USA researchers publish study on health disparities in cervical cancer
The study, published in the International Journal of Molecular Sciences, sought to explore why cervical cancer is more aggressive in women of African ancestry than it is in women of European ancestry.
By Carol McPhail
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Researchers at the USA Health Mitchell Cancer Institute (MCI) have published a study on racial disparities in cervical cancer in the International Journal of Molecular Sciences.
The study, titled “Genome-Wide DNA Methylation Profiling Reveals Ancestry-Associated Epigenetic Reprogramming in Cervical Intraepithelial Neoplasia,” sought to explore why cervical cancer is more aggressive in women of African ancestry than it is in women of European ancestry.
Cervical cancer kills an estimated 4,200 women in the U.S. each year. Women of African ancestry are 41% more likely to develop cervical cancer than are women of European ancestry, and they are 75% more likely to die from it, studies show. The topic is especially relevant in Alabama, a diverse state that has some of the highest rates for cervical cancer incidence and mortality in the nation.
“We know that there are differences in the body’s response to human papillomavirus, or HPV, that may play a role in the development of cervical intraepithelial neoplasia – differences encoded by stress, which may play a role in the differences we see by ancestry,” said Jennifer Young Pierce, M.D., MPH, a gynecologic oncologist and director of the Division of Cancer Control and Prevention at MCI who was one of the authors of the study.
Cervical cancer develops primarily through persistent infection by HPV. HPV has a unique ability to turn off or turn on specific cellular genes, which transforms normal cervical epithelial cells to become cancerous, said Santanu Dasgupta, Ph.D., director of the Mitochondria Research Laboratory at MCI and an associate professor of pathology and urology at the Frederick P. Whiddon College of Medicine at the University of South Alabama.
The researchers studied precancerous cervical tissue biopsies from women of African ancestry and women of European ancestry. They found that the pattern of “turn-off” and “turn-on” genes, or pathway signatures, differed between the two groups.
“We identified that changes in cellular genes are quite different in cervical biopsies of women with African ancestry compared to women with European ancestry. These findings could explain the highly aggressive nature of cervical cancer in these women,” Dasgupta said. “We also observed significant loss of expression of two tumor suppressor genes – SH3GL2 and ARHGAP25 – in precancer cervical lesions of women with African ancestry for the first time.”
The findings suggest that restoring tumor suppressor genes may reverse the early development of cervical cancer, Dasgupta said. “Routine assessment of these changes along with HPV screening could inform the clinician on appropriate interventions to prevent the development of lethal cancer.”
The American College of Obstetricians & Gynecologists (ACOG) recommends individuals ages 21 to 29 be screened for cervical cancer every three years with a Pap test. Those 30 to 65 should undergo clinician-collected primary high-risk HPV screening every five years or patient-collected primary high-risk HPV screening every three years and follow up on abnormal results.
The research was funded through a grant from the Elsa U. Pardee Foundation, the Mitchell Cancer Institute, and the University of South Alabama. Other authors of the study include Mohamed Masoud, M.D.; Charu Shastri, M.D.; Rajarshi Banerjee, M.S.; Saanvi Dasgupta, Hector Chavarria-Bernal, M.D.; and Karan P. Singh, Ph.D.
