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january is national cervical health awareness month

The U.S. Congress designated January as Cervical Health Awareness Month to highlight the impact that vaccinations and screenings can have on reducing the incidence of cervical cancer. Nearly 13,000 women in the United States are diagnosed with cervical cancer each year, but the disease is preventable with vaccination and appropriate screening (Papanicolaou (Pap) and HPV screening tests).

According to Centers for Disease Control and Prevention (CDC) data, while rates of cancer diagnosis and cancer deaths continue to decline each year, the number of new deaths is going up . This happens because the size of our population is growing and aging each year.

CDC Cervical Cancer Chart
Delaware Statistics
According to the CDC, the rate of HPV associated cancers in Delaware during 2011-2015 was 13.49, which was one of the highest rates in the nation.
do you know the Risk Factors for Cervical Cancer?

Almost all cervical cancers are caused by the human papillomavirus (HPV).  HPV is a common virus that can be passed from one person to another during sex. There are many types of HPV. Some HPV types can cause changes on a woman's cervix that can lead to cervical cancer over time, while other types can cause genital or skin warts. 

HPV is so common that most people get it at some time in their lives. HPV usually causes no symptoms so patients can't tell that they have it. For most women, HPV will go away on its own. However, if it does not, there is a chance that over time it may cause cervical cancer. 

Other factors that can increase the risk of cervical cancer include:
learn more about the keys to cervical cancer prevention: hpv vaccination and screening tests 

ImagePack Vaccine C ervical cancer rates are declining in the United States but this form of cancer is still killing too many women. HPV vaccination and cervical cancer screening are the keys to cancer prevention.    

HPV Vaccination
The HPV vaccine protects against the types of HPV that most often cause not only cervical cancer but also vaginal, vulvar, anal, and oral cancers. It is recommended for preteens (both boys and girls) aged 11 to 12 years, but can be given as early as age 9 and until age 26. The vaccine produces a stronger immune response when received in the preteen years. The vaccine is given in a series of either two or three shots, depending on the patient's age. It is important to note that even women who are vaccinated against HPV need to have regular Pap tests to screen for cervical cancer.   Efficacy and immunogenicity data is also available for males and females up through age 45 in preventing, but the ACIP has not made recommendations regarding this age range.  The HPV vaccine protects against nine (9) types of HPV.  

Screening Tests
Two tests can help prevent cervical cancer in your patients.  
  1. The Pap test (or Pap smear) looks for precancerous cell changes on the cervix that may become cervical cancer if they are not treated appropriately. Patients should start getting Pap tests at age 21.
  2. The human papillomavirus (HPV) test looks for the virus that can cause these cell changes. This test can help healthcare providers know which women are at highest risk for cervical cancer. Pap and HPV tests (either alone or in combination) are recommended for women over 30.
The most important thing you can do to help prevent cervical cancer is to ensure your patients are having regular screening tests starting at age 21.

The US Preventative Task Force (USPTF) Guidelines recommend the following:
Starting at age 21, if Pap test results are normal, the chance of getting cervical cancer in the next few years is very low. For that reason, it is at your medical discretion to wait to repeat the Pap test for as long as three years. If the patient is 30 years old or older, you may choose to perform an HPV test along with the Pap test (co-testing). If both test results are normal, you may have your patient wait five years to have your next Pap test.

For women aged 21 to 65, it is important to continue screening your patients with a Pap test. However, if your patient is older than 65 and has had normal Pap test results for several years, or if she has had her cervix removed as part of a total hysterectomy for a non-cancerous condition, like fibroids, you may consider not performing a Pap test .
aap toolkit offers resources to help practice implement hpv vaccination protocols  

e-toolkit Looking to make a change in your office around HPV vaccination protocols? The American Academy of Pediatrics AAP HPV - Make a Change toolkit is a great place to start. It features  tools for standing orders, recall reminders, feedback assessment. The toolkit also includes  literature  that supports a multi-prong approach to improving both vaccine initiation and series completion to effectively combat the increase in HPV rates.  There is evidence to support the application to HPV vaccination both for client reminder and recall programs and for provider assessment and feedback interventions. Multiple targeted approaches will be needed to substantially impact HPV vaccine rates.
Looking for patient stories or infographics or your office or a health fair? The HPV Roundtable shares a wealth of resources for providers and staff. 

e-learning image Human papillomavirus (HPV) is a very common virus that infects nearly 80 million people - about one in four - in the U.S., causing more than 31,000 cases of cancer each year. 

In a March 2018 webinar hosted by National Foundation for Infectious Disease (NFID) entitled,  HPV Vaccination: Recommendations and Strategies for Improving Coverage, NFID Medical Director, William Schaffner, MD; NFID President-Elect Joseph A. Bocchini, Jr., MD, Louisiana State University Health Sciences Center; and Shannon Stokley, DrPH, Immunization Services Division of the National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention (CDC), provided an update on current HPV vaccine recommendations, vaccine safety and effectiveness, and strategies for improving immunization rates.  You can view the archived video and access the slide deck here .
six reasons why your patients need to vaccinate against hpv   

vaccine Are some of your patients hesitant to get an HPV vaccine? Here are six great reasons to share with patients to encourage them to vaccinate against HPV  to protect against cervical and other cancers:
  1. HPV is common
  2. HPV vaccination is preventing cancer-causing infections
  3. HPV is cancer prevention
  4. Getting HPV vaccine for your child now is better than treating cancer later in life
  5. Three vaccines are recommended for 11-12 year olds to protect against the infections that can cause meningitis, HPV cancers, and whooping cough
  6. You can give your child safe, effective, and long lasting protection from cancers caused by HPV with two doses of HPV vaccine at ages 11-12
Outcomes data demonstrates that with even with low vaccination rates in the United States there have been reductions in CIN2+ lesions attributable to types targeted by the HPV 6/11/16/18 vaccine.   Countries with high vaccination rates, such as Australia, have seen sharp declines in HPV related pre- cancers and cancers, including in populations who have higher rates of cervical cancer .
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join the quality insights hpv initiative to gain additional education and best practices

Interested in partnering with Quality Insights today to learn more about ways to increase HPV vaccination rates in your practice? We are currently recruiting practices in Delaware who vaccinate adolescent patients to participate in this campaign. Download the HPV Project Flyer for additional details.

If you have questions or are interested in joining Quality Insights in this important project, please email  Lisa Gruss or call 1.800.642.8686, Ext. 138.
contact information

For more details about the Quality Insights Improving HPV Vaccination Rates in Delaware project,  please email Lisa Gruss or call 1.800.642.8686, Ext. 138.

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This project is in collaboration with the Division of Public Health (DPH) - Comprehensive Cancer Control Program, Immunization and 
Vaccines for Children, and the Centers for Disease Control and Prevention (CDC). Publication number DEDPH-HPV-011519