Human Papillomavirus and Cervical Cancer

Screening and Prevention of Reproductive Cancers and Breast Cancer

HUMAN PAPILLOMAVIRUS AND CERVICAL CANCER

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.

1. Eddy DM. Screening for cervical cancer. Ann Intern Med 1990;113(3):214-26.
2. Sawaya GF, Brown AD, Washington AE, Garber AM. Clinical practice. Current approaches to cervical cancer screening. N Engl J Med 2001;344:1603-7.
3. American Cancer Society. (2004, accessed October 27, 2004) Cancer Facts & Figures 2004. [Online] www.cancer.org/downloads/STT/CAFF_FinalPWSecured.pdf.
4. 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 Position Statement is currently under Policy Committee review for update.

[back to top]

SCREENING AND PREVENTION OF REPRODUCTIVE CANCERS AND BREAST CANCER

ARHP supports successful, evidence-based strategies that reduce the incidence, morbidity, and mortality of reproductive cancers and breast cancer.

Federal funding for high quality, peer-reviewed research and public information campaigns about the risk factors of reproductive cancers and breast cancer should remain a priority.

Since certain cancers exclusively affect women, are more prevalent in women than in men, or affect women differently than they do men, it is important that clinical research address these differences.

ARHP supports policies that seek to reduce disparities in reproductive cancers and breast cancer survival rates among individuals of varying ethnic backgrounds and socio-economic status. All individuals deserve quality care, access to high-quality clinical trials, psychosocial support, and follow-up treatment.

Genetic testing for reproductive cancers and breast cancer has potentially advantageous as well as potentially harmful effects. ARHP supports an open discussion between women and their health care providers about the benefits and risks associated with genetic testing.

Breast Cancer

The highest quality studies and expert consensus show there is no causal link between induced and spontaneous abortion and risk for breast cancer. ARHP supports public policy efforts that inform individuals about this evidence.

Since there is no scientific evidence that breast self-exam saves lives or enables women to detect breast cancer at earlier stages, ARHP does not recommend for or against the practice of breast self-exam. The decision to practice breast self-exam should be made by individuals who are appropriately informed about this activity from their health care providers.

ARHP’s Screening and Prevention of Reproductive Cancers and Breast Cancer statement was approved by ARHP’s board of directors on June 7, 2003. This Position Statement is currently under Policy Committee review for update.