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Cancer Plan: Breast Cancer
Cervical cancer screening is important to detect significant abnormal cell changes that may arise before cancer develops. Since the introduction of the Papanicolaou (Pap) test, cervical cancer incidence and mortality rates have significantly declined in the United States and in Maine (Figures 22 & 23). Less than fifty women in Maine were diagnosed with cervical cancer in 2005. While the number of women affected by cervical cancer is relatively small compared to other cancers, it is one of the most preventable and treatable cancers.
Figure 22: Age-Adjusted Cervical Cancer Incidence Rates, 1995-2002
Source: Surveillance, Epidemiology and End Results Program and the Maine Cancer Registry Program.
Figure 23: Age-Adjusted Cervical Cancer Mortality Rates, 1995-2002
Source: National Center for Health Statistics
The primary risk factor for cervical cancer is certain types of human papillomavirus (HPV). Other risk factors include smoking, poor nutrition, and immunosuppression. Southeast Asian women have the highest invasive cervical cancer incidence rates. For example, cervical cancer incidence rates are five times higher among Vietnamese American women than white women.
Additionally, after the age of 25, the incidence and mortality of invasive cancer in African American women increases rapidly with age, while in white women, it rises more slowly.
Studies have shown repeatedly that early detection is effective in reducing the number of women dying of cervical cancer. With routine screening, women significantly improve their odds of finding cervical cancer at its earliest and most treatable stages. Several national organizations have developed screening guidelines (Appendix D).
In 2004, almost 89% of Maine women had a Pap test within three years. This is one of the highest screening rates for cervical cancer in United States. This is due in part to the successful implementation of the Maine Breast and Cervical Health Program, which offers free mammography and Pap tests to income eligible women ages 40 and over. Advocacy and education efforts have also played an important role. Additionally, all Maine insurers are required to pay for cervical cancer screening, which helps to reduce the financial barrier to getting screened.
Goal: To reduce by 30% the rate of cervical cancer deaths by 2010.
Baseline: 2.1 per 100,000 deaths, Maine Cancer Registry, 2002.
Objective 1: Increase the proportion of Maine women with a uterine cervix who have ever received a Pap test to 98% by 2010.
Baseline: 96% of women aged 18 and older with a uterine cervix have ever received a Pap test, BRFSS, 2004.
Strategies
- Provide advocacy for ongoing implementation of Maine Breast and Cervical Health Program.
- Provide advocacy for ongoing funding of Title X (Family Planning) activities.
- Provide continuing education programs about cervical cancer screening inclusive of HPV and vaccine education to health care professionals.
- Collaborate with organizations that represent women with a higher prevalence of cervical cancer to develop and disseminate culturally and linguistically appropriate messages.
Objective 2: Increase the proportion of Maine women with a uterine cervix that received a Pap test within the preceding 1 to 3 years to 92% by 2010.
Baseline: 89% of women aged 18 and older with a uterine cervix have received a Pap test within the previous 3 years, BRFSS, 2004.
Strategies
- 1. Provide advocacy for ongoing implementation of Maine Breast and Cervical Health Program
- Provide advocacy for ongoing funding of Title X (Family Planning) activities.
- Provide continuing education programs about cervical cancer screening inclusive of HPV and vaccine education to health care professionals.
- Collaborate with organizations that represent women with a higher prevalence of cervical cancer to develop and disseminate culturally and linguistically appropriate messages.
Objective 3: Maintain the proportion of patients diagnosed with invasive cervical cancer who receive or have access to appropriate treatment (within 60 days to treatment starting) by 2010.
Baseline: 100% Maine Breast and Cervical Health Program/April 2005 MDE Submission Data Quality.
Strategies
- Develop a relationship with cancer treating hospitals to explore the collection of data on timely results.
Objective 4: Reduce the number of women who are diagnosed with regional or distant stage cervical cancer by 2010.
Baseline: 30% Regional and 6% Distant, Maine Cancer Registry, DHHS, 1995-2002.
Strategies
- Conduct case studies of current cancer deaths.
- Develop interventions based on the analysis of case studies.
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