The Challenge of Eliminating Cervical Cancer in the United States: A Story of Politics, Prudishness, and Prevention

Fisher, Joslyn W.; Brundage, Susan I.

doi:10.1080/03630240902915101

Cited by 18 publications

(19 citation statements)

References 52 publications

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“…6,7 During the 1950s and 1960s, approximately 95% of all invasive cervical cancers were squamous cell carcinomas, and adenocarcinomas, the second most common histologic cell type, accounted for only 5% of cervical cancer cases. 6,8,9 More recently, there has been a shift in the distribution of the histologic subtypes of cervical cancer. At present, the squamous type accounts for approximately 75% of invasive cervical cancer, whereas adenocarcinomas account for the remaining 25%.…”

Section: Introductionmentioning

confidence: 99%

Cervical Cancer Trends in the United States: A 35-Year Population-Based Analysis

Adegoke

Kulasingam

Virnig

2012

Journal of Women's Health

273

182

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Purpose: To analyze trends in invasive cervical cancer incidence by age, histology, and race over a 35-year period (1973-2007) in order to gain insight into changes in the presentation of cervical cancer. Methods: Data from the nine Surveillance, Epidemiology, and End Results (SEER) registries that continuously collected information on invasive cervical cancer were analyzed for trends. Standardized to the 2000 U.S population, annual age-adjusted incidence rates were estimated by race and histologic subtype. Histologic subtype was classified into squamous, adenocarcinoma, and adenosquamous. Results: Overall incidence rates for invasive cervical cancer decreased by 54% over the 35 years, from 13.07/ 100,000 (1973)(1974)(1975)) to 6.01/100,000 (2006)(2007), and the incidence rates declined by 51% and 70.2%, respectively, among whites and blacks. The incidence rates for squamous carcinoma decreased by 61.1% from 10.2/ 100,000 (1973)(1974)(1975)) to 3.97/100,000 (2006)(2007). Incidence rates for adenosquamous cell carcinomas decreased by 16% from 0.27/100,000 (1973)(1974)(1975) to 0.23/100,000 (2006)(2007), and incidence rates for adenocarcinomas increased by 32.2% from 1.09/100,000 (1973)(1974)(1975)) to 1.44/100,000 (2006)(2007). This increase in adenocarcinomas was due to an increase in incidence in white women; a decrease in incidence was observed for black women. Conclusions: Although marked reductions in the overall and race-specific incidence rates of invasive cervical cancer have been achieved, they mask important variation by histologic subtype. These findings suggest that alternatives to Pap smear-based screening, such as human papillomavirus (HPV) testing and HPV vaccination, need to be prioritized if adenocarcinomas of the cervix are to be controlled.

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Section: Introductionmentioning

confidence: 99%

Cervical Cancer Trends in the United States: A 35-Year Population-Based Analysis

Adegoke

Kulasingam

Virnig

2012

Journal of Women's Health

273

182

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“…Globally, the Pap test is the principal means of detecting abnormalities, although organisation of screening programmes, coverage, eligibility criteria and recommended screening intervals differ. The Pap smear has become routine and reduced the incidence and mortality of cervical cancer [46], but cervical cancer still causes significant morbidity and mortality in developing countries. For instance in Nigeria, the prevalence of HR HPV and cytological abnormalities in women is 16.6% and consistent with other regions in Africa [40].…”

Section: Resultsmentioning

confidence: 99%

“…Therefore the discovery of the link between HPV and cervical cancer, and hence, the possibility of immunisation, enabled primary prevention. In sharp contrast with routinising Pap smears, the medical community, policymakers, and the public showed rapid attention to the HPV vaccines [46]. In 2006, the US Food and Drug Administration (FDA) approved of a noninfectious recombinant quadrivalent HPV vaccine (Gardasil) targeting HPV-16 and 18 as well as HPV-6 and 11 against genital warts for use in girls and women aged 9–26.…”

Section: Resultsmentioning

confidence: 99%

Applying a gender lens on human papillomavirus infection: cervical cancer screening, HPV DNA testing, and HPV vaccination

Branković

Verdonk

Klinge

2013

Int J Equity Health

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BackgroundOur aim is to provide a state-of-the-art overview of knowledge on sex (biological) and gender (sociocultural) aspects of Human papillomavirus (HPV) and cervical cancer for educational purposes. Considerable disparities exist in cervical cancer incidences between different subgroups of women. We provide an outline on the crucial issues and debates based on the recent literature published in leading gender medicine journals. Intersectionality was applied in order to help categorise the knowledge.MethodsKey terms (HPV, cervical cancer) were screened in Gender Medicine, Journal of Women’s Health and Women & Health from January 2005-June 2012. Additional searches were conducted for topics insufficiently mentioned, such as HPV vaccination of boys. In total, 71 publications were included (56 original papers, four reviews, six reports, three commentaries, one editorial and one policy statement).ResultsResearch reveals complexity in the way various subgroups of women adhere to cervical screening. Less educated women, older women, uninsured women, homeless women, migrant women facing language barriers, women who have sex with women and obese women participate in Pap smears less frequently. A series of barriers can act to impede decisions to vaccinate against HPV.ConclusionsBoth male and female controlled preventive methods and treatment measures should be developed in order to tackle HPV infection and different strategies are needed for different subgroups. A substantial discussion and research on alternative methods of prevention was and is lacking. In future research, sex and gender aspects of HPV-related diseases of boys and men as well as subgroup differences in HPV risk need to be addressed.

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“…An improved understanding of the contexts in which follow up care decisions take place—from both patients and provider perspectives- will improve the provision of vital services. As the history of disease eradication or at least reduction suggests (Fisher & Brundage, 2009), employing a multi-dimensional approach (patient, procedure/provider/system, and ecological/community) is essential to a comprehensive understanding of complex health decisions. In the case of follow up care for an atypical Pap test result, addressing the specific perspectives of the response types described in this article may hold great promise in further reducing deaths from this preventable cancer.…”

Section: Discussionmentioning

confidence: 99%

Perspectives on Pap Test Follow-Up Care Among Rural Appalachian Women

et al. 2010

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Approximately one to three quarters of women notified of abnormal Pap test results do not receive appropriate follow up care, dramatically elevating their risk for invasive cervical cancer (ICC). We explored barriers to/facilitators of follow up care for women in two counties in Appalachian Kentucky, where ICC incidence and mortality are significantly higher than the national average. Indepth interviews were conducted among 27 Appalachian women and seven local health department personnel. Those who had been told of an atypical Pap test result tended to have one of three reactions; (1) not alarmed and generally did not obtain follow-up care; (2) alarmed and obtained follow up care; or (3) alarmed, but did not obtain care. Each of these typologies appeared to be shaped by a differing set of three categories of influences: personal factors; procedure/provider/system factors; and ecological/community factors. Recommendations to increase appropriate follow up care included pursuing research on explanations for these typologies and developing tailored interventions specific to women in each of the response types.

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The Challenge of Eliminating Cervical Cancer in the United States: A Story of Politics, Prudishness, and Prevention

Cited by 18 publications

References 52 publications

Cervical Cancer Trends in the United States: A 35-Year Population-Based Analysis

Cervical Cancer Trends in the United States: A 35-Year Population-Based Analysis

Applying a gender lens on human papillomavirus infection: cervical cancer screening, HPV DNA testing, and HPV vaccination

Perspectives on Pap Test Follow-Up Care Among Rural Appalachian Women

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