Nicky is a Board Certified Family Nurse Practitioner. She's worked in the emergency room setting for over 7 years.
Cancer is a major challenge to healthcare. It greatly impacts national morbidity and mortality rates. In addition, cancer increases healthcare expenditures and adds to the overall fiscal burden of the United States. Due to its high cost and impact on global health, cancer, especially gynecological cancer related issues cannot go unnoticed. Gynecological cancers have gained increasing attention. They affect a woman’s reproductive tract namely, the uterus, fallopian tube, ovary, cervix, vagina, and vulva. They can be aggressive and invasive, significantly adding to morbidity and mortality. Cervical cancer alone affects 530 thousand women yearly (Webb, 2015).
Cervical cancer affects the lowermost portion of the uterus in women. It is among the leading gynecological cancers. Advances in medicine have resulted in a decline in cervical cancer diagnosis. Still, cervical cancer poses a high threat to women’s health. It is a top cause of death in women globally, with women in underdeveloped countries with a greater mortality rate (Mansori et al., 2018).
Reducing deaths from cervical cancer is of utmost importance to national and global health. The burden of cervical cancer is substantial with a reported 2.4 deaths per 100, 000 women (ODPHP, 2018). Cancer related deaths can cause various burdens to its victims’ families and friends
Women’s Health and Impact on Healthcare
Annually, approximately 530, 000 women are diagnosed with cervical cancer (Webb, 2015). Disease diagnosis is often related to factors associated with a woman’s race or ethnicity, socioeconomic status, education, and geographic location. These influencers can largely determine diagnosis, treatment, and or survival rates. For instance, low income women are more likely to receive late diagnosis and late treatment interventions for cervical cancer. They are also more likely to die from the disease when compared to patients who are privately insured (Acharya, S., & Grigsby, P. W, 2016).
Evidence supported, and cost-effective interventions are readily available for cervical cancer, yet many women lacks access to adequate healthcare. The implication for healthcare is that health disparity stresses a crucial demand for proper access to healthcare for the vulnerable population among an already vulnerable women’s populace. Thus, identifying and meeting challenges to healthcare access among women is vital to meeting health disparities in cervical cancer care.
Evidenced-based and Cost-Effective Interventions
The incidence rate of cervical cancer has declined throughout the years. This is widely due to cervical cancer screening. Cervical cancer screening has led to early detection and early treatment interventions; significantly decreasing cervical cancer associated deaths. 90 percent of cervical cancers are caused by the human papillomavirus (Cervical Cancer Screening, 2018). Even though HPV infection is usually transient and self-limiting, persistent exposure to high risk strands of HPV can lead to precancerous lesions.
The U.S Preventative Services Task Force recommends that women ages 21 through 65 receive a Papanicolaou (Pap) test every three years to screen for HPV and precancer lesions (USPSTF, 2018). Current cervical screening guidelines (pap smear and diagnostic follow-up) is considered the most cost-effective cervical cancer interventions (Kim et al., 2015).
Cervical Cancer: Screening Drawbacks
Gaps to cytology screening compliance exist. Barriers to screening compliance may be due to cultural factors such as discomfort with male physician or language barriers. Other barriers to screening compliance include health literacy concerning cervical cancer risk factors, and fear of discovering cancer. Hispanic women are more likely to refuse cytology screening due to fear of finding cancer, while African American women’s noncompliance is due largely to poor health literacy of cervical cancer (Akinlotan et al., 2017). Culturally competent patient care and education is vital to reducing challenges to cervical cancer screening compliance.
Clinical Prevention Education
Effective patient education concerning cervical cancer is significant to increasing cervical cancer screening rates. Primary care clinicians are obligated to provide their patients with the health information needed to make an informed decision. Community based educational programs can also provide valuable health information and improve cervical cancer screening compliance. Peer education programs provide and effective strategy to improve cervical cancer behaviors.
Cervical cancer is burdensome to women’s health. Though there is a decrease in its incidence, cervical cancer remains a major challenge to women’s health. Healthy People 2020 objectives is to decrease the number of cervical cancer related deaths. Its achieving depends on continued monitoring of trends in cervical cancer and investments in screening and treatment interventions. Disparities present a challenge to screening compliance. Culturally competent care as well as culturally appropriate patient education is vital to improving knowledge of risk factors and therefore screening compliance.
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Understanding Cervical Cancer
Acharya, S., & Grigsby, P. W. (2016). Access to health care and disparities in cervical cancer diagnosis, treatment, and survival. International Journal of Radiation Oncology, Biology, Physics, 96, E290.
Akinlotan, M., Bolin, J., Helduser, J., Ojinnaka, C., Lichorad, A., & McClellan, D. (2017). Cervical cancer screening barriers and risk factor knowledge among uninsured women. Journal of Community Health, 42(4), 770–778.
Cervical Cancer Screening. (2018). Women’s Healthcare: A Clinical Journal for NPs, 6(2), 13– 17.
Kim, J. J., Campos, N. G., Sy, S., Burger, E. A., Cuzick, J., Castle, P. E., Wheeler, C. M. (2015). Inefficiencies and high-value improvements in U.S. cervical cancer screening practice: A cost-effectiveness analysis. Annals of Internal Medicine, 163(8), 589–597.
Mansori, K., Khazaei, S., Shadmani, F. K., Hanis, S. M., Jenabi, E., Soheylizad, M., Ayubi, E. (2018). Global inequalities in cervical cancer incidence and mortality. Middle East Journal of Cancer, 9(3), 235–242.
Office of Disease Prevention and Health Promotion. Healthy people 2020: Cancer. Retrieved from: https://www.healthypeople.gov/2020/topicsobjectives/topic/cancer/objectives
U.S Preventative Services Task Force. (2018). Cervical cancer: Screening. Retrieved from: https://www.uspreventiveservicestaskforce.org/Page/Document/UpdateSum maryFinal/cervical-cancer-screening.
Webb, P. M. (2015). Environmental (nongenetic) factors in gynecological cancers: update and future perspectives. Future Oncology, 11(2), 295–307.
This content is accurate and true to the best of the author’s knowledge and does not substitute for diagnosis, prognosis, treatment, prescription, and/or dietary advice from a licensed health professional. Drugs, supplements, and natural remedies may have dangerous side effects. If pregnant or nursing, consult with a qualified provider on an individual basis. Seek immediate help if you are experiencing a medical emergency.
© 2019 Nicky Fuller
Nicky Fuller (author) from Florida, USA on January 02, 2020:
Thank you Angel Guzman. There are free or affordable services out there. Unfortunately, many women are unaware of where they can obtain free or affordable healthcare services, particularly cervical cancer screening. More education and community outreach programs are needed in high risk or vulnerable populations.
Angel Guzman from Joliet, Illinois on January 02, 2020:
Very good much needed article Nicky. Its really sad and frustrating the state of the healthcare system in the US and everywhere. A non for profit model would be ideal and that would take some deep analysis to make sure its fair for everyone consumer and provider. I bet you have some stories working in the ER. Happy New Year.