Alabama ranks third in the nation in the incidence and deaths from a cancer that can be prevented: cervical cancer. To address this public health problem, primary care providers and community leaders throughout the state launched a statewide action plan to eliminate cervical cancer in Alabama by 2033 called “Operation Wipe Out Cervical Cancer Alabama.”
Partners with the Alabama Department of Public Health in this initiative are the University of Alabama at Birmingham Department of Obstetrics and Gynecology and O’Neal Comprehensive Cancer Center, TogetHER for Health, Rotary Club of Birmingham and the American Cancer Society.
Nancy Wright is the Director of the ADPH Cancer Prevention and Control Division. She said this plan has been in the works since last year.
“Last fall, physicians and partners from across the state gathered together in Birmingham and discussed what the barriers are to preventing cervical cancer and what the solutions are,” she explained. “So, in that meeting, we talked about the importance of HPV vaccination, and that actually prevents cervical cancer, and the need to increase our state's vaccination rates.”
HPV vaccines, or human papillomavirus vaccines, are inoculations that prevent infection by certain types of human papillomavirus. Available HPV vaccines protect against either two, four, or nine types of HPV. All HPV vaccines protect against at least HPV types 16 and 18, which cause the greatest risk of cervical cancer. Wright said there’s also another preventative measure aside from inoculations.
“So, we prevent it with the HPV vaccination. But we can also detect it early, which when treatment is more likely to be successful through screening,” she explained. “And screening is of course, getting a Pap smear or a Pap/HPV test every three to five years.”
The World Health Organization reports nearly all cases of cervical cancer can be attributed to HPV infection. Although most HPV infections clear up on their own and most pre-cancerous lesions resolve spontaneously, there is a risk for all women that HPV infection may become chronic and pre-cancerous lesions progress to invasive cervical cancer.
“Most women in Alabama and the U.S. (four out of five women) are exposed to that HPV virus in our lifetime,” said Wright. “A small percentage of those women, less than 10%, are not able to beat that virus. So, the virus grows and then over time, it can turn into cervical cancer. So, that's why that HPV vaccination is so important.”
The statewide action plan uses evidence-based strategies to promote HPV vaccination, promote cervical cancer screening, and ensure adherence to follow-up in the event of cervical cancer screening abnormal results. HPV vaccinations are a powerful tool to protect children and adolescents before they are exposed to the virus.
Wright and other medical providers recommend the HPV inoculation in childhood. “If children can get that as early as nine years old, but especially 12 to 14 years old… then when they are exposed to HPV during their lifetime, they won't contract the virus. So, the virus won't have an opportunity to turn into cervical cancer.”
Cervical cancer screening among women 21 to 65 years of age detects abnormal cells in the cervix which can develop into cancer. Appropriate follow-up and treatment for women with abnormal results improves the chance of recovery from cervical cancer.
“30 women die annually from cervical cancer,” said Wright. “Alabama's mortality and incidence rate is statistically significantly higher than the nation. We are third in the nation for high mortality and high incidence for cervical cancer, especially in Black women, and especially in rural areas,” she continued. “So, knowing that this is a disease that is preventable, and highly survivable, if found early, just makes it unacceptable, that we don't all work toward doing that.”
HPV vaccinations for children are available for free in Alabama’s county health departments. Cervical cancer screening is available also through state county health departments and federally qualified health care centers. They're free through the Alabama Cervical Cancer Prevention Program.
For more information on the statewide action plan to eliminate cervical cancer as a public health problem in Alabama, visit alabamapublichealth.gov/bandc/assets/cervicalcancer_actionplan.pdf.
