While deaths from cervical cancer have plunged in wealthy nations over the past 50 years, the disease remains a top killer of younger women in many parts of the world, new research shows.

In fact, researchers found, in Latin American and Caribbean countries, cervical cancer robs young and middle-aged women of more years of life than any other disease.

The findings underscore the need for prevention efforts and screening in developing nations, said study author Dr. Zuo-Feng Zhang of the University of California Los Angeles.

He and his colleagues report the findings in the current issue of the International Journal of Cancer.

Routine Pap testing is credited for the drop in cervical cancer deaths that has been seen in the U.S. and other developed nations over the past half century. Pap tests can reveal early cancer, as well as precancerous changes in cervical cells; if necessary, this abnormal tissue can be removed before cancer develops.

A woman can also cut her odds of developing cervical cancer by avoiding risk factors. In most cases, the disease is caused by infection with certain strains of the sexually transmitted human papillomavirus (HPV). Research indicates that women can lower their risk of both HPV and cervical cancer by not having sex before age 18 and by limiting their number of sexual partners.

In countries low on resources, however, routine Pap tests are not feasible, and education on cervical cancer risk factors is lacking. As a result, it’s estimated that more than 80 percent of the world’s cervical cancer cases occur in these nations.

In the new study, Zhang and his colleagues used a measure known as “years of life lost” to look at the impact of cervical cancer among women ages 25 to 64 in 2000. This measure, unlike a simple death rate, takes into account a woman’s age at death versus her life expectancy.

Globally, the researchers found, AIDS was responsible for the most years of life lost by far, followed by complications related to pregnancy and childbirth, and tuberculosis.

However, in Latin America and the Caribbean, cervical cancer was the most important cause of lost years. In addition, women in sub-Saharan Africa and south-central Asia lost more years to cervical cancer than to any other type of cancer.

In most other world regions, breast cancer was responsible for the most years of life lost, according to the report.]

Zhang told Reuters Health that more international attention needs to paid to the burden of cervical cancer in developing nations. Resource-poor regions, he said, need help from wealthier nations and international aid agencies to educate women on the risk factors for cervical cancer and to improve screening.

He noted that Pap tests, which involve sending cervical samples to a medical lab to be examined under the microscope and interpreted by a pathologist, require resources that poorer world regions lack.

But there are alternatives, including simple visual inspections of the cervix, which can spot lesions. While not as sensitive as the Pap test, Zhang said, “it’s better than no screening at all.”

SOURCE: International Journal of Cancer, April 10, 2004.