Challenges in reaching at-risk populations

Dennis Scribner, Jr, MD, FACOG, FACS, CPE, Chief of Gynecologic Oncology at Cancer Centers of America (CTCA) Phoenix, discusses challenges in reaching patients most at risk of developing cervical cancer of the uterus.

While new therapies can treat advanced cervical cancer, Scribner points out that from a public health perspective, women who do not receive a human papillomavirus (HPV) vaccine or who are not screened with a Pap smear are still at risk. Additionally, the population that does not get vaccinated is also more likely to not have a Pap test at the age when cervical dysplasia presents. According to Scribner, only one-third of people in the United States are vaccinated against HPV.

Early-stage disease or precancerous cervical dysplasia can be detected early enough to be treated routinely, Scribner says, and patients who are proactive in visiting a gynecologist or gynecologic oncologist have the best chance of a favorable cancer outcome. of the cervix.

Because people who don’t get the HPV vaccine are less likely to get tested regularly, this population is at higher risk of being diagnosed with advanced, more difficult-to-treat disease. Scribner suggests that encouraging HPV vaccination is still one of the most important factors that can reduce the incidence of cervical cancer.


0:08 | When we focus so much on the science behind the treatment of locally advanced, advanced, or extensively metastatic cervical cancer, that’s not really the focus of [where] we’re going to get the most for our money. It is a huge public health concern that only a third of patients in this country have received an HPV vaccine. When you look at screening history data for patients who do not receive an HPV vaccine, they are more likely not to have a Pap smear as they get older. And that’s the saddest thing about it, that you can comment and talk about and spend a lot of taxpayers’ money, and I’m glad we’re doing these trials for these unfortunate people who have these late-stage diseases.

But really, the focus should be on a public health perspective, making sure women get their shots [as well as]to understand [why] it is important to get them tested and treated. Because I always tell women when they’re in the office, and we focus on managing their early cancer—because most of the time in gynecology we don’t see dysplasia; it’s really cared for and treated most of the time by the gynecological community, which I’m happy about – but if I see patients with cervical dysplasia in my clinic, I focus on them being proactive about their load.

The fact that they come to the doctor, that they undergo their screening, [and] the fact that they are involved in their health care is what really changes their long-term outcomes, because these are the people who do not have cervical cancer. Or if [they’re] have cancer, it will be an early stage, and we can routinely cure these patients. So that’s the part that’s the challenge, I think, from an oncology perspective, is how do you get more people vaccinated?

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