US Fight Against Cervical Cancer Makes Pleasing But Patchy Progress

The fight against cervical cancer in the US is making pleasing overall progress, but is lagging behind in the case of black, Hispanic and low income women. This was how Susan Crosby, president of Women in Government, summarized the situation yesterday.

Women in Government, a not for profit bipartisan group of women legislators released the third annual report yesterday on the state by state comparison of the progress against cervical cancer in the US. The report is called Partnering for Progress 2007: the 'State' of Cervical Cancer Prevention in America.

On the positive side the report shows that a majority of states, including the District of Columbia, has seen a decrease in both incidence and mortality of cervical cancer. And this is the first time that a grade of Excellent has been awarded to a state - Minnesota, which scored 83 per cent (15 points out of 18).

After Minnesota the states who came near the top were Illinois (at 78 per cent) followed by Alabama, Connecticut, Maine, North Carolina and Rhode Island, equal at 72 per cent.

The score awarded to a state is based on a number of measures such as cervical cancer incidence and mortality, women's access to screening that uses the latest technology, screening rates (including women on low incomes), and the level of legslative priority given to the issue.

In the last year alone more than 25 legislative measures have been introduced in different states to tackle the problem of cervical cancer.

On the negative side, nearly half of the states have seen an increase in the number of women without health insurance. And, incidence rates for black and Hispanic women in most states are higher than for white women. Meanwhile screening rates for Hispanic women are mostly lower in most states, and lower across all states for Native American and Asian/Pacific Islander women.

Ms Crosby drew attention to the possibility that cervical cancer could be eliminated if maximum use was made of opportunities such as the availability of the vaccine against the sexually transmitted Human Papillomavirus (HPV), the virus that causes cervical cancer. In June 2006 the FDA gave the go ahead to use the vaccine in females aged 9 to 26. Another HPV vaccine is due to come before the FDA for approval this year.

The types of HPV that the vaccines protect against account for 70 per cent of cervical cancer cases, so it is still important to push for screening to catch the other 30 per cent. Also, screening will be important for those women who may already have been exposed to the HPV types target by the vaccines, and for women who for whatever reason do not get vaccinated.

The state that, according to the report has the second highest fatality rate of cervical cancer, West Virginia, is considering introducing legislation that would make it compulsory for pre-teen girls to have the HPV vaccine. According to the report, in West Virginia, four women per 100,000 die every year of cervical cancer. Washington DC was the only state to exceed this figure.

HPV is the most common sexually transmitted disease in America, where 6 million cases are diagnosed annually. The number of women in 2006 that will have been diagnosed with cervical cancer is estimated by the American Cancer Society (ACS) to reach 9,710, and 3,700 will have died of it.

According to the ACS, Hispanic women are two times more likely to get cervical cancer than non-Hispanic white women, and African-American women are 50 per cent more likely. The 5 year survival rate (for all combined diagnostic stages) of cervical cancer is just over 70 per cent, going up to 92 per cent for the earliest stage.

Detailed Guide to Cervical Cancer (American Cancer Society).

Partnering for Progress 2007: the 'State' of Cervical Cancer Prevention in America (Women in Government, US).

Written by: Catharine Paddock
Writer: Medical News Today