Cervical Cancer

Cervical cancer continues to be listed among the top gynecologic cancers worldwide. According to current data, it is ranked fourteenth among all cancers and fourth-ranked cancer among women worldwide. Cervical cancer intervention focuses on primary and secondary prevention. Primary prevention and screening is the best method to decrease the burden of cervical cancer and to decrease mortality. In the United States and other developing countries, most screening and diagnostic efforts are directed toward early identification of high-risk human papillomavirus (HPV) lesions through HPV testing and Pap smears. Although HPV testing is not recommended in women younger than 30 years of age, low-risk younger women should begin screening with Pap tests at age 21 and continue until age 65, according to the United States Preventive Services Task Force recommendations. Newer recommendations offer 3 to 5-year intervals between screening based on prior results and the use of pap and HPV co-testing.  Since cervical cancer is a sexually transmitted infection, it is a preventable disease. Targeted education, screening, and intervention can reduce the burden of disease. Like many diseases and cancers, disparities exist in screening rates, early diagnosis, and timely treatment. Screening rates tend to be less in low socioeconomic and low-resource areas with ethnic and age variations. Studies show that women with obesity and chronic disease may also have lower rates of cervical and breast cancer screening. A study on ethnic minority women in the United Kingdom reports several barriers to screening including lack of awareness, fear, embarrassment, and shame, and low perceived risk. One study reviewing the barriers for Haitian women revealed socioeconomic barriers, language barriers, and a limited understanding of health and disease.   In the United States, cervical cancer mortality is disproportionately higher for African American women. Since 2006, vaccination has been available for the prevention of cervical cancer. Vaccination can improve cancer death rates in underdeveloped countries where resources may not be available for routine screening and in populations with higher mortality rates.
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