With January being Cervical Health Awareness Month, it’s worth remembering that, according to the CDC, cervical cancer was once “the leading cause of cancer death for women in the United States.” Then came the Papanicolaou (Pap) test, introduced in the U.S. in the 1940s and used more widely in cervical screenings beginning in the 1950s and 1960s. By 2009, cervical cancer incidence and mortality in the United States were both down 75%, making it only the 12th most common cause of cancer death for women.
In 2006, the FDA approved the first vaccine for human papillomavirus (HPV), followed by two more vaccines in 2009 and 2014. (HPV is responsible for more than 90% of cervical cancers.) Adoption of the vaccine was initially slow but has been accelerating in recent years. Today, the CDC estimates that a combination of regular screenings and HPV vaccination could prevent 93% of all cervical cancers.
Cervical cancer remains, however, a serious disease. Prevention and early detection are key to reducing your patients’ risk. Yet the CDC reported in 2012 that 8 million women between the ages of 21 and 65 had not been screened for cervical cancer in the last five years. (Most women should be screened every three years.)
In 2019, the National Foundation for Infectious Diseases (NFID) reported that only half of adolescent boys and girls had received the HPV vaccine, leaving too many vulnerable to HPV and the cancers it can cause in the future.
Inequities in Testing and Vaccination
While the U.S. and other developed countries have made great strides in reducing cervical cancer, a study published in Obstetrics and Gynecology Clinics of North America found that it “remains the second most frequent of all female malignancies worldwide, with 80% of the cases occurring in resource-poor countries.” Each year, half a million women worldwide are diagnosed with cervical cancer and a quarter of a million die of the disease.
Even in the U.S., the incidence of cervical cancer remains much higher in impoverished communities. The same study reported that “U.S. women experienced at least 33% higher incidence of, and 71% higher mortality from cervical cancer in high poverty counties than in low poverty counties.”
“Despite the tools now available to us to prevent cervical cancer, this remains a deadly disease in lower-income communities where many women aren’t receiving regular screenings and aren’t gaining access to the vaccine,” says LifeBrite Laboratories CEO Christian Fletcher. “We have to do more to increase access in these communities to the tools we know can prevent 93% of cervical cancers.”
A Generational Delay
While even women who have received the HPV vaccine should continue to receive regular Pap tests and pelvic exams, screenings will remain even more important for those already too old to benefit from the vaccination. Early adolescence is when the HPV vaccination will do the most to prevent cervical cancer, and the Advisory Committee on Immunization Practices recommends that adults ages 27-45 only receive the vaccine based on shared clinical decision-making.
After age 45, however, vaccination is not recommended or licensed for use as it is unlikely to have any protective effect against related cancers. This means that many middle-aged and older adults must continue to rely solely on regular screenings for early detection and effective treatment. Barring future new discoveries in medical science, this will remain the case for decades to come. Only younger generations will experience the benefits of the HPV vaccine for preventing cervical cancer.
You Have the Tools to Defeat This
Whether it’s HPV vaccinations for your younger patients, or pelvic exams, Pap smears, and genetic tests for all women up to age 65, you have the tools to prevent and treat cervical cancers.
During Cervical Health Awareness Month and all year long, let’s work together to educate all your patients about the importance of vaccinations and screenings for cervical cancer. Cervical cancer is a disease we can defeat.