Cervical Health Awareness Month highlights prevention and
early detection
January 2007
 January is
Cervical Health Awareness Month. At Jhpiego, we are highlighting cervical
cancer awareness, prevention and early detection, as well as our country programs on cervical
cancer, throughout the month.
Did you know that:
- In the United States, about 14,000 women are diagnosed with
cervical cancer and more than 3,900 die from this disease each year?
- Hispanic women in the U.S. have the highest incidence rates
of cervical cancer when compared with other women in the U.S.?
- In the majority of developing countries, cervical cancer remains
the number one cause of cancer-related deaths among women?
- Women in developing countries account for more than 80% of the
yearly cases of cervical cancer worldwide?
Magnitude of the Problem
Cervical cancer disproportionately affects the poorest, most vulnerable
women in both developed and developing countries. The highest incidence and death rates
occur in the poorest regions of the world—South Asia, sub-Saharan Africa and parts of
Latin America.
Jhpiego is at the forefront of improving women’s health and saving lives
through cervical cancer prevention programs in developing countries.
Natural History of the Disease
Cervical cancer begins in the lining of the cervix. Normal cervical cells
gradually develop pre-cancerous changes that could eventually turn into cancer. But only a
small proportion of women with pre-cancerous changes of the cervix go on to develop cancer.
For most women, pre-cancerous cells remain unchanged and go away without any treatment.
Virtually all cervical cancer cases (99%) are linked to genital infection with human
papillomavirus (HPV), which is the most common viral infection of the reproductive tract.
Screening
Screening for cervical cancer is strongly recommended for women who have
been sexually active. Evidence suggests that most of the benefit can be obtained by
beginning screening within three years of onset of sexual activity or age 21 (whichever
comes first), and screening every three years thereafter.
The Pap test is used to detect cervical cancer or abnormal cells that may
lead to cancer. It can also find noncancerous conditions such as infection and inflammation.
If abnormal changes in the cells are found with the Pap test, other tests such as colposcopy,
endocervical curettage and cone biopsy are used to confirm the diagnosis of cervical cancer.
Pap tests are generally not feasible in the low-resource settings of developing
countries, where more than 95% of women have never had a Pap test. One promising alternative
is the Single Visit Approach—using visual inspection of the cervix and cryotherapy—which
has been found to be an acceptable and cost-effective approach to cervical cancer prevention.
HPV Vaccine
Two HPV genotypes (HPV 16 and 18) are responsible for the majority of HPV-related
cancers of the cervix, and two “low-risk” genotypes (HPV 6 and 11) cause a substantial
proportion of low-grade cervical dysplasia (i.e., cell abnormalities) detected in screening
programs, as well as more than 90% of genital warts.
The vaccine Gardasil® was recently recommended for the prevention of cervical
cancer and other diseases in women caused by certain types of HPV. This vaccine protects against
the four types of HPV genotypes (16, 18, 6 and 11). The U.S. Food and Drug Administration
licensed this vaccine, which is given through a series of three shots over a six-month period,
for use in girls and women ages 9–26 years.
Treatment
Treatment of cervical cancer depends on the stage of the cancer, the size and
shape of the tumor, the age and general health of the woman, and her desire to have children
in the future. Types of surgery for early cervical cancer include:
- LEEP (loop electrosurgical excision procedure), which uses
electricity to remove abnormal tissue
- Cryotherapy, which freezes abnormal cells
- Laser therapy, which uses light to burn abnormal tissue
In more advanced disease, a hysterectomy (removal of the uterus but not the
ovaries) may be performed. Radiation and chemotherapy may also be used to treat advanced
cervical cancer.
About Jhpiego
For 35 years, Jhpiego, (pronounced "ja-pie-go"), has empowered front-line health
workers by designing and implementing simple, low-cost, hands-on solutions that
strengthen the delivery of health care services, following the
household-to-hospital continuum of care. We partner with community- to
national-level organizations to build sustainable, local capacity through
advocacy, policy and guidelines development, and quality and performance
improvement approaches.
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