Ten-year trial results published in The Lancet shows a new treatment regime cut cervical cancer deaths by 40% – as experts demand it becomes standard care on the NHS
A British trial has discovered how to cut cervical cancer deaths by 40% in what has been described as the biggest improvement in treatment of the disease in 20 years.
The 10-year study, published in the Lancet, has sparked calls for the new treatment regime to be urgently introduced as the standard care by the NHS.
Currently the NHS treats cervical cancer patients with a combination of chemotherapy and radiotherapy, known as chemoradiation. The trial by University College London and University College London Hospital compared this standard care to an additional short course of chemotherapy before chemoradiation. Researchers tracked 500 patients from hospitals in the UK, Mexico, India, Italy and Brazil for a decade and have found the extra induction chemo cut risk of death by 40% and the risk of cancer coming back within at least five years by 35%.
Dr Iain Foulkes, research director at Cancer Research UK, which funded the research, said: “Timing is everything when you’re treating cancer. The simple act of adding induction chemotherapy to the start of chemoradiation treatment for cervical cancer has delivered remarkable results. A growing body of evidence is showing that additional chemotherapy before other treatments, like surgery and radiotherapy, can improve the chances of successful treatment for patients. Not only can it reduce the chances of cancer coming back, it can also be delivered quickly, using drugs already available worldwide.”
Two people a day die from cervical cancer in the UK and the disease claimed the life of Celebrity Big brother star Jade Goody in 2009. Her death aged just 27 sparked a rise in take-up of cervical cancer screening – becoming known as the “Jade Goody effect” – and her story is credited with saving many lives. She had spoken openly about receiving treatment when abnormal cells were found during a smear test on three occasions then receiving a fourth diagnosis of abnormal cells which she did not act upon as she admitted to being scared.
When diagnosed Ms Goody was told by doctors that the cancer had been present for two years and had destroyed more than half of her womb. During an operation to remove the tumour, it was discovered that the cancer had spread to her bowel, liver and groin and she was told it was terminal.
However the bounce in screening rates seen from 2009 has now disappeared and uptake is especially low among women aged 25 to 29. Overall the number of women who are up to date with screening was at 68.7% in 2022/23. This is down from 69.9% the previous year and 76% in 2010/11. The NHS cervical screening program’s efficiency standard is 75% and its optimal performance standard is 80%. A third of people say that being embarrassed about their body is one of the main reasons for not attending their appointment.
Chemoradiation has been the standard treatment for cervical cancer since 1999, but despite improvements in care, cancer returns in up to 30% of cases.
The Interlace phase III trial enrolled patients with locally advanced cervical cancer that had not spread to other organs. Patients were randomly allocated to receive either standard treatment or the new treatment combination. After five years, 80% of those who received a short course of chemotherapy first were alive and 73% had not seen their cancer return or spread. In the standard treatment group, 72% were alive and 64% had not seen their cancer return or spread.
Researchers said that five patients involved in the trial have been disease-free for more than 10 years.
Trial lead investigator Dr Mary McCormack said: “This approach is a straightforward way to make a positive difference, using existing drugs that are cheap and already approved for use in patients. It has already been adopted by some cancer centres and there’s no reason that this shouldn’t be offered to all patients undergoing chemoradiation for this cancer.”
Professor Jonathan Ledermann, senior author of the study from UCL Cancer Institute, said: “The incremental cost for using the drugs in the Interlace trial is low, making this a new treatment that can be easily implemented in all health economies, to significantly improve overall survival.”
Women aged 25 to 64 will receive a letter in the post from the NHS to invite them for cervical screening, which should then happen every three to five years. If you were invited for cervical screening but missed or did not book an appointment you should contact your GP surgery.
