1 / 16

Report from Cervical Cancer Committee Maryland State Cancer Plan

Report from Cervical Cancer Committee Maryland State Cancer Plan Strategies for Improving the Control of Cervical Cancer in Maryland. Background Information - The Good News Cervical Cancer is a Uniquely Controllable Cancer Thanks to: Good Understanding of Viral Pathway

zonta
Download Presentation

Report from Cervical Cancer Committee Maryland State Cancer Plan

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Report from Cervical Cancer Committee Maryland State Cancer Plan Strategies for Improving the Control of Cervical Cancer in Maryland

  2. Background Information - The Good News Cervical Cancer is a Uniquely Controllable Cancer Thanks to: Good Understanding of Viral Pathway Effective Diagnostic Tools (Pap Test) Effective Treatment Tools Ability to Diagnose and Begin Treatment at a Pre-cancerous Stage

  3. More Good News Burden of Cervical Cancer in State is relatively low In 1999, in Maryland: 226 women diagnosed with invasive cervical cancer 77 women died from cervical cancer Enormous improvement Since 1960’s with Pap Test Programs such as the CDC Breast and Cervical Program in place and highly effective

  4. BUT: Have we gotten too complacent about cervical cancer? Some women remain unscreened, and some cases receive less than optimal treatment New Maryland populations represent new risk groups for the disease We have a new understanding of the role of infectious agents, and different types of risk (HPV) Can we count on mortality rates continuing to decrease?

  5. Our Committee Set An Ambitious Goal: To Reduce Cervical Cancer Mortality in Maryland by 50% by 2010. How Can We Best Do That?

  6. “It is a truism of all public health programs that the closer one comes to full effectiveness, the costlier will be the achievement of the last few percentage points of success.” Anthony Miller, American Journal of Public Health, 1995.

  7. In Order to Plan and Use Resources Wisely - If all Invasive Cases and Deaths Represent Failures, We Need to Know: What Proportion Represent Failures of Detection? Who Are Those Women? What Can Be Done? What Proportion Represent Failures of Treatment? Who Are Those Women? What Can Be Done?

  8. The First Task Establish a Statewide Follow-Back Study Mechanism Long Term Goal: On-going Monitoring of Failures Through Follow-Back Ability to Evaluate and Modify Intervention Strategies Prior Examples: Connecticut, New York, Hopkins

  9. Problem – Failure of Detection: Women who have not been screened in the past five years may be at risk for cervical cancer BRFSS shows 85% of Maryland women report a Pap in past 3 years. This proportion is not increasing. Groups at High Risk for Poor Screening Include: Older Women New Populations to Maryland Low Resource Populations: uninsured, fewer years of school, low income.

  10. Where could we capture these women? • Inpatient Visits • Maryland law requires offer of Pap Test • Hopkins experience with inpatient screening shows high rates of abnormalities are found among inpatients • Emergency Room Use • University of Maryland experience shows high abnormal rates among ER users also • Although follow up is difficult, these in-reach strategies do capture under-screened, high risk women • Care by Providers who are not Ob-Gyns

  11. Problem – Failure of Treatment: After a Non Negative Pap Test, Diagnosis and Treatment may not Follow Best Practices Some women may go without necessary care Providers may be over-testing or treating other women Local resources may be overburdened, or misused Example: Long waiting times in some areas for diagnostic procedures such as colposcopy – Are all women who are referred actually needing this test?

  12. Solutions: Disseminate ASCCP* management guidelines to all providers who treat or manage women with cervical abnormalities. (*American Society for Colposcopy and Cervical Pathology) Continuously disseminate up-to-date recommendations as new information is known. Determine true volume of need, and investigate ways to bring colposcopy services to underserved areas of the State. Continue to identify strategies for reducing barriers to completing work-up and treatment.

  13. Take-Home Message: Three Reasons Why Cervical Cancer Control Is So Important

  14. #1: Cervical Cancer Rates are Important Indicators of Maryland’s Health In 2002, no woman in the US should die of cervical cancer 40 years after the introduction of the Pap test, women who fall through the cracks with invasive cervical cancer represent substandard cancer control Even a few women each year is too many Understanding these failures may lead to better approaches to health disparities overall

  15. #2: Addressing Cervical Cancer Can Address A Range of Women’s Health Needs Many health problems facing women in Maryland require addressing gynecological health across the entire life-course, not just during childbearing. Approaches to HIV/AIDS, STDS, and other health problems can be combined with controlling cervical cancer, to bring better health to Maryland women.

  16. # 3: Lessons Learned In Cervical Cancer Control • Are Important to Other Cancers • Strategies and Solutions We Test for Cervical Cancer • Creative In-reach and Out-reach Mechanisms • Removing Barriers along Treatment Pathways • Initiatives to Disseminate and Implement Best Practices • Approaches Tailored to Diverse Populations • Can Help Us Tackle Those Issues in More Common Cancers

More Related