HJBR Sep/Oct 2019

Healthcare Journal of BATON ROUGE I  SEP / OCT 2019 19 the virus is usually transiently present and is cleared. There are over 100 types of HPV, but only about 15 have been shown to cause cancer. When persistent, oncogenic types of HPV can lead to the development of precan- cerous and invasive cervical cancers (gen- erally over a span of several years follow- ing initial infection). Women who also have genital herpes may carry a higher risk too. Factors that favor exposure to HPV thus increase risk of cervical cancer. These include early sexual debut, multiple sex part- ners (especially a high-risk sexual partner), and prior infection with sexually transmis- sible agents. Women who have had precan- cerous cervical conditions, and those with a compromised immune system are also at risk. Cervical cancer rates are higher in women of low socioeconomic status, non- white versus white ethnicity, cigarette smok- ers, and oral contraceptive users. Family his- tory is not an influence on risk. Individual genetic factors that may predispose to pro- longed infection and progression to cancer are under active investigation, but are not part of regular screening and testing on a population-wide basis. However, modern Pap testing incorporates evaluation for the presence of HPV types that cause cancer. This has been an important advance for helping to sort out cellular changes most at risk for progression to malignancy. Women at Risk In Louisiana, black women have a higher incidence of cervical cancer diagnosis and mortality compared to white women in the state, as well as other African-American women across the U.S. Each year, 120 white and 88 black Louisianans receive the diag- nosis of cervical cancer. Deaths per year are 41 white and 31 black residents. Statewide, only 84 percent of women have appropriate cervical cancer screening. HPV vaccination rates (currently 39 percent) are only about half of the goal of 80 percent for adolescents. Overall, the survival percentages for all stages of cervical cancer treated in Louisi- ana are similar to the rest of the U.S., except for whites with early stage cervical cancer, who have somewhat lower cure rates. Given that most cases of cervical cancer could, in theory, be prevented or diagnosed early, opportunities for intervention are largely “Statewide, only 84 percent of women have appropriate cervical cancer screening. HPV vaccination rates (currently 39 percent) are only about half of the goal of 80 percent for adolescents.”