Overall, the good news surrounding cervical cancer continued in 2010. For yet another year, while incidences of cervical cancer remained the same, deaths resulting from the disease were down in the United States. What was formerly a mystery is now very well understood. In fact, cervical cancer is now considered the easiest female cancer to prevent; all it takes is regular screenings.
However, that doesn't mean doctors and medical researchers are just sitting on their hands when it comes to cervical cancer. They continue to aggressively research ways to maintain the steady decline of cervical cancer complications.
Until recently, it was thought that a Pap test (or "Pap smear") was the best way to screen for cervical cancer. But in April of 2010, the British Journal of Cancer published a study showing that for women over 30, HPV tests—which look for signs of the humanpapillomavirus (HPV), a sexually transmitted infection that causes most cases of cervical cancers—make much more effective primary screening tools. HPV tests are more likely to catch potential cervical abnormalities. Because of their higher effectiveness—and due to the fact that cervical cancer is slow-growing—HPV tests would only have to be administered every five years or so to be effective.
There is now an effective HPV vaccine available that prevents 90 percent of genital warts and 70 percent of cervical cancers. In 2009, one year after the Federal Drug Administration (FDA) approved a very first HPV vaccine, Gardisil, a second— Cervarix—was approved for the U.S. market.
The good news is that more and more people are learning of the HPV vaccine and the rate of vaccination is increasing; the bad news is that it is not increasing nearly fast enough. Research done over the last year has revealed that even though the HPV vaccine is known to be safe and effective, vaccination is still not quite par for the course. In fact, according to a report out of the Washington University School of Medicine, only about one in every three young women (ages 13 to 17) who should get the vaccine are being vaccinated. That report was published in June; a study published in November showed that fewer than 30 percent of those women eligible for the HPV vaccine were choosing to get it, and only about a third of those who began the vaccination process completed the three doses needed for the vaccine to be fully effective.
The primary reasons for the lack of participation in vaccination programs seem to stem from social pressures. For example, minority women were less likely to follow through on their vaccination. In addition, young women have a more difficult time getting vaccinated than older women. Although national guidelines encourage doctors to recommend the vaccine to girls starting at age 11, many doctors are hesitant to do so. A significant number of doctors surveyed stated that "parent opposition for moral or religious reasons" was a significant barrier to stronger vaccine recommendations. The perception among some parents and guardians is that vaccination against HPV would lead to increased sexual behavior among teens. Public health officials, however, strongly argue that this is a misguided belief and continue to call for the fostering of increased participation in vaccination programs and the elimination of barriers to the vaccine for young women and minority women.
Cervical Cancer Around the World
Worldwide, cervical cancer incidence and death rates have not improved with the steadiness that they have in the United States. Cervical cancer is the most common cancer for women in Central America, sub-Saharan Africa, and in many parts of South America and Southeast Asia. Worldwide, a woman dies of cervical cancer approximately every two minutes.
Public health professionals are out to improve these numbers. Among other developments, scientists have developed a needle-free delivery system for the HPV vaccine—a dry powder that goes directly to the mucous membranes in the respiratory tract or the mouth. Unlike needle injection, the powder is not susceptible to contamination and will be easier to store and transport in developing countries. Health professionals predict that a needle-free vaccine could lead to a significant increase in women participating in a vaccination program.
Another 2010 development that bodes well for the international outlook was the release of a study done by researchers at the Duke Institute for Genome Sciences & Policy. It is well known that many easy-to-make vaccines (such as the vaccine for polio) are manufactured in places like India for relative pennies compared to their cost in the U.S. Apparently, the same could soon be the norm for the HPV vaccine as well. The researchers analyzed patents worldwide and discovered that "biosimilar" vaccines that would protect against HPV could be legally produced in India. The result could be cheap, generic vaccines that would be affordable even for third-world populations.
Health professionals believe that these, and other developments on the horizon, will soon result in positive trends in cervical cancer worldwide that will eventually match those in the United States.