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Organizations Call for Increased PAP Tests

( - February 6, 2004) Three national public health organizations -- the National Coalition of STD Directors (NCSD), the American Social Health Association (ASHA), and the National Family Planning & Reproductive Health Association (NFPRHA) -- echoed CDC's recommendations contained in a January report to Congress calling for the reduction of cervical cancer incidence and deaths by increasing Pap test screening among women.

According to the CDC report, the survival rates for cervical cancer are more than 90% if detected early and managed promptly. Of the estimated 4,100 women who die from cervical cancer each year, nearly half have never been screened for cervical cancer, and another 10% have not had a Pap test within the previous 5 years.

"Cervical cancer is entirely preventable, treatable, and curable. Only 50 years ago, cervical cancer was the leading cause of death among women in the United States. Since the invention of the Pap test, the incidence of cervical cancer in the U.S. has dropped by nearly 75%," said Judith DeSarno, President & CEO of NFPRHA. "Yet too many women in the U.S. still die from cervical cancer because they do not have access to affordable gynecological care. We need to focus on better access to Pap screening in general, better access to the latest cancer screening technologies, better access to appropriate follow-up treatment and care, as well as increased funding for promising vaccine research."

Cervical cancer is caused by persistent infection with certain types of the Human Papillomavirus (HPV). HPV is the most common sexually transmitted disease in America, with approximately 75-80% of Americans having HPV at some point in their lives. For most people, HPV causes no ill effects and disappears on its own. In rare instances, certain strains of HPV can develop into cervical cancer. Of the 20 million Americans currently infected with HPV, only about 12,200 -- or .0006% -- will develop cervical cancer.

The report noted that there is evidence that condom use may actually reduce the risk of cervical cancer. Possible explanations for the protective effect of condoms against cancer may be that condom use reduces the quantity of HPV transmitted, the likelihood of re-exposure to HPV, or the exposure to a co-factor for cervical cancer, such as chlamydia or genital herpes.

According to the CDC report, the best way to prevent HPV infection is to refrain from all genital contact with another individual. For those who are sexually active, risk-reduction strategies like monogamy and reducing the number of sexual partners were among the suggestions included in the report.

The report noted that "the scientific evidence currently available is 'not sufficient to recommend condoms as a primary prevention strategy for the prevention of genital HPV infection.' This is not to say that condoms are ineffective," said James Allen, President & CEO of ASHA. "Rather, the CDC report simply says that the scientific evidence is inconclusive when it comes to HPV."

"While abstinence is a public health message that we can all support, it cannot be the only message," said Theresa Raphael, Executive Director of NCSD. "The reality is that 90% of Americans have sex before marriage and, public health officials are obligated to dwell in the real world and support an approach to STD and cervical cancer reduction that reflects how Americans actually live. For those who are sexually active, the regular and correct use of condoms remains the best protection against the transmission of all STDs."

NCSD represents the 65 Directors of public health sexually transmitted disease prevention programs in states, large cities/counties, and territories of the United States, and is dedicated to advocating for effective policies, strategies, and sufficient resources to fight the spread of sexually transmitted diseases.

ASHA has been dedicated to improving the health of individuals, families, and communities, with a focus on preventing sexually transmitted diseases and their harmful consequences since 1914.

NFPRHA, founded in 1971, is a non-profit membership organization established to assure access to voluntary, comprehensive and culturally sensitive family planning and reproductive health care services and to support reproductive freedom for all. NFPRHA advocates on behalf of Title X family planning agencies that serve more than 4 million women in over 4,600 clinics across the United States.

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