Until recently, cervical cancer was among the leading causes of cancer deaths in American women. However, the rate of deaths caused by cervical cancer reduced significantly with the increase in accessibility and awareness of the Pap test that is used for screening the disease. Despite these statistics, the death rate has not reduced considerably over the past one and a half decades. The most significant and most common risk factor for cervical cancer is the Human Papilloma Virus (HPV). There are many different types of HPV though most of them do not cause cervical cancer. Studies show that an estimated 80% of women are exposed to HPV in the course of their life. Many times, the immune system of the body manages to get rid of the virus from the human system before it can do any harm ( Feldman et al., 2018) . However, because the HPV is transmitted through sexual contact, having different sexual partners has been associated with a higher risk of getting cervical cancer because condoms do not give complete protection ( U.S. Preventive Services Task Force (USPSTF) , 2014) . Another risk factor for cervical cancer is smoking, which has been found to increase the risk of the disease by fourfold. Additionally, taking medical prescriptions that lower the immune system predisposes women to get cervical cancer ( Feldman et al., 2018) . This paper focuses of some of the recommended measures to prevent cervical cancer, how age and ethnicity might impact decisions related to preventative services, some of the drug treatments for patients diagnosed with cervical cancer, and the implications of these treatments.
The first recommended preventative measure for cervical cancer is a vaccine which helps to prevent infection with the HPV for girls as well as women aged between nine and forty-five years. An HPV vaccine known as Gardasil is an FDA approved measure to prevent cervical cancer caused by HPV ( Koutsky et al., 2016) . Similarly, Gardasil 9 is recommended and available in the United States for the prevention of infections from HPV 18, HPV 16, as well as five other types of HPV that are associated with cancer. Two other vaccines were previously available in the U.S. are the original Gardasil and Cervarix, but they are no longer approved for use in the U.S. ( Koutsky et al., 2016) . However, other countries outside the U.S. still use these vaccines for the prevention of cervical cancer. Secondly, for women who smoke, cessation is highly recommended to reduce the chances of getting cervical cancer. However, the most significant preventative measure that is recommended for preventing cervical cancer is through screening. Screening assists in finding any pre-cancer cells and treating them ( Franco, Duarte-Franco, & Ferenczy, 2015) . Testing offers that best opportunity for early detection of cervical cancer, which is when successful treatment is most probable. Additionally, screening also helps to prevent cervical cancer by helping to find abnormal cell changes and have them treated before they turn cancerous.
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Age and ethnicity have a considerable impact when it comes to decisions related to cervical cancer prevention services. A study conducted by Thomas, Saleem, and Abraham (2013) showed that women from minority ethnic communities had a significant lack of awareness about cervical cancer and many of them did not recognize terms such as Pap smear or cervical screening. This lack of knowledge prevents many women from deciding to seek out preventive measures for cervical cancer. Furthermore, according to the U.S. Preventive Services Task Force (USPSTF) (2014), many women from minority ethnic communities shy away from getting screened because of the feeling of shame, embarrassment, and fear. From the study, many women above 35 years and who were also married opted to stay away from getting screened because many believed that cervical cancer was related to having sexual intercourse outside marriage and, therefore, the diagnosis of cervical cancer would be considered shameful. According to the USPSTF, screening of women between 21 and 65 years significantly reduces the incidences of cervical cancer and mortality ( Marlow et al., 2016) .
The most common procedure used for treating cervical cancer is through chemotherapy. This treatment uses the anti-cancer prescription given by mouth or injected into a vein. Some of the drugs used in chemotherapy include Cisplatin, and Cisplatin plus 5-fluorouracil ( Dasari, Wudayagiri, & Valluru, 2015) . When cervical cancer is at an advanced stage, other chemo drugs are used for treatment. These drugs include Cisplatin, Paclitaxel (Taxol), Carboplatin, Gemcitabine, and or topotecan ( Franco, Duarte-Franco, & Ferenczy, 2015) . Other drugs that can be used include docetaxel, ifosfamide, 5-fluorouracil, mitomycin, and irinotecan.
Although chemo drugs destroy cancer cells, they also affect healthy cells, which may have particular implications for the patient. The side effects depend on the type of medication, dosage, and the duration of use. These implications include nausea, vomiting, hair loss, loss of appetite, fatigue, and mouth sores ( Dasari, Wudayagiri, & Valluru, 2015). Additionally, chemotherapy can interfere with cells that produce blood in the bone marrow, thus lowering the blood count. This situation may result in higher chances of getting infections; bruising or bleeding after a minor injury; and shortness of breath.
In conclusion, despite the benefits of cervical cancer screening, many women still do not get screened. It is therefore crucial for medical practitioners to improve education and understanding of cervical cancer in ethnic minority communities and also invest in adequate training of health practitioners to improve experiences and encourage continuous screening for all women.
References
Dasari, S., Wudayagiri, R., & Valluru, L. (2015). Cervical cancer: Biomarkers for diagnosis and treatment. Clinica Chimica Acta , 445 , 7-11. DOI: 10.1016/j.cca.2015.03.005
Feldman, S., Goodman, A., Peipert, J. F., & Goff, B. (2018). Patient education: Cervical cancer screening (Beyond the Basics) . Retrieved from https://www.uptodate.com/contents/cervical-cancer-screening-beyond-the-basics
Franco, E. L., Duarte-Franco, E., & Ferenczy, A. (2015). Cervical cancer: epidemiology, prevention and the role of human papillomavirus infection. Cmaj , 164 (7), 1017-1025. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC80931/
Koutsky, L. A., Ault, K. A., Wheeler, C. M., Brown, D. R., Barr, E., Alvarez, F. B. ... & Jansen, K. U. (2016). A controlled trial of a human papillomavirus type 16 vaccine. New England Journal of Medicine , 347 (21), 1645-1651. DOI: 10.1056/NEJMoa020586
Marlow, L. A. V., Robb, K. A., Simon, A. E., Waller, J., & Wardle, J. (2016). Awareness of cancer risk factors among ethnic minority groups in England. Public Health , 126 (8), 702-709. https://doi.org/10.1016/j.puhe.2012.05.005
Thomas, V. N., Saleem, T., & Abraham, R. (2013). Barriers to effective uptake of cancer screening among Black and minority ethnic groups. International journal of palliative nursing , 11 (11), 562-571. https://doi.org/10.12968/ijpn.2005.11.11.20096
U.S. Preventive Services Task Force (USPSTF) . (2014). The Guide to Clinical Preventive Services 2014: Recommendations of the U.S. Preventive Services Task Force . Retrieved from https://www.ahrq.gov/sites/default/files/publications/files/cpsguide.pdf
