The incidence of cervical cancer in Alabama is one of the highest in the United States, but doctors say the tools to effectively eradicate the disease already exist.
On average, about 7.5 out of 100,000 women in the United States get cervical cancer each year, but for Alabama women, that number jumps to 9.1 out of 100,000, according to a new report from the Alabama Department of Public Health.
Alabama’s cervical cancer rate — or the number of new cancers of a particular type — ranks fifth worst in the nation, according to the Centers for Disease Control and Prevention. Black women are also more likely than white women to get cancer.
“At the cancer center, people come to us and the question we get asked more often is, ‘When will you find a cure for cancer?'” said Isabel Scarinci, vice president for global and rural health in UAB’s Department of Obstetrics. and gynecology. “My mother died of metastatic breast cancer, I can tell you it’s very important. But my response is usually that we have a better offer for you – there is a case we can prevent.’
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Almost all cases of cervical cancer are caused by the HPV virus, a common sexually transmitted disease.
But between HPV vaccination before sexual activity and regular screenings, cervical cancer is one of the few cancers that can be prevented, experts across the state said, and it’s important that residents try to use all the tools available to save lives.
In addition, experts say that when the cancer is caught early, almost all patients can survive for five years or longer, according to the National Cancer Institute. These cases make up 43.8% of diagnoses.
Solutions for prevention and diagnostics
In addition to his work at UAB, Scarinci works with TogetHER for Health’s Operation Wipe Out, an initiative designed to help Alabamians use available tools — such as HPV vaccinations, Pap smears and routine cancer screenings — to eliminate the disease before it occurs.
“I’ve been doing cervical cancer research my whole career, and there’s not much to discover, is there?” Scarinci said. “We have the tools, vaccination and screening and appropriate follow-up. And now it’s really in the hands of service organizations, residents in general, to speak up and talk about the availability of services.”
Alabama women also have a higher death rate from cervical cancer across demographic groups. ADPH reported a national death rate of 2.3 per 100,000 women, while Alabama’s death rate was 3.3.
But cervical cancer forms slowly, Scarinci said. According to the American Cancer Society, the average age of a woman diagnosed with cervical cancer is 50.
The first step to prevention is vaccination, which is recommended for children aged 11-12, but can start as early as age 9. ADPH says the vaccine protects against two types of HPV, which cause 90% of cervical cancer. .
“The HPV virus causes most cervical cancers, and if you get the HPV vaccine, it will protect you from cervical cancer, which is exciting,” said Nancy Wright, director of ADPH’s Division of Cancer Prevention and Control. “I mean, there aren’t many cancers that we have to solve with a vaccine.” There are not many cancers that we can prevent.’
The number of children who are current with the HPV vaccine, which was recommended for girls in 2006 and for boys in 2011, varies from county to county in Alabama.
Because vaccination can start so early and cervical cancer diagnoses typically occur between ages 35-44, Heather White, executive director of TogetHER for Health, said cervical cancer fighters in the state want to take advantage of “that long window of time for cervical cancer “. grows in our favor.”
After vaccination, regular screenings and Pap smears can help health care providers detect changes in the cervix and allow them to treat precancerous cells. Cervical cancer screening is important because the early stages may not have clear symptoms.
The World Health Organization classifies cervical cancer removal as:
- 90% of girls fully vaccinated by age 15
- 70% of women were screened at 35 and again at 45
- 90% of women diagnosed with cervical disease, both precancerous and invasive cancer, receive treatment.
White said getting more women screened could “turn the tide of morbidity,” but noted that some women in Alabama may struggle to access care.
“Women have to be able to find providers, that’s another problem we run into in rural counties in Alabama, you know, it’s just a lack of health care providers,” White said, adding that TogetHER works closely with ADPH to identify services that already exist . “We want to be able to support the infrastructure that already exists and simply make it easier to connect the dots for women and children to access services that already exist.”
Scarini said she tends to see cases of cervical cancer in women who don’t have insurance or have low incomes.
“It’s this gradient relationship with poverty,” she said. “And so it’s a disease of poverty because it’s a disease of lack of screening.”
The Alabama Breast and Cervical Cancer Early Detection Program offers free breast and cervical cancer screenings to women who are uninsured or have an income below 250% of the federal poverty line. In Alabama, that means people with solo incomes of $2,831 a month or less in 2022 qualify. The program also offers complementary diagnostic services.
Between June 2020-21, providers caught 312 preinvasive and invasive cervical cancers using the program. Since its launch in 1996, the program has enabled screening to detect 3,227 cases of cervical cancer.
Alabama residents who would like more information about screening assistance can call (877) 252-3324.
Wright, who attended the UAB Cervical Cancer Summit with researchers and primary care providers across the state, said she thinks some Alabamians fear a cancer diagnosis because “they won’t have access to treatment or the money to be treated “.
“I think a lot of Alabamians don’t realize that cancer is not a death sentence.” You know, the sooner we catch it, there are things we can do to help you survive,” she said.
White said ADPH hopes to issue a “call to action” report in January summarizing the research findings. Now, doctors, providers and researchers across the state are working together to help identify and remove barriers to care for patients at risk for cervical cancer.
Sarah Swetlik is a gender and politics reporter AL.com. It is supported through a partnership with Report for America. Contribute to support the team here.