Thursday, January 28, 2016

What Is The Best Way to Prevent Cervical Cancer? Hint: It Starts with "V" and Rhymes with "Sixteen"

January is Cervical Cancer Awareness Month. Each January, we've taken a closer look at cervical cancer as we raise awareness to prevention and detection. As the yearly observance comes to an end. it's important to summarize the information that is available.



Cervical cancer is caused by certain strains of the Human Papilloma Virus (HPV), which spread mainly through sexual contact. According to the Centers for Disease Control (CDC), cervical cancer affects more than 12,000 women in the United States annually and caused more than 4,000 deaths in 2012. In the U.S., the incidence of cervical cancer is relatively low when compared with other countries. In 2012, the rate of cervical cancer in the U.S. was only 8.1 cases per 100,000 women.  In Malawi, the incidence of cervical cancer was 75.9 cases per 100,000 women in 2012. According to the Word Cancer Research Fund International, about 84% of cancer cases occurred in less developed nations than the U.S. and more than 528,000 cases of cervical cancer were diagnosed worldwide.


The CDC estimates that nine out of ten people will contract HPV at some point in their lifetime. Detection and prevention are key in preventing fatal cervical cancer cases. Cervical cancer can be detected with routine pap smears. Cervical cancer screening includes two types of screening tests: cytology-based screening, known as the Pap test or Pap smear, and HPV testing. The main purpose of screening with the Pap test is to detect abnormal cells that may develop into cancer if left untreated.




Cervical cancer can be prevented by getting one of the two HPV vaccines available. The HPV vaccines are important because the incidence of HPV is high in the U.S.  Gardasil is recommended by the CDC for all males and females ages 11 to 26  and prevents types 6, 11, 16, and 18. Cervarix vaccine is used in girls and young women ages 9 through 25 to prevent cervical cancer caused by certain types of HPV (types 16 and 18).  Unfortunaterly, the HPV vaccine has been a source of controversy since Gardasil was approved by the Food and Drug Administration (FDA) in 2006 and when Cervarix was approved in 2009. Many parents may feel hesitant to consider the future sexual activity of their children and thus choose to forgo the Gardasil vaccine. Others may also worry about the safety of the HPV vaccine based upon misinformation they have read on the Internet. However, the HPV vaccine is perfectly safe.  Both Gardasil and Cervarix went through the stringent FDA approval process and both demonstrated favorable results in studies which included over 10,000 girls from 12 different countries. It’s important to note that both males and females should get the HPV vaccine to reduce the incidence and opportunity for transmission in our communities.


The CDC has several resources about the HPV vaccine, including this pamphlet for distribution for patients and families: http://www.cdc.gov/vaccinesafety/pdf/parents-hpv-vaccine-is-safe.pdf


According to Health Finder.gov, there are several ways that we as nurses can help promote Cervical Cancer Awareness Month. We can encourage women to get their annual pap smears, remind women that this service is covered by their health insurance and we can encourage parents to vaccinate their children against HPV. But mostly importantly, we need to stress that the HPV vaccine is highly effective and safe. 


Cancer is never a good thing but the good news is that cervical cancer can be detected early and it can be prevented with the HPV vaccine!




For further reading, here’s an excellent document from Health Finder.gov about cervical cancer and the HPV vaccine: http://healthfinder.gov/NHO/PDFs/JanuaryNHOToolkit.pdf


References:

1. http://www.cdc.gov/cancer/cervical/statistics/
2. https://report.nih.gov/nihfactsheets/viewfactsheet.aspx?csid=76
3. http://www.wcrf.org/int/cancer-facts-figures/data-specific-cancers/cervical-cancer-statistics
4. http://www.cdc.gov/hpv/parents/vaccine.html
5. http://www.cdc.gov/vaccinesafety/vaccines/hpv-vaccine.html
6. http://healthfinder.gov/nho/januarytoolkit.aspx
7. http://www.cancer.gov/types/cervical/pap-hpv-testing-fact-sheet
8. http://www.nature.com/news/the-world-must-accept-that-the-hpv-vaccine-is-safe-1.18918



Angela Quinn is a registered nurse on Long Island, NY. Angela is passionate about nursing and public health. She volunteers as an Executive Board Member of Nurses Who Vaccinate and is also the founder of Correcting the Misconceptions of Anti-Vaccine Resources, a professional blog which refutes anti-vaccine articles and blogs that promote misinformation and misconceptions about vaccines.