Opinion: Women don’t have to die from cervical cancer

Opinion: Women don’t have to die from cervical cancer

Opinion: Women don’t have to die from cervical cancer

Editor’s Note: 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 NewYork-Presbyterian Brooklyn Methodist Hospital and vice president of obstetrics and gynecology at Weill Cornell Medicine. The opinions expressed in this comment are my own. Read more opinion on CNN.


As physicians specializing in women’s reproductive health, we are on the front lines of an preventable crisis. Imagine treating a woman with advanced cancer who has a 17% five-year survival rate, knowing she never should have developed the deadly disease in the first place.

Eloise Chapman-Davis

That’s what we’re up against with cervical cancer. However, we have the clinical tools to not only reduce but eliminate nearly all of the approximately 14,000 new cases and 4,300 deaths from cervical cancer each year.

Denise Howard

We have effective exams: the traditional Pap smear and the HPV test. If these screening tests are abnormal, additional tests can determine who needs more treatment to prevent the cancer from developing. 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 vaccine’s tremendous impact. The US saw a 65% drop in cervical cancer rates from 2012 to 2019 among women aged 20 to 24 who were 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 late for cervical cancer screening is growing and, alarmingly, late-stage cases are rising.

We’ve had the painful experience of watching mothers in the prime of life die from this preventable disease, leaving young children behind – even women who had an abnormal screening but never received follow-up care. It is devastating to see a healthy person slowly die from preventable cancer.

Simply put, cervical cancer should never occur. In this cervical cancer awareness month, we must commit to making this a reality. Here’s what needs to happen.

Eliminating cervical cancer requires commitment on many levels, from public awareness campaigns with culturally appropriate messages that convey the power of the vaccine and testing to prevent cancer, to resources that ensure all women have easy access to comprehensive health screenings. routine.

Timely triage reminders and systems for prioritizing follow-up care are essential. Many women with abnormal tests do not receive their results, reminders or follow-up instructions that they understand, and therefore do not receive appropriate treatment. Barriers also include logistical challenges such as transportation and language issues. Studies suggest 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 must be vigilant about reaching and monitoring patients with suspicious test findings. Large health systems can harness the power of the electronic medical record to track abnormal tests and ensure these women receive proper follow-up.

Pediatricians should encourage parents of children aged 9 years and older to get 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. Doctors not recommending the vaccine and growing parental concerns about its safety, despite more than 15 years of evidence that it is safe and effective, were cited as the top reasons why more children are not getting this life-saving vaccine. .

College campuses must do large-scale vaccination campaigns. These students are at high risk of contracting HPV, yet only half report having received the full series of HPV vaccines. This service is to be provided at no cost to students.

Large racial disparities must also be addressed. As black physicians, we are frustrated that black women continue to be more likely to die from the disease than any other race, according to the American Cancer Society. The system failures that contribute to this tragedy range from women of color receiving less aggressive treatment to barriers around accessing affordable routine health care and the specialized, high-quality care 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 to age 45 and should discuss with their physician whether it is suitable for them. Insurance providers must cover the cost of the vaccine for these older ages.

Women should see a gynecologist regularly until old age. We see cervical cancer patients in their 60s and 70s who haven’t had a scan in 20 years. Many people stop seeing a gynecologist after pregnancy or menopause, but this shouldn’t be the case. Performing quality gynecological exams throughout a woman’s life is essential to preserve her.

We also need to empower women to be their own advocates through health education. Women should receive the test result with an explanation of what it means and any clearly outlined next steps. No news after an exhibition is not good news. In an ideal world, women would view their HPV status as critical information with the power to save their lives.

Education makes the difference. At NewYork-Presbyterian and Weill Cornell Medicine, we have produced a series of easy-to-understand, publicly available videos about cervical cancer and the HPV vaccine. We showed several vaccine videos to over 100 parents at one of our pediatric clinics that primarily serve low-income families as part of a pilot study. Their knowledge scores on a vaccine and HPV questionnaire they completed before and after watching the videos increased by nearly 80%, and about 40% of unvaccinated children received the HPV vaccine within one month. Our goal is to expand this effort.

We have the tools to prevent cervical cancer, but we don’t use them effectively. It is unacceptable and we can no longer ignore the problem. It’s time for a full-scale offensive focused on all fronts to make cervical cancer a disease of the past.

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