Patient understanding of cervical cancer screening can be a determining factor in how positively they report the experience. In honor of World Cancer Day, here are 10 cervical cancer facts that your patient may not know, together with takeaway messages for you to use as a guide for patient education.

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Cervical cancer is responsible for 6.6% of female cancer deaths worldwide

 

Cervical cancer kills an estimated 280,000 women around the world every year. Over 500,000 will be diagnosed. In most areas of the world cervical cancer still ranks as one of the most frequent causes of female cancer death. Although 90% of deaths to cervical cancer occur in low or middle-income countries (LMICs), regular cervical cancer screening is the means to prevent cervical cancer deaths, although methods of screening vary based on the healthcare system. Sadly, in places where women need screening most, less than 3% of women are screened within the recommended guidelines.

 

Patient takeaway message: 

Cervical cancer kills. Screening saves lives.

 

Clinician resources:

Global Cancer Observatory Fact Sheet

World Health Organization Cervical Cancer Fact Sheet

 


4000 US women die needlessly of cervical cancer each year

 

Anyone with a cervix is at risk of developing cervical cancer. Living in a high resource country lowers the statistical chance of women dying from cervical cancer but it does not remove it, and women with traditional barriers to accessing health systems sometimes have as high of mortality rates as LMICs. Although some estimate cervical cancer screening rates as high as 80% in the USA, loss to follow up is a significant issue. Up to 40% loss to follow up is reported for women needing to travel 29 miles or more to attend colposcopy or secondary screenings.

 

Patient takeaway message:

Screening is the first step of the process. If results show abnormalities, secondary screening is essential.

 

Clinician resources:

A review of cervical cancer screening intervention research: implications for public health programs and future research.

National Cancer Institute Cancer Facts: Cervical Cancer

 


It can take 15 to 20 years to develop cervical cancer with normal immune systems

 

The idea of cancer is very worrying for most patients. It can be reassuring to understand that the progression from potentially precancerous lesions to cervical cancer is not a rapid process in most women. As long as they are conducted at the recommended 3-5 year intervals, then standard cervical cancer screening is enough to prevent most abnormalities from developing into cancer.

 

Patient takeaway message:

Cervical cancer is one of the most preventable forms of cancer.

 

Clinician resources: 

World Health Organization: Human papillomavirus (HPV) and cervical cancer

 


 

There is a significant shortage of OBGYN coverage in the USA, and only half of US counties have an OB/GYN. This leaves 10 million women without adequate coverage. There is a rise in the number of nurse practitioners and family doctors and PAs and midwives providing primary and secondary cervical cancer screening, which eases some of the burdens on physician time. Explore the options available in your practice with patients so help them find the best fit for their needs.

 

Patient takeaway message: 

There are many ways to receive cervical cancer screening.

 

Clinician resources:

The Future of Women’s Health Whitepaper

National Cancer Institute Progress Report: Cervical Cancer

 


 

31% of US women have not received a Pap test in the past 3 years

 

Embarrassment is often a factor for women avoiding cervical cancer screening. It is important for women to understand both the importance of cervical cancer screening and what will happen during the process. Research has shown that patient understanding of medical procedures can be the biggest determining factor in their satisfaction of the experience (above pain/discomfort)

 

Patient takeaway message:

Your physician is not judging when performing cervical cancer screening. They are trying to save your life.

 

Clinician resource:

Patient Experience: What patients want, what physicians think, and how to bridge the gap.

Center for Disease Control Health Factstats Pap Tests

 


 

8 out of 10 people will have the HPV virus at some point in their lives but many still do not know the link between HPV infection and cervical cancer. There are many misconceptions about HPV infection, especially around the need for vaccination. Physician recommendation can be the biggest factor in determining whether a parent will vaccinate their child against HPV.

 

Patient takeaway message:

Vaccination will offer your child protection against HPV. Potentially saving their lives from cancer.

 

Clinician resource:

Center for Disease Control Genital HPV Infection fact sheet

Us vs HPV webinar series

 


 

Lack of access to healthcare prevents many women from receiving the necessary cervical cancer screening. For some this may be caused by geographical factors, where innovation in telehealth can help a wider range of clinicians offer advanced screening through remote mentorship.

Language skills play a significant role in how well patients negotiate the healthcare system. For many recent immigrants, the struggle to understand a system in a foreign language, can be an insurmountable barrier to receiving care. Healthcare providers can be cognizant of the issues facing immigrant women, taking extra time to provide education or clarify any written materials.

 

Patient takeaway message:

There are resources available to help you understand the healthcare system.

 

Clinician resource:

Can telehealth solve the OBGYN shortage?

Patient Experience: What patients want, what physicians think, and how to bridge the gap.

 


Black women are dying of cervical cancer at rate nearly 2x the rate of white women

 

The race dynamics that can occur in the healthcare system are unlikely to surprise clinicians. Lack of access to healthcare is an issue that has many factors. Black, Hispanic and Native American women are more likely to delay cervical cancer screening, raising the mortality rate for these groups. (Multiple factors are responsible for this delay, including lack of awareness of the need for screening, difficulty accessing services or taking time off work to attend screenings.)

Many women do not realize that cervical cancer screening is now covered by the Affordable Care Act or the National Breast and Cervical Cancer Early Detection Program, opening the doors to preventative screening to all women.   On an individual level, clinicians can be mindful that people of color may have had previous negative experiences in the healthcare system and may require extra sensitivity.

 

Patient takeaway message:

Cervical cancer screening is available to all women, regardless of their insurance status.

 

Clinician resources:

America’s cervical cancer crisis

National Breast and Cervical Cancer Early Detection Program (NBCCEDP)

Cervical Cancer Death Rates 41% Higher Among Black Women

 


 

Anyone who has a cervix needs cervical cancer screening regardless of sexual orientation

 

For many patients, it is not a given that anyone who has a cervix, including patients who underwent genital reconstructive procedures, requires cervical cancer screening. The misconception that HPV is only transferred through penetrative vaginal sex may lead to women who have sex with women or those engaging in oral sex thinking they are not at risk for cervical cancer. Certain populations at risk for development of invasive cervical cancer may fall outside of traditional patient tracking and management systems today, such as those who changed their genital anatomy to align with their gender identity/expression, those who are not engaging in vaginal sex, or those who never been a part of a traditional screening system due to lack of visits to a gynecologist. Healthcare workers should stress the need for cervical cancer screening as long as the patient has a cervix.

Patient takeaway:

Anyone who has a cervix could contract cervical cancer.

 

Clinician resources:

Canadian Cancer Society: Trans men and cervical cancer screening

 


 

HPV/HIV coinfection dramatically increases the risk of cervical cancer. Women with HIV infection are 5 times more likely to develop cervical cancer than those without. If dysplasia develops, it typically progresses at twice the rate of standard non-HIV cases. Up to 75% of women with HIV have an HPV coinfection (their weakened immune systems make it harder to fight off the HPV infection.) Clinicians should be aware of the best practice guidelines for cervical cancer screening in HIV+ women and urge their patients to adhere to the more rigorous screening recommendations.

 

Patient takeaway message:

HIV+ women need more regular screening than HIV- women

 

Clinician resources:

Cervical cancer & HIV: a quiet tragedy

Guidelines for Prevention and Treatment of Opportunistic Infections in HIV-Infected Adults and Adolescents

 

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