Opinion: Women do not have to die from cervical cancer

Opinion: Women do not have to die from cervical cancer

Note to the Editor: Dr. Eloise Chapman-Davis is director of gynecologic oncology at NewYork-Presbyterian/Weill Cornell Medical Center and Weill Cornell Medicine. Dr. Denise Howard is chief of obstetrics and gynecology at Brooklyn Methodist Hospital-New York-Presbyterian and vice chair of obstetrics and gynecology at Weill Cornell Medicine. The opinions expressed in this commentary are their own. Read more opinion on CNN.



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As doctors who specialize in women’s reproductive health, we are at the forefront of a preventable crisis. Imagine treating a woman with advanced cancer who has a five-year survival rate of 17%, knowing that she should not have developed the fatal disease in the first place.

Eloise Chapman-Davis

Here’s what’s next for cervical cancer. But we have the clinical tools to not only reduce but eliminate almost all 14,000 new cases and 4,300 deaths from cervical cancer.

Denise Howard

We have effective screenings: the traditional Pap smear and the HPV test. If these screening tests are abnormal, further tests can determine who needs further treatment to prevent the development of cancer. Importantly, we have the HPV vaccine, which protects against the high-risk types of human papillomavirus (HPV) that cause most cases of cervical cancer and is nearly 100% effective, according to the National Cancer Institute.

A report published earlier this month shows the huge impact of the vaccine. Cervical cancer rates in the United States fell by 65% ​​from 2012 to 2019 among women aged 20-24, the first to receive the vaccine. The vaccine, combined with screening, could wipe out cervical cancer and make it a disease of the past.

But the percentage of women who are overdue for cervical cancer screening is increasing, and, alarmingly, late cases are increasing.

It’s been a heartbreaking experience to see mothers in life dying from this preventable disease, leaving behind small children – even women who had an abnormal screening but never received follow-up care. Watching an otherwise healthy person slowly die from a preventable cancer is horrible.

Simply put, cervical cancer should never happen. This Cervical Cancer Awareness Month, we should commit to making that happen. This is what has to happen.

Eradicating cervical cancer requires commitment at multiple levels, from public awareness campaigns with culturally appropriate messages that broadcast the power of vaccines and screenings to prevent cancer to resources that ensure all women have easy access to routine health examinations.

Timely reminders and screening systems are essential to prioritize follow-up care. Too many women with abnormal screenings do not receive their results, reminders or follow-up instructions that they understand and therefore do not receive appropriate treatment. Barriers include logistical challenges such as transport and language. Studies indicate that 13% to 40% of cervical cancer diagnoses result from lack of follow-up among women with an abnormal screening test.

Gynecology and primary care practices should be vigilant in approaching and monitoring patients with questionable test results. Large health systems can leverage the power of the electronic health record to track abnormal tests and ensure these women receive appropriate follow-up.

Pediatricians should encourage parents of children 9 years of age and older to receive the HPV vaccine and emphasize its safety. About 60% of teens are up to date on their HPV vaccines, according to the US Centers for Disease Control and Prevention. Physicians not recommending the vaccine and parents’ growing concern about its safety, despite more than 15 years of evidence that it is safe and effective, have been cited as the main reasons more children are not receiving this life-saving vaccine.

College campuses should conduct large-scale, catch-up vaccination outreach. These students are at high risk for VSD, but only half reported receiving the full HPV vaccine series. This service should be provided at no cost to students.

Large racial disparities must also be addressed. As Black women physicians, we are frustrated that Black women are more likely to die from the disease than any other race, according to the American Cancer Society. System failures that contribute to this tragedy range from less aggressive treatment for black women to barriers to access to affordable routine health care and the high-quality specialized treatment needed to treat cancer. Everyone deserves access to quality care.

Older patients should be informed that the approval of the HPV vaccine has been extended up to the age of 45 and discuss with their doctor whether it is right for them. Insurance providers should cover the cost of the vaccine for these elderly people.

Women should see a gynecologist regularly well into their older years. We see patients with cervical cancer in their 60s and 70s who have not been screened for 20 years. Many people stop seeing a gynecologist after childbirth or menopause, but this should not be the case. Getting high-quality gynecological exams throughout a woman’s life is essential to preserving it.

We also need to empower women to be their own advocates through health education. Women should receive their screening result with an explanation of what it means and any next steps clearly outlined. No news after screening is good news. In an ideal world, women would see their HPV status as essential information that has the power to save their lives.

Education makes a difference. At NewYork-Presbyterian and Weill Cornell Medicine, we made a series of videos on cervical cancer and the HPV vaccine publicly available that were easy to understand and publicly available. We showed some of the vaccine videos to more than 100 parents in one of our pediatric practices that serve mostly low-income families as part of a pilot study. Their knowledge scores on a questionnaire about the vaccine and HPV they completed before and after watching the videos increased by nearly 80%, and about 40% of the unvaccinated children received the HPV vaccine within one month. We aim to expand this effort.

We have the tools to prevent cervical cancer but we fail to use them effectively. It is unacceptable, and we can no longer ignore the problem. It is time for a full-scale, multifaceted attack to make cervical cancer a disease of the past.

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