March 06, 2014
By Ambassador Sally G. Cowal
We celebrate International Women's Day March 8. Originally, it was an event to promote equal political rights, including the right to vote, for women. As a Chicagoan I'm proud to say that one of the earliest Women's Day observances was held in that city in 1908!
Today, although women have the right to vote almost everywhere, health inequalities and disparities between women in the developed and developing worlds -- and between men and women in many countries and regions of the world -- continue to exist.
Women's health is important, not only for women, but for men and for families. Women are the caregivers in most places in the world, and when a woman is ill or dies prematurely, her family -particularly her children - carry the burden. That is one of the reasons why it is so important to prevent premature illness and death in women from cancer. Although we think of cancer as a disease that affects people in high income countries, the reality is that 57% of cancer cases and 65% of cancer deaths are in low and middle income countries - that is 5.3 million deaths a year. And the trends point to a continuing shift of the burden to lower income countries.
In addition, the cancer experience in lower income countries is very different from the experience of cancer patients in the US. For example, in the US, 60% of breast cancer cases are diagnosed in the earliest stages of disease, whereas in Brazil only 20%, and in Mexico, only 10% are diagnosed at an early stage. When cancer is caught later, treatment is less likely to be successful. As a result, advances in cancer survival that we have experienced over the last few decades in the US are not reflected in the experiences of people with cancer in lower income countries. More...
January 23, 2014
EDITOR'S NOTE: The President's Cancer Panel has released a report that says increasing HPV vaccination is one of the most important opportunities in cancer prevention. The report calls for re-energized efforts to promote vaccination and reach the HPV vaccines' potential to save lives by preventing avoidable cancers in men and women. It explores underuse of HPV vaccines, identifies key barriers to increasing vaccine uptake, and provides actionable recommendations for overcoming these obstacles. To coincide with the release, here is our recent blog on the subject.
By Debbie Saslow, PhD
The HPV vaccines (Gardasil and Cervarix) have been recommended for girls in the US for nearly 10 years. They protect against human papillomavirus (HPV), the virus that causes most cases of cervical cancer, and Gardasil also protects against nearly all cases of genital warts. Uptake of HPV vaccination has been slow in this country, though; less than 35% of girls have gotten all 3 recommended doses.
Despite low vaccination rates, we have already seen HPV infections (related to the types of HPV targeted by the vaccines) drop by 56% in the United States. In countries that have higher vaccine rates, there are even larger drops. Indeed, data published last year suggest that higher vaccination rates could reap great benefits.
The potential to eliminate genital warts
A study from Australia, where more than 70% of adolescent girls are vaccinated, suggests that in countries where vaccine coverage is high, genital warts may be eliminated in the coming decades.
The government-funded Australian HPV vaccine program has provided free vaccine in schools to 12- and 13-year-old girls since 2007. From 2007-2010, free vaccine was also offered to girls and women ages 14-26.
The number of cases of genital warts among young people has dropped dramatically since the program began. More...
January 30, 2013
By Debbie Saslow, PhD
A lot has happened in the area of cervical cancer this past year. The American Cancer Society, the U.S. Preventive Services Task Force and the American College of Obstetricians and Gynecologists all released virtually identical screening guidelines, leading to less confusion and higher acceptance from health care professionals and the public.
Thanks to screening, cervical cancer is not very common in the U.S., with about 12,340 new cases of invasive cervical cancer expected to be diagnosed in 2013. Unfortunately the same is not true around the world, where more than half a million women are diagnosed with cervical cancer each year. It is actually the 2nd largest cancer killer among women in most low- and middle-income countries.
Sadly, this disease threatens to undermine the important gains worldwide that have been made in sexual and reproductive health, maternal and child health, HIV/AIDs and other infectious diseases. For women in many countries in Africa, Asia, and Latin America, cervical cancer is often detected late, when there is little hope for successful treatment. And it can be devastating to the whole family, both emotionally and financially.
The good news is that a lot has been happening in global cervical cancer. Indeed, many underserved societies have been actively advocating for improved cervical cancer control policies. In response, governments are increasingly making the HPV vaccine available through their health systems and are supporting new cervical cancer screening methods appropriate for their needs and resources. More...
March 14, 2012
By Debbie Saslow, PhD
When it comes to screening for cancer, a common belief held by doctors as well as patients is "more is better." It seems only logical that more frequent screening with the newest technologies translates to more cancers detected at the earliest possible time and, ultimately, more lives saved.
Cervical cancer is an example of why this is not necessarily so. Dating back to the late 1940s, the Pap test has been detecting not only early cervical cancers, but changes in the cervix ("pre-cancers") that when treated or removed lead to actual prevention of cancer in addition to early detection. For decades, the majority of women in this country have scheduled their doctor appointments around their "annual Pap." As a result of widespread Pap testing, mortality rates dropped by 70% and the Pap test became the biggest success story for cancer screening in history.
In the late 1980s, it was discovered that cervical cancer is caused by HPV, the human papilloma virus. Studies of the natural history of HPV and cervical cancer showed that it takes, on average, 10-20 years from the time a woman is first infected with HPV until the time a cervical cancer might appear.
In 1987, the American Cancer Society, and several other national organizations, recommended that most women could safely be screened for cervical cancer with the Pap test every 3 years rather than every year. Twenty-five years later, studies show that the majority of health care providers still recommend annual screenings and that the majority of women expect annual screenings. More...
July 26, 2011
By Debbie Saslow, PhD
Many people ask me about whether or not their daughters should get the human papillomavirus (HPV) vaccine, which can help prevent cervical cancer. As with all new vaccines, there has been some controversy. Some parents have been reluctant to get their daughters vaccinated before they are sexually active, yet this is precisely when the vaccine will be most effective. Others were concerned about safety; the HPV vaccines are extremely safe, based on tens of millions of doses distributed worldwide. There was also an initial push, generated by the manufacturer, to require HPV vaccination for middle school enrollment. To date only Virginia and Washington, D.C., have such a requirement.
To answer the question of whether to vaccinate, it helps to have some background:
In the United States, an estimated 12,200 cases of invasive cervical cancer were expected to be diagnosed in 2010, with an estimated 4,210 deaths. But there have been fewer deaths over the past several decades due to cancer screening tests. That's great news. But we can reduce the number of people even getting cervical cancer by doing what we know works. More...