google Scholar (15 minute search). This fraction is important for scientific research, so I did not delete it. However, finding proper references and properly qualifying how it was calculate is important. — Preceding unsigned comment added by 132.216.227.218 (talk) 14:00, 5 January 2013 (UTC)

The text states "Molecular studies show that HPV DNA is present in almost all (99.7%) cervical cancers. Human papillomavirus type 16 causes about half of cases, and type 18, about 13% of them.2" Do not have time to read the whole paper right now but this is not sufficient justification to remove the ref. Doc James (talk · contribs · email) (if I write on your page reply on mine) 14:14, 5 January 2013 (UTC)

We typically just paraphrase what high quality sources state. We do not typically research why these high quality sources have come to the conclusions they have.

This source also makes the claim [1] Doc James (talk · contribs · email) (if I write on your page reply on mine) 14:18, 5 January 2013 (UTC)

More importantly, this statement is in direct contradiction with what is written in the first paragraph of the wikipedia article. The 70% figure is wrong. Someone should clean this up. 132.216.227.218 (talk) 14:31, 5 January 2013 (UTC)

May be we are dealing with slightly different ways of looking at the issue. While in >90 of causes HPV may place a role, it is not the sole factor. Thus 30% of disease can still be attributed to other stuff, like smoking. Doc James (talk · contribs · email) (if I write on your page reply on mine) 14:37, 5 January 2013 (UTC)

Yes it does appear that the abstract is wrong. Have fixed and will look into it further. Doc James (talk · contribs · email) (if I write on your page reply on mine) 14:45, 5 January 2013 (UTC)

Recent edits - screening section

The recent edits by User:Medstudent2014, are among those we were asked to look at. The ones here have removed this source with 2010 EU guidelines, replacing it with a US one. Mostly the content seems similar, but the EU guideline ("screening policy" section) says: "...cervix screening, which should start in the age range 20–30 [12, 13], but preferentially not before age 25 or 30 years, depending on the burden of the disease in the population and the available resources." contradicting both the old and, even more, the new text here - it was "Cervical cancer screening is typically recommended starting at age 21", now "...cervical cancer screening should begin at age 21".

This is just based on a quick look, without knowlege of the sources or if they are still the latest. Further scrutiny might bwe a good idea. Johnbod (talk) 00:09, 14 April 2014 (UTC)

Comment Response - screening section

Thank you User:Johnbod for commenting about my edits. My edits are based on the U.S. guidelines for cervical cancer screening. The guidelines that I have included in my edits come from the American College of Obstetrics and Gynecology and include the most up to date screening guidelines for cervical cancer in the U.S. Therefore, I have updated the page to include the statement "in the U.S." to clarify this discrepancy.

Medstudent2014 (talk) 13:35, 17 April 2014 (UTC)

I understand that for your own educational purposes US guidelines are probably enough. But Wikipedia is a global encyclopedia (see Wikipedia:Systemic bias), and so far your edits have removed a reference to the EU guideline, and not corrected or explained a discrepancy that was already there, but which you have heightened, between the EU vs the US guidelines, re the best age to start screening. Putting "in the US" where you did makes it unclear how much after that only covers the US. The unqualified statement "cervical cancer screening should begin at age 21" still remains. Johnbod (talk) 13:44, 17 April 2014 (UTC)

You make a great point. I added a statement about the European Guidelines. Medstudent2014 (talk) 14:32, 17 April 2014 (UTC)

Thanks, much better. I've added a quote re the Preferentially 25-30 bit, despite the odd English. The UK NHS offer it to all of 25 & over, which I expect is EU-typical in practice (patient info page). Johnbod (talk) 14:51, 17 April 2014 (UTC)

Harald zur Hausen

It's astounding that the awarding of the Nobel prize in medicine to zur Hausen for the discovery of the link between HPV and cervical cancer was not in this article before today....all I can say is 'wow'. My face is red on behalf of Wikipedia.

  Bfpage |leave a message  21:28, 9 May 2015 (UTC)

Still editing

Please note the more recent reference and I am adding material that was not previously in this section. I would like to request that you wait for just a little longer before your editing when I have completed adding the new material. Thank you. Best Regards,

  Bfpage |leave a message  10:58, 20 May 2015 (UTC)

Sure. Just adjusted a few things. Multiple pregnancies are more of an association or risk factor for disease rather than a cause.

With respect to vaccination being 92 to 100% effective, that is only for the two types they mention not for cervical cancer generally.

Some of the content you have added was already covered in the article in only slightly different language. Best Doc James (talk · contribs · email) 11:11, 20 May 2015 (UTC)

Ordering the prevention section

Doc James I have tried to re-order the prevention section to reflect the most effective prevention method listed first to the least effective prevention method listed last. I have not removed any material, but reordered it to align it with the NIH Cervical Cancer Prevention document. I have included statistics and an up-to-date reference. Let me know why you don't prefer this re-ordering in accordance with the NIH. With the Best of Regards,

  Bfpage |leave a message  11:05, 20 May 2015 (UTC)

The method that has prevented 80% of mortality from cervical cancer is "Screening". Thus that is the most effective method. Doc James (talk · contribs · email) 11:06, 20 May 2015 (UTC)

Not having sex is not possible for many people. And advising people to not have sex has been proven not to work. So while theoretically effective it is not in actuality. Doc James (talk · contribs · email) 11:09, 20 May 2015 (UTC)

You are correct. I am only citing the source and for whatever reason, the NIH/NCI lists abstinence as the first and most effective preventative measure to reduce cervical cancer. "Proven not to work" is not contained in the source. Wikipedia is not advising people not to have sex. We edit to provide information so that they can make the best choice with the most complete reliable information possible. Choosing not to have sex in some circumstances (for example with someone who just told you they have HPV) may be a choice they might make. You can't possibly be suggesting that we don't tell people that refraining from sexual intercourse will prevent acquiring this disease, or others? are you?

  Bfpage |leave a message  11:16, 20 May 2015 (UTC)

No what I am stating is that 80% of cervical cancer death in the developed world has been preventing by screening (which the sources state).

There is good evidence that telling teens not to have sex is not terrible effective per [2]

So well not having sex may be effective many people cannot achieve that. Thus in the real world screening is the most effective measure. We still screen people who deny having sex.

Is disagree with that NCI articles ordering of sections. Doc James (talk · contribs · email) 11:22, 20 May 2015 (UTC)

Let me see if I understand what you are saying, you must be typing very fast - even though the NIH lists screening as the fourth most effective method of preventing cervical cancer, you want it listed first?

  Bfpage |leave a message  11:36, 20 May 2015 (UTC)

Where does the NIH say it is the fourth most effective? Yes I think we should list screening first.Doc James (talk · contribs · email) 11:38, 20 May 2015 (UTC)

Prevention strategies with the biggest benefit from greatest to least

According to: NIH

Here are the prevention strategies with the biggest benefits in prevention, in order:

• abstinence
• Barrier protection and/or spermicidal gel during sexual intercourse
• vaccination
• Screening via Gynecologic Examinations and Cytologic Screening
• Stop Smoking
• High parity
• Long-term use of oral contraceptives

  Bfpage |leave a message  11:31, 20 May 2015 (UTC)

Sure the NIH is an okay source but not an excellent source. I am not sure why they choose this ordering. I do not see where they say it is by the order of benefit? Doc James (talk · contribs · email) 11:35, 20 May 2015 (UTC)

Especially when they say barrier protection decreases by 40% and vaccination by 92%? Doc James (talk · contribs · email) 11:41, 20 May 2015 (UTC)

Hello! I must admit, your edits are coming so fast that I am having trouble following our whole discussion here. I'm going to let some time go by and come back to this. I apologize for any hint of contentiousness or confrontation. I am pretty certain that we will be able to come up with a way to improve the article, using the best sources possible and in way that will be acceptable to you. The Best of Regards,

  Bfpage |leave a message  11:46, 20 May 2015 (UTC)

You have made the last edit to the article :-) The question I have about ordering of sections is that the NIH ref does not mention that they are ordered by importance or effectiveness. At least not that I can see.Doc James (talk · contribs · email) 11:49, 20 May 2015 (UTC)

...not quite, I added a small section on the use of oral contraceptives increasing the risk of developing cervical cancer. From the information in the reference that I used, immunization is listed as being more 'preventative' than screening. What do you think?

  Bfpage |leave a message  00:22, 21 May 2015 (UTC)

I do not get that from that reference. Feel free to ask for another opinion at WP:MED. Doc James (talk · contribs · email) 07:57, 21 May 2015 (UTC)

You mean 'get a second opinion'? (I'm sorry, I couldn't resist it....)

  Bfpage |leave a message  23:23, 23 May 2015 (UTC)

Yes exactly. Doc James (talk · contribs · email) 00:31, 24 May 2015 (UTC)

Article Very outdated and thus Wrong

"The implications of the recognition that, in the absence of viral DNA, cervical cancer does not develop, are of considerable practical importance. On the one hand, the concept of risk groups comes into focus. High risk women can now be sharply redefined as the group of persistent HPV carriers. Operatively, this represents substantial progress from previous versions of the high risk group that identified women by their exposure to a constellation of ill defined factors (low socioeconomic status, high number of sexual partners, smoking, use of oral contraceptives, history of STDs, and any combination of the above). Most of these factors are now viewed either as surrogates of HPV exposure or as relevant cofactors given the presence of HPV DNA."

from this metastudy here: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1769629/

points out that ONLY HPV infection causes cancer of the cervix NOTHING else, yet the article repeats in several places figures and arguements that suggest a causation rather than a correlation with other factors. As no specific science is given showing these factors they are at best vague and most likely wrong. Given the paper was written over a decade ago the article needs tidying up and this wrong impression removed. — Preceding unsigned comment added by 178.190.206.90 (talk) 03:14, 10 August 2015 (UTC)

"Human papillomavirus (HPV) infection appears to be involved in the development of more than 90% of cases;[4][5] most people who have had HPV infections, however, do not develop cervical cancer"

And this is based on more recent sources than 2002. Doc James (talk · contribs · email) 05:35, 10 August 2015 (UTC)

Exenteration

I've removed the diagrams of exenteration for the time being, since they're not discussed in the text. The images of a radical procedure on their own with no explanation of the context in which the procedure is required are unnecessarily alarming for someone new to the subject who would have no idea what staging is associated with this procedure. I have no objection to the judicious use of an image provided sourced context is provided showing its application. Acroterion (talk) 17:12, 22 September 2015 (UTC)

Simply add some text to go with the images if you want. I do not see problems with the images by themselves. Doc James (talk · contribs · email) 18:39, 23 September 2015 (UTC)

Anyway have added some details. Doc James (talk · contribs · email) 18:48, 23 September 2015 (UTC)

Thanks, you've addressed my concern. It isn't my field and I tread with caution in medical subjects. Acroterion (talk) 18:52, 23 September 2015 (UTC)

"exenteration" is not the best word. It simply means complete removal of the tumor. Doc James (talk · contribs · email) 19:46, 23 September 2015 (UTC)

Hysterectomy-corrected cervical cancer mortality rates

Beavis, A. L.; Gravitt, P. E.; Rositch, A. F. (2017). "Hysterectomy-corrected cervical cancer mortality rates reveal a larger racial disparity in the United States". Cancer. doi:10.1002/cncr.30507. is currently getting web coverage (SlashDot, ArsTechnica), and may be worth adding to the relevant section when the article has had time for the experts to criticize it. RDBrown (talk) 02:50, 25 January 2017 (UTC)

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1996 popular press piece

I have removed the content here based on this 1996 popular press peice[3]

We should stick with review articles, especially in the lead of the article. Doc James (talk · contribs · email) 06:09, 9 September 2017 (UTC)

Can you find an acceptable source that contains the same content?

One of the things about HPV, particularly in the developing world, is that it kills chaste wives who are married to philandering husbands. It would be unfortunate if people read this article and then falsely blamed women for being promiscuous, when they were infected by their husbands. WhatamIdoing (talk) 14:39, 9 September 2017 (UTC)

Yes found one[4] Doc James (talk · contribs · email) 15:24, 9 September 2017 (UTC)

good source--Ozzie10aaaa (talk) 01:13, 12 September 2017 (UTC)

Not B-class

This article is not B-class per the WPMED quality scale. It has had maintenance tags since at least 2015, has many dated sources and information, and does not appear to have been kept updated or accurate. SandyGeorgia (Talk) 18:30, 16 March 2021 (UTC)