WEDNESDAY, Jan. 18, 2006 (HealthDay News) -- Efforts to screen American women for cervical cancer have gotten better, but improvement is still needed.
That's the conclusion of a new report that tracked recent progress on the issue state by state.
"The big news here is basically 20 states have made significant improvements, but no state is doing an excellent job," said Susan Crosby, president of Women In Government, a nonprofit, bipartisan association representing elected women state officials.
Crosby's group released their second annual report on the issue on Wednesday.
The report's creators measured eight statewide factors, including rates of cervical cancer incidence, death and screening; numbers of uninsured women; Medicaid coverage of testing for the human papillomavirus (HPV), which causes cervical cancer; and legislative efforts for screening, building task forces and other forms of support.
Each of the factors was scored from zero to two points, with a total of 16 points possible.
No state got that perfect score, however.
"We have found a number of states have improved since we issued our first report in 2005," Crosby said. "Twenty states and the District of Columbia have improved their scores."
The winners? Minnesota got the highest score, a 13, or 81 percent, and four other states -- Illinois, Maryland, North Carolina and Rhode Island -- got the next highest score of 12 (75 percent).
Tennessee got the lowest score, with 38 percent, while California, Idaho, Kentucky South Dakota and West Virginia each got 44 percent scores.
Why aren't some states doing a better job of boosting screening rates? Sometimes doctors are not up to date, and don't recommend the newer tests, Crosby said. "Women often have to take control of their own body and their own health," she added.
In 2005, about 10,370 cases of invasive cervical cancer were predicted in the United States, according to the American Cancer Society. The cervix is the lower part of a woman's uterus. Cervical cancers typically do not form suddenly, but grow slowly over years. Most cases occur in midlife, with half of women diagnosed between the ages of 35 and 55.
The traditional Pap test, which consists of collecting a small sample of cells from the cervix, placing them on a slide and examining the slide under a microscope, has greatly decreased cervical cancer deaths in the developed world in the last 50 years. Now, a more advanced form of the test, liquid-based cytology, consists of placing the cells into a liquid after collection and sending them to the lab for analysis. When the Pap is used in conjunction with a test for HPV, it's even more effective.
An HPV test is approved for use by the U.S. Food and Drug Administration in conjunction with the Pap test to screen women aged 30 and older. For many young women, the virus will clear up on its own.
HPV is common, according to the report. By the age of 50, about 80 percent of women will have had HPV at some point. It's spread by skin-to-skin genital contact. The virus can stay dormant for months or years before it's detectable.
If your physician doesn't mention the HPV test, bring it up, Crosby said.
Worldwide, there are 13 high-risk strains of HPV, said Dr. Marie Savard, a Philadelphia internist and a women's health advocate who is also a speaker's bureau member for the manufacturer of an HPV test. But just two, strains 16 and 18, will cause most cervical cancers in the United States, she said. Two companies are developing vaccines targeted against these strains.
For now, Savard said, the Pap and the HPV tests are the best bets to catch cervical cancer early.
Under current American Cancer Society recommendations, cervical cancer screening is recommended for women within three years of becoming sexually active, or at age 21, whichever comes first, and should continue until a woman is about 65 or 70. After three good Pap test results, and a negative HPV test (if you are over 30), women can widen the screening interval from an annual test to one every three years, Savard said, citing recommendations by professional organizations.
More information
To learn more about cervical cancer prevention, visit the Women in Government.
