January 19, 2011 5:43 AM
Bet you didn’t know that January is cervical cancer awareness month. But that’s not necessarily a bad thing, according to Dr. William “Rusty” Robinson III, section chief of gynecologic oncology at the Tulane University School of Medicine. The incidence of cervical cancer has fallen significantly over the last 50 years, largely as a result of screening programs.
The irony is that while the incidence of invasive cervical cancer has dropped — only about 12,000 cases are diagnosed annually in the U.S. — the incidence of pre-invasive disease has risen at least as significantly. About 500,000 cases of cervical cancer are diagnosed annually.
Cervical cancer has a relatively long pre-cancerous stage during which annual Pap smear screenings can detect the disease, but some women still fail to get annual Pap smear exams.
“The women today who are diagnosed with invasive cervical cancer are largely those we’re not catching with our screening system,” Robinson says. These women tend to be less well educated, come from lower socio-economic status, and are under- or uninsured.
However, Robinson expects the incidence of both invasive cervical cancer and precancerous disease to continue to decline, now that an effective vaccine is available.
Most cervical cancers are caused by exposure to HPV (human papillomavirus) through sexual activity. The HPV vaccine consists of a series of three injections given to girls, preferably before they become sexually active and typically between the ages of 9 and 25.
“If HPV infections are prevented, we can reduce the number of invasive cervical cancers without worrying whether or not a woman has access to Pap smears,” says Robinson.
However, the costs are high — the course of three injections can run as much as $600 — and some insurers don’t cover them.
“The question is: do we have the political will as a nation to require HPV vaccination for all young girls, just like we require vaccination against other diseases before a child can start school?”
Melanie Cross is manager of communications at the Tulane Cancer Center.
Tulane University, New Orleans, LA 70118 504-865-5000 firstname.lastname@example.org