More than 12,000 women a year get cervical cancer, yet up to 93% of these cancers are preventable. The Centers for Disease Control reports that up to 8 million American women have not been screened for cervical cancer in the last 5 years, which is approximately 10% of all women who are at risk for the disease. The Papanicoolaou (Pap) test screens for abnormal cells and is a time tested screening method for detecting cervical carcinoma. More recently, testing for HPV infection to identify women at high risk for the disease has also been added to the screening and detection process. HPV vaccination is also another important part of the cervical cancer reduction public health program; however, vaccination does not prevent against all cervical cancers, and screening is critical to early diagnosis.
The Japanese Health Ministry withdrew HPV Vaccination recommendations for young girls to help prevent cervical cancer because of numerous complaints of side effects. Hundreds of vaccinated girls have complained of long term pain and numbness after receiving the vaccine. While the ministry is not suspending the use fo the vaccination, it has instructed local governments to not promote its use. This withdrawal of immunization recommendation is unusual because it was used regularly by local governments and is required by law.
Although the HPV vaccine has been recommended for teenage girls to help prevent the development of cervical cancer caused by infection with high risk serotypes of the Human Papilloma Virus (HPV), about 75% of teenage girls were not current with the HPV vaccination. More than 40% of parents reported that they had no intention of having their daughters complete the HPV immunization process. Parents' reasons for not completing this immunization schedule included beliefs that it was not needed or necessary (17%), safety concerns (16%), lack of sexual activity in the children (11%) and lack of knowledge (10%). This study was conducted between 2008 and 2010 and included a review of the tetanus diphtheria and acellular pertussis (Tdap), the quadrivalent meningococcal (MCV4) and the HPV immunization. About 20% of teens were not up-to-date for the Tdap immunizations and approximately 65% were not up-to-date for the MCV4 immunizations.
New guidelines for cervical cancer screening have been released by the American Cancer Society in conjunction with the U.S. Preventive Task Force (USPTF) that are based on new understanding of the role that human papillomavirus (HPV) infection plays in the development of this disease. The guidelines recommend less frequent testing across all age groups and are aimed at detecting early cellular abnormalities while at the same time reducing unnecessary biopsy procedures and the anxiety caused by false positive PAP smears. Vaccination against HPV has reduced the incidence of cervical malignancy but the vaccine only protects against for 70% of cervical malignancies. The decreased recommendations for screening may cause women to reduce the frequency of their gynecologic visits and consequently cause missed opportunities for the detection of other women's health issues that are detected during routine visits.