Panel: Cancer Prevention & Early Detection Ronald D. Alvarez, - - PowerPoint PPT Presentation

Panel: Cancer Prevention & Early Detection

Ronald D. Alvarez, MD, MBA

Professor and Chairman, Obstetrics & Gynecology Betty and Lonnie S. Burnett Endowed Chair, Obstetrics and Gynecology Vanderbilt University Medical Center

Kim Sandler, MD

Co-Director, Lung Cancer Screening Program Assistant Professor of Radiology & Radiological Sciences Vanderbilt University Medical Center

Pamela Hull, PhD

Associate Director for Community Outreach & Engagement Vanderbilt-Ingram Cancer Center Associate Professor of Medicine in Epidemiology Vanderbilt University Medical Center

Cathy Eng, MD, FACP, FASCO

David H. Johnson Chair in Surgical and Medical Oncology Co-Leader, Gastrointestinal Cancer Research Program Professor of Medicine in Hematology & Oncology | Co-Director, GI Oncology Vice-Chair, SWOG GI Committee

Cervical Cancer Screening

Ronald D. Alvarez, MD, MBA Vanderbilt University Medical Center

Cervical Cancer Stats

Cases Deaths US (2020) 13,800 4,290 World (2018) 569,800 311,400

Cancer Statistics, 2020 Global Cancer Facts and Figures, 2018

Cervical Cancer in US

Cervical cancer incidence rates, 2016 Cervical cancer death rates, 2016

Singh J Community Health 2012

Screening has Reduced Cervical Cancer Mortality in the US

5

2018 USPSTF Cervical Cancer Screening Guidelines

• Women < age 21

– No screening indicated

• Women age 21-29

– Cervical cytology every 3 yrs

• Women age 30-65

– Cervical cytology every 3 yrs – hrHPV testing every 5 yrs – Cervical cytology/HPV co-testing every 5 yrs

• Women > age 65

– Discontinue with adequate prior screening and no prior CIN 2 or greater

• Post hysterectomy

– Discontinue screening if for benign indication and no prior CIN 2 or greater

USPSTF, JAMA, 2018

Challenges with Cervical Cancer Screening in Rural and Underserved Populations

• So many other higher

priority concerns

• Poor knowledge of risks

for cervical and other HPV associated cancers

• Noncompliance with

cervical cancer screening (and HPV vaccination) recommendations

• Lack of alternative and

more convenient screening strategies

Enhancing Cervical Cancer Screening in Rural and Underserved Populations

• Address basic human needs
• Enhance education and

communication

• Engage community health

advisors

• Employ self testing strategies
• Utilize alternative strategies

(i.e. VIA, VILI)

• Move from opportunistic to
• rganized screening in most

vulnerable populations

Make Cervical Cancer Screening Irrelevant –Vaccinate!

Questions?