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Cervical cancer prevention
Authors:Isabel C. Scarinci PhD  MPH  Francisco A.R. Garcia MD  Erin Kobetz PhD  Edward E. Partridge MD  Heather M. Brandt PhD  Maria C. Bell MD  Mark Dignan PhD  Grace X. Ma MD  Jane L. Daye MA  Philip E. Castle PhD
Affiliation:1. Division of Preventive Medicine, University of Alabama at Birmingham, Birmingham, Alabama;2. University of Alabama at Birmingham Comprehensive Cancer, University of Alabama at Birmingham, Birmingham, AlabamaFax: (205) 934‐7959;3. Department of Obstetrics and Gynecology, University of Arizona, Tucson, Arizona;4. Department of Epidemiology and Public Health, University of Miami Miller School of Medicine, Miami, Florida;5. University of Alabama at Birmingham Comprehensive Cancer, University of Alabama at Birmingham, Birmingham, Alabama;6. Department of Health Promotion, Education, and Behavior, University of South Carolina, Columbia, South Carolina;7. Sanford Women's Health, Sanford Clinic, Sioux Falls, South Dakota;8. Prevention Research Center, University of Kentucky, Lexington, Kentucky;9. Center for Asian Health, Temple University, Philadelphia, Pennsylvania;10. Center for Reducing Cancer Health Disparities, National Cancer Institute, National Institutes of Health, Bethesda, Maryland;11. Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
Abstract:Cervical cancer is the second most common female tumor worldwide, and its incidence is disproportionately high (>80%) in the developing world. In the United States, in which Papanicolaou (Pap) tests have reduced the annual incidence to approximately 11,000 cervical cancers, >60% of cases are reported to occur in medically underserved populations as part of a complex of diseases linked to poverty, race/ethnicity, and/or health disparities. Because carcinogenic human papillomavirus (HPV) infections cause virtually all cervical cancer, 2 new approaches for cervical cancer prevention have emerged: 1) HPV vaccination to prevent infections in younger women (aged ≤18 years) and 2) carcinogenic HPV detection in older women (aged ≥30 years). Together, HPV vaccination and testing, if used in an age‐appropriate manner, have the potential to transform cervical cancer prevention, particularly among underserved populations. Nevertheless, significant barriers of access, acceptability, and adoption to any cervical cancer prevention strategy remain. Without understanding and addressing these obstacles, these promising new tools for cervical cancer prevention may be futile. In the current study, the delivery of cervical cancer prevention strategies to these US populations that experience a high cervical cancer burden (African‐American women in South Carolina, Alabama, and Mississippi; Haitian immigrant women in Miami; Hispanic women in the US‐Mexico Border; Sioux/Native American women in the Northern Plains; white women in the Appalachia; and Vietnamese‐American women in Pennsylvania and New Jersey) is reviewed. The goal was to inform future research and outreach efforts to reduce the burden of cervical cancer in underserved populations. Cancer 2010. © 2010 American Cancer Society.
Keywords:cervical cancer  human papillomavirus testing  human papillomavirus vaccination  cervical cancer prevention
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