'Ending Cervical Cancer in our Lifetime'
                                                     
National Lieutenant Governors Association
                                                                          DELAWARE

State initiates program to end HPV, cervical cancer
10/10/06
by Kristin Vorce

Univ. of Delaware, student newspaper
Lt. Gov. John Carney announced the "Ending Cervical Cancer in Our Lifetime" campaign at The Woman's Place at St. Francis Hospital last Thursday.  Carney said Delaware is one of 10 states to pioneer the program, which uses a brochure and bracelet to educate women on the human papillomavirus and cervical cancer.

"It's really a very simple campaign with a simple message," he said. "Women need to make the connection between HPV and cervical cancer and then take the necessary steps to prevent the virus and to get screenings."  According to the National Women's Health Resource Center, an estimated 9,710 cases of cervical cancer will be diagnosed in the United States in 2006.  Dr. Rachel Heinle, one of the founders of The Woman's Place, said HPV is responsible for 99.7 percent of cervical cancer.

Heinle said the FDA recently approved a vaccine which protects against four types of HPV, including two types responsible for 70 percent of cervical cancer.  "It's really revolutionary that we have a vaccine against a form of cancer," she said.  Heinle said ideally women should receive the vaccine before they become sexually active. She said women should have a Pap test annually to screen for HPV, regardless of whether they are vaccinated.  The vaccine requires a series of three injections over a one-year period and costs approximately $120 per injection, according to the American Cancer Society's Web site.

Heinle said because 65 to 85 percent of the sexually active public has HPV, condom use and safe sex practices are also important. She also said women should not smoke because smoking accelerates the spread of cervical cancer.   "I think the campaign's going to be hugely successful," Heinle said. "The key is education. I think a lot of people don't know what HPV is or how it's spread.  "They're going to realize no one's immune to getting it."

Public health officials such as Dr. Janice Tildon-Burton, president of the Medical Society of Delaware, Dr. Molly McBride of The Woman's Place and Dr. Nicholas Petrelli, medical director of the Helen F. Graham Cancer Center, were present at the campaign kick-off.  Carney said lowering cancer rates in Delaware has been a primary goal for state officials. He said next they plan to target prostate cancer, which is prevalent among black men.  "Never before have we approached fighting cancer as aggressively as we have in the last four years," Carney said. "If we get the word out and work with our partners, then we can achieve the goal.  "We're not going to be satisfied until we have the lowest cancer ratings."


State joins HPV, vaccine education initiative
By Hiran Ratnayake, The News Journal
Sunday, October 8, 2006

     Delaware
and nine other states have launched a cervical cancer educational campaign that promotes a vaccine that helps prevent the disease. The vaccine's maker, Merck & Co. Inc., which stands to make billions of dollars from the drug, funded the campaign.  An eight-page pamphlet, the campaign's centerpiece, mentions abstinence, safe sex and routine Pap smears, as well as a vaccine for human papillomavirus. HPV is a sexually transmitted disease that causes 99.7 percent of cervical cancer cases. The three-shot vaccine, which cost $120 a shot, "protects against four types of HPV, including the two types of HPV which cause 70 percent of cervical cancer cases," the pamphlet states.  The brochure, which will be distributed to 8,000 families in Delaware and households in nine other states, was paid for with $50,000 from Merck, which in June won Food and Drug Administration approval for its vaccine.  The National Lieutenant Governors Association, which launched the campaign, approached several drug companies for grant funding.  Marc Boston, spokesman for Whitehouse Station, N.J.-based Merck, said the company-financed campaign was processed in compliance with federal law. Federal laws bar companies providing funding for independent public policy grants from having influence over content, such as that in the brochures.  "We have to make sure our grants conform to regulatory guidelines," Boston said.  For Merck, the vaccine Gardasil could be worth as much as $19 billion worldwide by the end of the decade, analysts have said.  Doug Gramiak, spokesman for Lt. Gov. John C. Carney Jr., said the goal of the campaign is not to advertise Gardasil, which is approved in the United States for females ages 9 to 26.  "All we're doing is giving people all of these options," he said. "It's an educational program. We are not endorsing the vaccine. We are talking about abstinence, safe sex or vaccination. There are a number of things you can do, and it also mentions that there's new technology out there."  Cervical cancer killed 76 females in Delaware from 1999 to 2003, the most recent data available, according to the Division of Public Health. Delaware's death rate from cervical cancer is the 45th-worst in the nation. From 1999 to 2003, Delaware's mortality rate was 22.8 percent higher than the U.S. rate.  In October 2005, after an abnormal Pap smear, Vicki Frischkorn, a Townsend resident, had a precancerous lesion in her cervix removed. She said the brochure helped her talk to her 10-year-old daughter about sex and cervical cancer. Frischkorn will have her daughter inoculated.  "My ultimate goal as a parent is to keep her safe," said Frischkorn, 39. "I don't think this is any different from going to have a flu shot. This is a life-threatening disease that they can get, but I don't wish it on anybody."
Societal impacts questioned
     An intense debate began when the FDA approved Gardasil for girls as young as 9, and then the Centers for Disease Control and Prevention's Advisory Committee on Immunization Practices recommended routine vaccination for girls 11 to 12. The recommendation that young girls receive the vaccine caused a stir, with some groups claiming it could promote sex.  Controversy has quieted in some circles. The Family Research Council, a powerful Christian lobbying group, has said the benefits of the vaccine outweigh the risks, while emphasizing that the abstinence and fidelity in marriage are safer than the vaccine.  The vaccine is also supported by St. Francis Hospital, the state's only Catholic hospital, which does not perform tubal ligations and vasectomies.  Dr. Cary Gutbezahol, who is responsible for making sure the St. Francis medical staff adheres to the hospital's bylaws, rules and regulations, said promoting a vaccine differs from birth control.  "I don't think anybody is saying that we encourage you to have the vaccine if you have sex," said Gutbezahol, vice president of medical management at St. Francis. "You could almost make the same argument about hepatitis B, another sexually transmitted disease."
'Chance to wipe this disease out'
    
Others are not persuaded.  Although she extolled the benefits of the vaccine as the state rolled out the campaign Thursday, Dr. Janice Tildon-Burton, president of the Medical Society of Delaware, later expressed reservations.  "As a parent, I'm a little ambivalent of a 9-year-old getting a vaccination," Tildon-Burton said. "But there are predators out there, and children could be exposed through no fault of their own. We have a chance to wipe this disease out."  Bess McAneny, a registered nurse who lives in Newark, went further. She said the vaccine should not be administered.  "The emphasis should be on the lifestyle of abstinence and not promoting that liberated value of sexuality," McAneny said. "This is a vaccine being imposed on a child because of a behavior, and that doesn't justify the reason for the vaccine."  Dr. Molly McBride is head of The Woman's Place, which recently opened and is linked with St. Francis Hospital. She said she has had to remove parts of the cervixes of females as young as 18 who had precancerous lesions. "It's one of the most aggressive forms of cancer," she said. "It's up to parents whether to get their kids vaccinated or not. But what mom doesn't want to protect her kid from cancer?"

October 5, 2006
State launches cancer fight

WILMINGTON — Almost 100 percent of cervical cancer cases are caused by the human papillomavirus (HPV), yet few women are aware of the link between the two conditions, Wilmington gynecologist Molly McBride said Thursday at a press conference announcing a new statewide cervical cancer education campaign.  She joined other Delaware physicians and Lt. Gov. John C. Carney at the Woman’s Place in Wilmington to launch the “Ending Cervical Cancer in Our Lifetime” program.  The campaign is a project of the National Lieutenant Governors Association and is funded by a grant from Merck, the maker of the first HPV vaccine.  Delaware is one of 10 states participating in the program.

“One of the big priorities Delaware has in health care is to reduce the incidence and mortality of cancer in the state,” Lt. Gov. Carney said.   He hopes the cervical cancer education campaign will give women the information they need to combat a highly preventable form of cancer.  Dr. McBride said HPV is a common sexually transmitted virus that 85 percent of women will be positive for at some point in their life.  By receiving regular pap-smears and asking for an HPV test at their gynecological exams, she said women can find out whether they have the type of HPV that causes cervical cancer.  Women can completely protect themselves from the virus by abstaining from sex or limit their chances of contracting it by practicing safe sex.

There is also a new vaccine given to females ages 9 through 26 that is up to 70 percent effective in preventing HPV, Dr. McBride said.  And women who have the high-risk subtype of HPV can prevent cervical cancer by receiving regular gynecological checkups and undergoing procedures that get rid of precancerous cells.  “Cervical cancer is preventable,” Dr. McBride said. “We’re looking at eradicating it in our lifetime.”  As part of the campaign, doctors and health centers will distribute brochures to women to educate them about cervical cancer and HPV.  The brochures come with a cervical cancer awareness bracelet, designed to spark conversation about the two conditions.  “This is a subject that is often uncomfortable for parents and young girls and women to talk about,” Lt. Gov. Carney said. “The bracelet is a way to ease that tension.”

By giving a cervical cancer bracelet to someone, medical experts believe it will help create awareness and spur conversation about a sometimes embarrassing topic.  Dr. McBride said she’s met several mothers who are uncomfortable talking to their daughters about the virus and are hesitant to let them get the vaccine.  “They think it will condone them having sex,” she said. “What I tell people is not to focus on the sexually transmitted nature (of HPV), but the fact that it causes cancer.  “Wouldn’t you do anything for your daughter for her not to get cancer?”  She is confident the “Ending Cervical Cancer in Our Lifetime” brochures will help do away with much of the embarrassment that surrounds the condition and inform people about a very important and overlooked topic.  “Most women are shocked when I tell them that cervical cancer is caused by a sexually transmitted virus,” Dr. McBride said.  “It’s really new news to a lot of people.”  Visit maketheconnection.org to learn more.