Cervical cancer: an overview with suggested practice and policy goals.

L ast year, the American Cancer Society predicted 11,150 cases of invasive cervical cancer would be diagnosed and 3,670 women in the United States would die from the disease (American Cancer Society [ACS], 2006b). While the incidence of cervical cancer in the United States has decreased significantly in the last 50 years, primarily due to effective screening programs, many women still suffer and die unnecessarily. However, the past couple of years have marked a turning point in the fight against cervical cancer. The availability of a test for the human papillomavirus (HPV), the cause of virtually all cases of cervical cancer, and development of an HPV vaccine bring powerful new prevention tools to this fight. Cervical cancer is not only in the public eye but at the top of public policy agendas as well, as legislators and public health officials develop strategies to ensure widespread access to these technologies. At the same time, an increasing awareness of cervical cancer and HPV has given new urgency to education and outreach efforts to inform women about prevention options. Public health attention also has turned to the developing world, where cervical cancer remains a leading cancer killer among women of reproductive age and where access to advanced preventive technologies in cervical cancer screening and vaccination is limited. Federal and state governments and public health agencies play a key role in the prevention of cervical cancer. At the federal level, the government funds public health programs such as the National Breast and Cervical Cancer Early Detection Program, and administers Medicaid and Medicare. It also has authority over the Food and Drug Administration, which reviews and approves new medicines, vaccines, and technologies. States also play a tremendous role in preventing this disease, including (but not limited to) the administration of federal programs such as local health departments, determining specific coverage issues under Medicaid, and educating the pubCNE Objectives and Evaluation Form appear on page 51.