January has been declared Cervical Cancer Awareness Month.
The Centers for Disease Control estimates that half of the women who get cervical cancer in the United States are not screened for it. Of those who are screened, another 10 to 20 percent have not received the appropriate follow up care.
This, despite the fact that cervical cancer is "essentially 100 percent curable," according to Dr. Michael Bookman, the director of clinical research for the University of Arizona Cancer Center.
Cervical cancer is caused by the human papilloma virus, or HPV. It typically infects people when they are adolescent, Bookman explained.
"Over 80 percent of women and boys will get infected with this virus and never know...that they've been infected," he said. "And, the infection is handled normally by the immune system and that eradicates the virus."
In a small fraction of people who are infected, however, the immune system will not be able to eliminated the virus and it will develop into a chronic infection.
"And, in a small fraction of those individuals with this chronic infection, the virus gets inside cells within the cervix and, over a period of several years, can cause changes in those cells that lead to the development of pre-invasive disease," Bookman explained.
Most women have no symptoms, which is why early screening is so critical. When a woman does get symptoms, such as pain or bleeding, they have probably already developed cancer, which is much harder to treat, and cure rates are much lower.
According to Bookman, because of prevention and screening, tens of thousands of U.S. women are diagnosed, but only 4,000 to 5,000 actually die from cervical cancer. In contrast, it is the number one cause of cancer-related deaths in some parts of the world, including Central and South America and parts of Asia, where extensive prevention and screening programs are lacking.
Martha Moore-Monroy is the program director of [REACH] (http://womenshealth.arizona.edu/reach/home), a cervical cancer outreach group housed within the UA's College of Public Health. She said such disparities also hit a little closer to home.
She said Latinas in the U.S. are much more likely to develop cervical cancer than women in other racial groups.
Moore-Monroy attributes this to a number of social and structural barriers, such as a lack of insurance coverage, linguistic differences, insufficient information about available resources, and transportation issues to get the proper screening.
And, when they are screened, "Sometimes there's loss to follow up," Moore-Monroy said.
"So even the women who get screened, they may fall in the cracks between screening, diagnosis and treatment," she added.
To address such disparities, the Arizona Department of Health formed the Well Woman HealthCheck Program in 1993. This program is designed to help low income and un- or underinsured women get access to screening.
Also, uninsured women in Arizona who are actually diagnosed with breast or cervical cancer can get access to treatment through the Breast and Cervical Cancer Treatment Program.