The death rate from cancer of the uterine cervix in the United States has increased in the recent past especially among the older African-American women. According to a research conducted by the Johns Hopkins University, the rate of mortality among the black women in the US is almost 77% higher than was previously anticipated. On the other hand, the death rate of the white women is pegged at 47% more than it was previously thought (“Cervical Cancer”) In the wake of these unprecedented levels of death, what remains apparent is the fact that most cancers of the uterine cervix could be prevented on early detection thus preventing the increased mortality rates. Most cervical cancers are caused by several types of the human papillomavirus (HPV. As such, screening of all women who have attained the age of 21 for the strains of this virus and taking prompt steps in treating the infection at the early stages is a good step towards reducing the death rates.
Health Promotion/ Disease Prevention
The Health People 2020 has candidly outlined its goals in an attempt to promote the health levels across the world. The four primary objectives include attaining high-quality health, achieving equity in health, creating an environment that encourages good health and promoting quality of life at all the life stages. The basis of uterine cancer prevention and treatment must remain in tandem with the Health People 2020 for the achievement of better results (Brown et al . 2014). In 2018, it is estimated that a significant number of women amounting to 13, 240 will be diagnosed with cancer of the uterine cervix. Between 1975 and 2014, the incident rates have however dropped by 50% as a result of screening which has enabled the detection of cervical alterations before they turn cancerous. Consequently, in 2018, the death rates are estimated to be at 4170 deaths. The diagnosis for most cervical cancers occurs between the ages of 35 and 44 with incidences of the disease in women above 65 years remaining at 15%. Most critical to note is that the condition has a survival rate of 5 years after diagnosis which makes it a cause for alarm for all the public health professionals (“Cervical Cancer”).
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Treatment and the prevention of deaths from the uterine cancer of the cervix depend primarily on screening. Cancer screening should effectively begin at the age of 21 for all women. Furthermore, Pap test should be conducted for every woman between the age of 21 and 39 after every three years. Tests for HPV should only occur if the woman has shown abnormal results from the Pap test. Women falling between the ages of 30 and 65 should have both Pap and HPV tests every five years. Women of 65 years and above must also have regular screenings conducted on them. At-risk populations should have more tests than any other group. Some of these at-risk populations include the HIV infected, those who have undergone an organ transplant, or those who have had exposure to the drug diethylstilbestrol (DES).
Policies, Programs, and Clinical Practice
The World Health Organization (WHO) is at the forefront of creating policies and programs that ensure that deaths resulting from cervical cancer can be mitigated. It further provides for complementary strategies that enhance comprehensive screening of cancer of the uterine cervix and also highlights the need for collaboration across various organizations, programs, and partners (World Health Organization, 2013). Through the comprehensive cervical cancer control, WHO provides guidelines which include vaccination of young girls aged 9 to 13 years with two doses of HPV vaccine, a factor that prevents infection with HPV (Siegel, Miller, & Jemal, 2015). Girls in up to 55 countries in the world receive protection from this program through a routine administration of the HPV vaccine jab. Such a move has influenced clinical practice in many low and middle-income countries as more HPV vaccine provided by the government and supported by the GAVI, the Vaccine Alliance. The WHO has also pushed for the use of HPV tests as a standard screening procedure in a bid to prevent the cervical cancer of the uterus. The WHO guidelines also provide that communication should be held widely in an attempt to convince adolescents, educators, parents, and educators to embrace screening in a bid to prevent deaths resulting from this cancer (World Health Organization, 2013).
Critical to note is that preventing the deaths resulting from infection of the cancerous HPV in women requires a comprehensive approach. Currently, vaccination and a continued cervical cancer screening are the two primary strategies used in this prevention. For a successful implementation, there must be a coordinated effort from various stakeholders including the clinicians, government bodies, and patients. In the US, several challenges have faced such programs due to lack of a national cervical cancer screening program or a mandatory vaccination policy. Siegel, Miller, and Jemal (2015) noted that the American Cancer Society further postulates that strong prevention policies that focus on reducing the burden on treatment will also reduce death associated with uterine cervical cancer. In this regard, insurance companies will have to cover preventive services such as vaccines and treatment in policies such as Medicare and Affordable Care Act.
In conclusion, the deaths rates from the cancer of uterine cancer have been on the rising end in the past few years especially among the African-American women. Reduction in the mortality rates can only be mitigated through early detection and treatment thereafter. Policies that focus on vaccination, testing, and awareness have done a tremendous job in changing clinical practice and enlightening the masses on the need for screening.
References
Brown, M. L., Klabunde, C. N., Cronin, K. A., White, M. C., Richardson, L. C., & McNeel, T. S. (2014). Peer Reviewed: Challenges in Meeting Healthy People 2020 Objectives for Cancer-Related Preventive Services, National Health Interview Survey, 2008 and 2010. Preventing chronic disease , 11 .
Cervical Cancer: Statistics Approved by the Cancer.Net Editorial Board, 2018 https://www.cancer.net/cancer-types/cervical-cancer/statistics
Siegel, R. L., Miller, K. D., & Jemal, A. (2015). Cancer statistics, 2015. CA: a cancer journal for clinicians , 65 (1), 5-29.
World Health Organization. (2013). WHO guidelines for screening and treatment of precancerous lesions for cervical cancer prevention: supplemental material: GRADE evidence-to-recommendation tables and evidence profiles for each recommendation.
