SAY SOMETHINGTogether we can end cervical cancer December 2006
Program Overview • Say Something is a collaborative project between Popsmear.org and Tamika & Friends - two organizations created by cervical cancer survivors Christine Baze and Tamika Felder • Our mission is to empower all women by providing them with information on how to prevent cervical cancer
What is Cervical Cancer? • Cells in the cervix can change and become abnormal. • Abnormal cell changes can be treated, IF found early. This almost always prevents cervical cancer. • If not found early, the abnormal cells can grow out of control and become cervical cancer. • REMEMBER! You can’t FEEL cell changes. Most people have no symptoms!
Anatomy Overview • The cervix is located at the top of the vagina • It is the opening to the uterus which dilates during childbirth to allow the baby to pass out of the uterus into the birth canal • In most cases the cervix is removed during a hysterectomy but this is not universal
Cervical Cancer Overview • Since the introduction of the pap test, rates of cervical cancer have dramatically declined. • However, according to the American Cancer Society more than 10,000 women will be diagnosed in the US with cervical cancer this year. • Approximately 4,000 will die.
Cervical Cancer Overview • Cervical cancer is caused by a virus. • The Human Papillomavirus (HPV) • HPV is very common. • More than 80% of women will acquire an HPV infection before their 50th birthday. • In most women, the body’s immune system fights off the virus before it causes problems. • However, when the infection doesn’t go away on its own, certain types of high-risk HPV can cause cell changes that MAY develop into cervical cancer if not detected and treated early.
Cervical Cancer Overview • How do you get HPV? • HPV is spread from person to person through sex or skin-to-skin contact. Condoms provide some protection but cannot prevent the infection completely because they do not cover the entire genital region. • HPV infection is not a sign of promiscuity or infidelity • While having more than one sexual partner may increase the risk of getting HPV, it is possible to get the virus from just one person. • Women who have had just one sexual partner for many years are still at risk for cervical cancer. HPV can “hide” in cervical cells for a long period of time and not be detected. • It is impossible to determine when you acquired an HPV infection or how long you have had it.
Cervical Cancer Overview • Additional risk factors for cervical cancer • Smoking • Illnesses which reduce the body’s ability to fight off infections (such as HIV/AIDs) • Developing cervical cancer • Once cervical cells start to change, it typically takes 10-15 years before cancer develops. • As cells change, they become “pre-cancerous”- a condition also known as dysplasia. • Cervical dysplasia can be treated with cryotherapy (freezing pre-cancerous cells), a LEEP procedure (very thin, electrically charged wire is used to cut out abnormal cells), or a cone biopsy (where a cone shaped wedge of tissue is removed from the cervix).
Cervical Cancer Screening • What is a Pap test? • During a pap test your doctor scrapes a small sample of cells from your cervix and sends it a laboratory. • A technologist looks at the cells under the microscope for signs of abnormal changes. • How accurate are Pap tests? • A conventional (dry slide) pap test is about 50-60% accurate. • Detects abnormal cells 50-60% of the time when they are present • The new liquid based pap tests (ThinPrep or SurePath) are about 50-85% accurate. • Detects abnormal cells 50-85% of the time when they are present • It is still possible to develop invasive cervical cancer with regular pap testing (annual to semi-annual screening) • 50% of all invasive cases occur in women screened in the previous 5 years
Cervical Cancer Screening • What is the HPV test? • The HPV test uses advanced, molecular technology to determine whether one of the virus types that causes cervical cancer is present in cervical cells. • In March of 2003 the test was approved by the FDA for use with a pap test for routine screening of women aged 30 and older. • The HPV test identifies 95-100% of women with cervical disease. 50-85% accuracy 95-100% accuracy
Cervical Cancer Screening • How should I be screened for cervical cancer? • If you are UNDER the age of 30, you should be screened yearly with a Pap test. • Ask your doctor to use a liquid-based Pap, ThinPrep or SurePath to ensure the best results. • If your Pap test comes back as inconclusive (ASC-US), you should then receive an HPV test. • If your HPV test is negative, you are not at risk for cervical cancer. • If your HPV test is positive, your doctor will perform a colposcopy. • Cervical Cancer Screening: Under 30 • Annual pap testing (ThinPrep, Surepath) • HPV testing if Pap test is inconclusive
Cervical Cancer Screening • How should I be screened for cervical cancer? • If you are age 30 or older, you should be screened with both a Pap test and an HPV test. • An HPV test sample is taken at the same time as the Pap test sample-it does not require a separate procedure or trip to the doctor. • If the results of both tests are negative, you can safely wait 3 years before being screened with both tests again. • American Cancer Society and American College of Obstetricians and Gynecologist both support combination screening. • Cervical Cancer Screening: 30 and Older • Combination screening with a pap test and an HPV test • Rescreening annually or up to every 3 years if both tests are negative
Asking for the HPV Test • Helpful hints for obtaining the HPV test with your pap test • Call your doctor’s office before your next exam to find out if they offer the HPV test as part of routine screening for cervical cancer. • If your doctor does not offer the HPV test for screening, ask if it is possible to do so for you. • If your physician (or office staff) believes HPV testing is unnecessary, say that you would like the test “for my extra peaceof mind.” • Most physicians will honor your request. If your’sdoes not, you will need to determine if having a physician whomakes you a partner in managing your own health is important to you.
What Your Results Mean • If you are HPV positive and Pap negative, it does not mean you have or will get cervical cancer but it does mean you are at slightly higher risk. • There is a very high chance you will get rid of the HPV on your own. • To be certain, you should repeat both the Pap and the HPV tests in 6-12 months. • If you are still HPV positive (even if your Pap is normal), it is recommended that you have a colposcopy.
Insurance Coverage • HPV testing is covered by the majority of public and private payers including some of the largest national payers as well as regional payers. • To be certain it’s covered, call your insurance company before your visit. • For insurance related problems, call the HPV Test hotline • 1-866-895-1HPV (1-866-895-1478)
What YOU Can Do • Demand the best. Insist your health care provider use all FDA-approved cervical cancer screening technologies. • Talk to your doctor and know that you are partners in your healthcare. • With combination screening you may only need cervical cancer screening every three years, but it is still important to visit your gynecologist every year for other preventative screenings
New HPV Vaccine (Gardasil) • For girls/women ages 9 -26 • Prevents infection with HPV types 6, 11, 16, 18 • 6 and 11 cause 90% of genital warts • 16 and 18 cause about 70% of cervical cancers • Vaccine requires 3 doses over a 6 month period • Cost = $120 per dose
Another HPV Vaccine Candidate (Cervarix) • Prevents infection with HPV types 16 & 18 • 16 and 18 cause about 70% of cervical cancers • Currently in Phase III clinical trials • Hoping for FDA approval in 2007
The Vaccine(s) • The vaccine(s) are NOT enough on their own to protect against cervical cancer • Regular screening is women’s “first and primary weapon against this disease.” • Need to continue to communicate this message with vaccine message For more vaccine information: • FDA: www.fda.gov/womens/getthefacts/hpv.html • Merck: www.gardasil.com
Additional Resources • www.popsmear.org (Popsmear.org) • www.tamikaandfriends.org (Tamika & Friends) • www.cluw.org/cervcancer.html (CCPW, CLUW) • www.thehpvtest.com • www.cancer.org (American Cancer Society) • www.ashastd.org (American Social Health Association) • www.cdc.gov (Centers for Disease Control) • www.theisisproject.org (The Balm In Gilead) • www.womeningoverment.org (Women In Government)
The Take Away • Certain high risk types of HPV can cause cervical cancer. • #1 risk factor for cervical cancer is not being screened. • Use your health insurance to be proactive about the health of you and your family.
The Take Away • Use new technologies to prevent cervical cancer • Girls and young women 9 - 26, get the HPV vaccine • Under the age of 30, get a liquid Pap test • 30 or over, get the liquid Pap AND the HPV test
The Take Away SAY SOMETHING! • Share this information with friends, family and co-workers, union • Refer to the Say Something materials: • www.say-something.org • order Tool kits and help spread the word
Points To Take with You Take time to take care of yourself! REMEMBER TO SAY SOMETHING! Because together, we can end cervical cancer SS PWRPT 1/07