More Pap Tests and HPV Vaccines Would Save Lives
The Centers for Disease Control and Prevention (CDC) states quite clearly “No woman should ever die from cervical cancer.” It is a disease that can be prevented through vaccination or detected early and cured through regular Pap testing. Yet cervical cancer still kills a few thousand U.S. women each year.
Even worse news is that Louisiana accounts for a large number of those deaths, with the state having the fourth highest cervical cancer mortality rate in the nation.
These are statistics that can and must be changed. According to the Louisiana Tumor Registry (LTR), Pap tests have radically reduced nationwide cervical cancer deaths to less than a third of the rate that women died of the disease in 1969, yet there are still women who do not get regular screenings. The CDC says that in 2012, 8 million women had not been screened in the last five years – in spite of the fact that seven out of 10 of those had a regular doctor and health insurance.
LBCHP Eligibility, Screening Recommendations
The hope is that those numbers will start to change since the Affordable Care Act (ACA) requires that cervical cancer Pap test screenings be covered by all insurance plans, and as word gets out that low-income, uninsured and underinsured women are eligible for federal testing programs. In this state, the CDC-funded Louisiana Breast and Cervical Health Program (LBCHP) (www.lbchp.org) provides cervical cancer screenings for women between 21-64 years old and whose household incomes are at or below 200 percent of the 2014 Federal Poverty Level. (That translates into an annual income of under $23,340 for a single person, for example, or $47,700 for a family of four, etc.)
Women should also know that screening interval recommendations have changed and become less burdensome. Health organizations, ranging from the American Cancer Society to the U.S. Preventative Services Task Force, recommend that average-risk women be screened every three years - not annually, as in the past.
Black, Vietnamese & Hispanic Women at Higher Risk
According to the LTR, black women in Louisiana have both higher cervical cancer incidence and mortality rates than black women nationwide. The CDC says that Hispanic women in the U.S. experience the highest cervical cancer incidence rates of any racial/ethnic group anywhere in the country. And, overall the CDC says, black, Hispanic and Vietnamese women have cervical cancer mortality rates above the national average. These groups have traditionally have had less access to Pap tests, but with the advent of ACA, knowledge about programs such as LBCHP, and the longer recommended times between screenings, these groups can reduce their death rates.
A Vaccine That Prevents Cancer
One of only two vaccines that help prevent cancer, the HPV vaccine protects against the human papillomavirus, which is so common that the CDC says that nearly all men and women will get it at some point in their lives, and estimates that approximately 79 million Americans are currently infected. HPV causes a number of cancers (99 percent of all cervical cancers), as well as genital warts in both men and women, which the vaccine can prevent. Therefore, the CDC advises that all children get the three-dose series over six months, starting at age 11 or 12, so that the vaccine generates its best immune response, which lessens as people age, and to be sure that the series is administered long before any exposure to the virus.
And though age 11 or 12 is optimum, the CDC says young men should still get vaccinated through age 21 (through age 26, if gay, bisexual or if their immune system is compromised) and young women through age 26. Most private health insurance plans now cover the HPV vaccine at no out-of-pocket cost because of ACA, while low-income children may be eligible for it through the federal Vaccines for Children Program (www.cdc.gov/vaccines/programs/vfc/index.html). Parents, as well as health care providers, whom the CDC says are not doing enough to get the word out about the HPV vaccine, are encouraged take advantage of one of the two HPV vaccines, which the CDC notes are “Safe, effective and grossly underutilized.”
Since their introductions in 2006, Cervarix and Gardasil (Gardasil is for both boys and girls and also protects against genital warts) have been shown to reduce U.S. HPV infections 56 percent, in spite of low HPV vaccination rates, while in Australia, where the vaccine uptake is high, precancers of the cervix and genital warts have been dramatically reduced.
And just a few days ago, the U.S. Food and Drug Administration approved Gardasil 9, which protects against nine types of HPV, five more than the previous version of Gardasil. It is approved for use in females age nine through 26 and males age nine through 15.
The Louisiana Comprehensive Cancer Control Program (LCCCP) (www.lcccp.org), which works on creating awareness about cancers that can be prevented or mitigated with screenings and lifestyle choices, is one of the CDC-funded Louisiana Cancer Prevention and Control Programs (LCP) housed at the LSU Health Sciences Center School of Public Health. Sister programs include the Louisiana Breast and Cervical Health Program (LBCHP) and the Louisiana Tumor Registry (LTR). For more information, go to www.louisianacancer.org.