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THE US National Cancer Institute has issued an alert to doctors around the world to change the way they treat cervical cancer after five separate studies showed survival rates could be improved by up to 50 per cent, potentially saving thousands of lives worldwide every year.

The clinical alert is only the fifth the institute, the main US national cancer research agency, has issued in its 11-year history. It was sent to 20,000 cancer specialists belonging to the international oncology major organisations on Monday.

Results from the five studies show that combining chemo-therapy with radiotherapy for advanced cervical cancer cuts deaths by 30 to 50 per cent compared with the standard treatment, used in the US and the UK, of surgery or radiotherapy alone. Last year there were 3,500 cases of cervical cancer in the UK and 1,222 deaths.

Three of the studies are due to be published in the New England Journal of Medicine in April but the journal broke its own embargo this week and published the details on the Internet "because of the public health implications". The other two studies are to be published later in the year.

Mitchell Morris, of the Anderson Cancer Centre in Houston, Texas, who led one of the studies, said: "It's rare to see such a dramatic difference. This is the first major change in the treatment of cervical cancer in 40 years."

The studies, involving 1,700 women, show that combining radiotherapy with the platinum- based drug, cisplatin, has a synergistic effect (greater than the sum of their separate effects), possibly because the chemotherapy makes the cancer cells more susceptible to radiation.

However, the women have only been followed over three years and a longer study is required to see if the improved survival is maintained.

Cervical cancer has been declining in the UK since the introduction of national screening but the disease largely still kills those who have never been screened.

Julietta Patnick, national co-ordinator of the programme, said: "This obviously sounds like good news. We are talking about hundreds of deaths that could be saved. But it is worth reminding women that attending regularly for a cervical smear every three to five years cuts their risk of cervical cancer by 80-90 per cent."

t Recent failures in the cervical screening programme have damaged patient confidence, according to a NOP survey published yesterday.

It found half of women aged 20 and over said they were "less confident" in the service following the Kent and Canterbury scandal and problems elsewhere.

Only 17 per cent of GPs shared the same opinion. 70 per cent said they were "as confident" as before.

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