This morning, I spent a few hours at Brigham and Women’s Hospital’s research day, a rapid-fire set of slideshows by doctors and researchers highlighting their work over the past year. There was one especially intriguing presentation that drew a connection between a 55-year-old observation made by a clinician at the old Boston Lying-In Hospital and new, modern techniques, which could result in a simple tool to prevent cervical cancer.
Dr. Christopher Crum, a Brigham pathologist, began with an unusual slide: a copy of a medical journal article from 1957. Dr. Paul Young, of the Brigham’s predecessor, the Lying-In Hospital, described a frightening-sounding medical procedure that was then apparently somewhat routine—cauterizing a woman’s cervix after she gave birth. Young went on to observe that later on, there were no cervical cancers seen in this population of women.
As far as I could tell, this wasn’t the kind of randomized trial one would need to show that a procedure prevented cancer, but Crum’s group has used modern techniques to analyze cells in a zone of the cervix where cancers originate and come to a startlingly similar conclusion. It has been known, Crum said, that there was an area of the cervix where virtually all cervical cancers began. He and his team looked at the gene activity and other hallmarks of cells in that region and found a distinct subpopulation that they call the “squamocolumnar junction” that seemed to play a key role in cervical cancer.
Cells in that region turn out to be easy to remove—with something as simple as a probe that can freeze and kill them. Or, Crum noted, physicians could paint a chemical onto that layer of the cervix to remove those cells—and the risk of cervical cancer.
Crum lauded the vaccine for human papilloma virus, a powerful way to prevent cervical cancer. But he noted that this new work might point the way to a different, simple way to prevent cancer: by removing the vulnerable cells that are its source. His team published its results earlier this year in the journal Proceedings of the National Academy of Sciences.
As a posssible global health intervention, that’s a huge prospect: in a single year cervical cancer is diagnosed in more than half a million women worldwide and kills about half that many people.