Human Papillomavirus and Cervical Cancer
HUMAN PAPILLOMAVIRUS AND CERVICAL CANCER
[This statement is currently under review by ARHP’s policy committee. An updated statement will be posted as soon as it is revised and approved by the ARHP board of directors.]
Vaccines for human papillomavirus (HPV) represent the next major breakthrough in prevention of cancer and sexually transmitted infections. The Association of Reproductive Health Professionals (ARHP) supports the development of and widespread access to HPV vaccines as part of a comprehensive prevention screening and treatment strategy for cervical cancer and other HPV-related conditions, such as genital warts. HPV vaccines will be able to prevent some of the most virulent strains of HPV that cause cervical cancer and genital warts.
Cervical cancer has become the second most common female malignancy worldwide and kills nearly 250,000 women each year.[1,2] In the United States alone, every year close to 12,000 women are diagnosed with cervical cancer, resulting in 4,000 deaths.[3] Nearly half of the women who are diagnosed with cervical cancer in the United States have not been properly screened.[4] For this reason, routine visits to a health care provider for ongoing surveillance remain a critical component in the fight against cervical cancer. ARHP encourages health care providers to adopt screening for HPV using the latest technologies available, including the liquid-based Pap test and HPV DNA testing, for all appropriate candidates.
ARHP encourages HPV vaccines to become the standard of care. ARHP supports the recommendation of the Advisory Committee on Immunization Practices (ACIP) of the Centers for Disease Control and Prevention (CDC) that HPV vaccines be added to the routine schedule for girls and women throughout the age ranges as deemed appropriate by ACIP. ARHP supports the vaccines’ placement on CDC’s “Vaccines for Children” program, which helps ensure that girls from low-income families are immunized. ARHP strongly encourages all states within the United States to adopt vaccination policies to ensure that all people can easily access this important method of prevention.
ARHP supports and encourages access to HPV and cervical cancer prevention, screening, and treatment for women and girls, regardless of age, race, ethnicity, income, sexual orientation, or immigration status. Although HPV vaccines are important developments in efforts to eradicate cervical cancer and genital warts, disparities in access to health care continue to be a public health challenge. Lack of access leaves many girls and women without regular and adequate preventive health care services. To encourage equal access to these technologies by all people who need them, ARHP supports private insurance coverage and public funding for the vaccines and related prevention, screening, and treatment technologies and encourages the US Department of Health and Human Services to make the vaccines available through the Title X program initiative.
HPV vaccines can be effective only if providers and the public are educated about their safety and efficacy and are encouraged to offer and receive them. ARHP supports provider training for the vaccine and related screening and treatment technologies and their incorporation into practice and for public education about the benefits of these new tools. While vaccines offer a new approach to preventing HPV and cervical cancer, ARHP encourages health care providers to continue promoting safe sex practices and choices to their patients.
- Eddy DM. Screening for cervical cancer. Ann Intern Med 1990;113(3):214-26.
- Sawaya GF, Brown AD, Washington AE, Garber AM. Clinical practice. Current approaches to cervical cancer screening. N Engl J Med 2001;344:1603-7.
- American Cancer Society. (2004, accessed October 27, 2004) Cancer Facts & Figures 2004. [Online] www.cancer.org/downloads/STT/CAFF_FinalPWSecured.pdf.
- National Institutes of Health. Cervical Cancer. NIH Consensus Statement. 1996;14:1-38.
ARHP's position statement on HPV and cervical cancer was recommended by ARHP's policy committee on August 25, 2006 and approved by ARHP's board of directors on September 6, 2006.
[This statement is currently under review by ARHP’s policy committee. An updated statement will be posted as soon as it is revised and approved by the ARHP board of directors.]
Sexual expression is a normal and healthy part of human behavior. Parents, health care providers, and educators each have a role in providing comprehensive, accurate, age-appropriate information about the many facets of sexuality to all people, regardless of age, race, sexual orientation, sexual preference or income.
Attitudes, beliefs and values about sexuality, intimacy, relationships and identity form over a lifetime. Good sexuality education encompasses sexual development, reproductive health, interpersonal relationships, affection, intimacy, body image, and gender roles in a person's thoughts, feelings and actions.
Parents and other responsible adults are encouraged to learn more about positive and productive ways to discuss sexuality and to initiate discussions of sexuality with children in their care.
Healthcare providers can provide important information on sexuality and reproductive health, and need to be able to communicate this information without restriction to patients in private. This includes the provision of sexuality information and healthcare to minors without parental consent or notification.
Comprehensive school-based sex education that is appropriate to students' age and developmental level is an essential part of education programs for every age. Effective programs respect the diversity of values and beliefs represented in the community and complement and augment the sexuality education children receive from their families. In this way, comprehensive sexuality education programs help young people develop positive views of sexuality, give them accurate information regarding health and sexuality, and assist them in acquiring the skills to make healthy decisions regarding their own sexuality now and in the future.
Effective school-based sex educational curricula provide comprehensive, medically accurate information on sexual and reproductive behavior and health. While ARHP supports an individual's decision to abstain from sexual activity, it recommends that abstinence be taught only in the context of a comprehensive program of sexuality education in order to enable all individuals to make safe and informed choices about their sexual behavior.
ARHP's Sexuality and Sex Education statement was approved by ARHP's executive committee on August 22, 2002 and recommended by ARHP's policy committee on May 24, 2002.
