Cervical Cancer Prevention Month January 2011 Morehouse College
What is Cervical Cancer? Cervical Cancer begins in the cervix (lower part of the womb, called the uterus). Cervical Cancer, at one point, was the #1 cause of death from cancer in women. Thanks to technological advances, (which most often can be attributed to the Pap Test), the number of women in the United States with cervical cancer has dropped dramatically over the years. At this time, this is the only gynecological cancer that can be prevented with routine screening. Information provided by the Cervical Cancer Campaign: www.cervicalcancercampaign.org/ccfacts/. Cervical Cancer Facts. 28 th of December 2010.
The Cervix has two parts: The outer part, closest to the vagina, is called the ectocervix. The inner part, closest to the uterus, is called the endocervix. Where the two parts meet is most often where cervical cancers start: This is also called the transformation zone. The Cervix is made up of many layers of cells, although there are only two types of cells on the surface of the cervix: Squamous epithelial cells line the outer part of the cervix Columnar epithelial cells line the inner part of the cervix Information provided by the Cervical Cancer Campaign: www.cervicalcancercampaign.org/ccfacts/. Cervical Cancer Facts. 28 th of December 2010.
According to the American Cancer Society s booklet, Cancer Facts & Figures, the following statistics are provided on cervical cancer in the United States: Approximately 11,070 women will find out they have invasive cervical cancer this year. This year, approximately 3,870 women will die from cervical cancer. Hispanic Women and African-American Women are more likely to get cervical cancer than non-hispanic white women. Nearly half of the women that get cervical cancer are between 30 and 55 years old. All women with cervical cancer have had a human papillomavirus (HPV) infection at one point in their life. Most women with HPV will never get a disease related to that condition. In the past 50 years, Pap test screenings have reduced cervical cancer deaths by 74%. Information provided by the Cervical Cancer Campaign: www.cervicalcancercampaign.org/ccfacts/. Cervical Cancer Facts: Statistics about Cervical Cancer. 28 th of December 2010.
When should I get a Cervical Cancer Screening Test? Age Beginning at Age 21 Ages 21-29 Frequency Screening should begin at age 21 (regardless of sexual history). Screening before age 21 is not necessary because there is a very low risk of cancer. Pap Tests are recommended every 2 years. Ages 30-65 Ages 65 70+ Women aged 30 years and older who have had three consecutive negative cervical cytology screening tests results, and who have no other health issues, can extend the screening to every 3 years. Women who have had 3 or more normal Pap Test results in a row and no abnormal test in the last 10 years and are 65-70 and older don t have to get a Pap Test again. Please note that it is best to talk to your health care provider about the best testing schedule for you. Information provided by the Cervical Cancer Campaign: www.cervicalcancercampaign.org/ccfacts/. Cervical Cancer Facts: When Should I Get a Cervical Cancer Screening Test?. 28 th of December 2010.
Information provided by the Cervical Cancer Campaign: www.cervicalcancercampaign.org/ccfacts/. Cervical Cancer Facts: How do I know if I have cervical cancer?. 28 th of December 2010. Unusual discharge from the vagina Blood spots or light bleeding when you are not having your period Bleeding after menopause Bleeding or pain during sex Ongoing pelvic, leg or back pain Urinary problems because of blockage or a kidney or ureter Bleeding from the rectum or bladder Weight Loss If you have any of these symptoms, speak to your healthcare provider. It s important to note that having these symptoms does not necessarily mean you have Cervical Cancer, but it s important that you do not ignore any symptom.
Tables of Risk Factors Risk Factors Not getting screened regularly with a Pap Test High-risk human papillomaviruses (HPV) Smoking HIV Infection Additional Risk Factors I have had cervical cancer previously My mother or sister has had cervical cancer I have had a recent or past chlamydia infection I don t eat many fruits and vegetables, especially foods with vitamins A, C, and E I am overweight I use oral contraceptives (using the pill for more than 5 years, may increase risk) I have given birth to several children Information provided by the Cervical Cancer Campaign: www.cervicalcancercampaign.org/ccfacts/. Cervical Cancer Facts: Are You at Risk for Cervical Cancer. 28 th of December 2010.
Stage 0 This stage is called the carcinoma in situ (CIS). The tumor at this stage is still very superficial, and has only grown in the layer of cells lining the cervix. Stage 1A1 The doctor is not able to see the cancer without a microscope. The cancer is less than 3 mm deep and 7 mm wide. Stage 1A2 The doctor is not able to see the cancer without a microscope. The cancer is anywhere from 3 to 5 mm deep and still less than 7 mm wide. Stage 1B1 The doctor is able to see the cancer without the use of a microscope. It is no bigger than 4 cm in size. Stage 1B2 The doctor is able to see the cancer without the use of a microscope. It is larger than 4 cm in size. Information provided by the Cervical Cancer Campaign: www.cervicalcancercampaign.org/ccfacts/. Cervical Cancer Facts: Understanding your Stage of Cervical Cancer. 28 th of December 2010.
Cervical Cancer Stages 2-3 Stage 2A The cancer now extends to your upper vagina. It has not yet spread into the tissues deeper than the vagina. Stage 2B The cancer has spread to the tissues surrounding your vagina and cervix. It has not spread to the wall of the pelvis. Stage 3A The cancer has now spread to the lower third of your vagina, and has not spread to the wall of your pelvis. Stage 3B The cancer has invaded the soft tissues surrounding your vagina and cervix all the way to the wall of the pelvis. This may cause blockage of urine flow to your bladder. Information provided by the Cervical Cancer Campaign: www.cervicalcancercampaign.org/ccfacts/. Cervical Cancer Facts: Understanding your Stage of Cervical Cancer. 28 th of December 2010.
Stage 4A The cancer has now invaded nearby organs. For example, your bladder or rectum. Stage 4B The cancer has invaded distant organs. For example, your lungs. According to the Cervical Cancer Campaign, Physicians will discuss many options of treatment. They will take into consideration the stage of the cancer, as well as the woman s health before recommending a plan. The doctor may use clinical studies from past cases of women in similar stages of cervical cancer. This enables the doctor to make some predictions about how the cancer will react and which treatment may be best for the patient. Information provided by the Cervical Cancer Campaign: www.cervicalcancercampaign.org/ccfacts/. Cervical Cancer Facts: Understanding your Stage of Cervical Cancer. 28 th of December 2010.
What you can do if you are at Risk Get a regular Pap Test This test is the best way to reduce your risk for cervical cancer. This test can also detect HPV infection and precancerous changes. If these changes are caught early enough, you can avoid the invasive cervical cancer. Talk with your doctor about the HPV vaccine Gardasil, a vaccine that was approved in 2006 by the FDA, protects against HPV Types 16 and 18, which cause 70% of all cervical cancers. For more information on the vaccine visit: www.gardasil.com. Take steps to prevent HPV infection during sexual activity The only way to completely prevent HPV is to not engage in sexual activity. If you do have sex, try to limit the number of partners you have, as well as using protection at all times. Eat Fruits and Vegetables daily According to the Cervical Cancer Campaign, The connection between diet and risk reduction for cervical cancer is still not clear. Still, in a recent review of the research of 33 studies of diet and cancer, a few studies showed a possible protective effect of fruits, vegetables, vitamins C and E, beta- and alpha-carotene, lycopene, etc. If you are overweight, lose weight Being overweight increases your risk for cervical cancer. Losing weight may help reduce your risk. Information provided by the Cervical Cancer Campaign: www.cervicalcancercampaign.org/ccfacts/. Cervical Cancer Facts: What Can you do If You re At Risk for Cervical Cancer?. 28 th of December 2010.
Two Types of Treatments for Cervical Cancer Surgery: Removes as much of the cancer as possible. Mostly used for smaller cancers that have not spread beyond the cervix. Local Treatments Radiation: Kills cancer cells by using high-energy rays directed at the tumor from outside your body or with radioactive material placed at specific areas near the cervix. Systematic Treatments Chemotherapy: Drugs are used to kill the cancer cells. This has not proven that effective when used alone for cervical cancer. Most women who have chemotherapy combine it with radiation for better results. Information provided by the Cervical Cancer Campaign: www.cervicalcancercampaign.org/ccfacts/. Cervical Cancer Facts: Types of Treatment for Cervical Cancer. 28 th of December 2010.
Female Cervical Cancer Incidence and Death Rates (Statistics from the Centers for Disease Control and Prevention: 2007) Incidence Rates Death Rates 12.0 11.5 10.2 Rates per 100,000 persons 10.0 8.0 6.0 4.0 2.0 7.9 7.5 2.4 2.2 4.3 6.9 7.0 2.0 2.3 3.0 0.0 All Races White Black Asian/Pacific Islander Statistical Information provided by Centers for Disease Control and Prevention: www.cdc.gov: 28 th of December 2010. Cervical Cancer Incidence and Death Rates Table. American Indian/Alaska Native Hispanic
Cervical Cancer Incidence and Death Rates by State Southeast: 2007 Tennessee 2.8 7.8 North Carolina 2.4 7.2 South Carolina Alabama 3.0 3.0 7.9 9.6 Death Incidence Georgia 3.0 8.4 Florida 2.5 8.8 0.0 2.0 4.0 6.0 8.0 10.0 Rates per 100,000 persons Statistics provided by the Centers for Disease Control and Prevention: www.cdc.gov: Table 5.3.1F and Table 5.3.2F. Cervical Cancer Statistics. 28 th December 2010.
Data represents period: 12/1/09-11/30/10 400 391 300 200 170 100 0 # of covered Females Aged 21 and Over on Medical Plan # of Pap Tests within a 12 month period
Morehouse College Medical Plan Gardasil is covered under the wellness benefit for members and dependents up to age 26 Plan A: WELLNESS EXPENSE (Ages 19 and over includes immunizations, mammogram, pap smear, prostate exam, colon exam, colonoscopy with routine diagnosis (coverage of general anesthesia for a colonoscopy will be based on medical necessity), routine exam, lab, and x-rays) PPO..... $25 Copay per visit, then 100% NON-PPO... Not Covered Plan B: WELLNESS EXPENSE (Ages 19 and over includes immunizations, mammogram, pap smear, prostate exam, colon exam, colonoscopy with routine diagnosis (coverage of general anesthesia for a colonoscopy will be based on medical necessity), routine exam, lab, and x-rays) PPO..... $20 Copay per visit, then 100% NON-PPO... Not Covered