Cervical dysplasia: early intervention - Cervical Dysplasia

Alternative Medicine Review, May, 2003 by Keri Marshall

Although numerous epidemiological studies have examined the association between risk of cervical cancer and dietary cofactors, most studies appear to have methodological limitations. A major limitation of many observational studies is reliance on dietary self-report, which has many potential sources of error and bias. Also, many nutritional epidemiological studies were conducted before a reliable test for HPV status was available. (104)

As with many nutritional-based clinical trials, nutrient-based cervical cancer prevention trials have been designed without adequate information or qualitative analysis as to when in the carcinogenesis continuum a particular nutrient is actively effective. Additionally, little light has been shed on the duration of treatment and length of follow-up needed to demonstrate an effect. Current evidence suggests nutritional factors play a role in the progression of normal cervical epithelium to preinvasive cervical lesions and ultimately carcinoma. However, lack of knowledge of biological mechanisms, which determines optimal timing for intervention, is lacking. This ultimately deters the ability to test the effect of a nutrient appropriately in clinical trials. To date, only five phase III nutrient chemoprevention trials have been completed, with only one showing positive effect. Until more intervention studies have been completed, it is reasonable to assume nutrient supplementation may be an effective tool in preventing progression of cervical dysplasia to cervical cancer, especially when serum and plasma markers unequivocally demonstrate specific nutrient deficiencies. More importantly, adequate dosage and duration of treatment need to be further evaluated.