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Archive for the ‘cervical cancer’ Category

When talking about bringing the number of cervical cancer deaths to zero, it is crucial not to forget about LGBTQ people’s distinct experiences accessing health care. We know cervical cancer is completely preventable, and that regular pap smears are designed to catch any changes in the cervix that may lead to cancer later on. Just as with many other Latinas, however, preventing cervical cancer for LGBTQ Latin@s becomes a matter of access – to affordable exams, to providers who are culturally competent, and to providers who are trained to deal with LGBTQ patients. Unfortunately, for many LGBTQ Latin@s, affordable preventive care with properly trained clinicians is simply not accessible.

One of the most pressing issues for LGBTQ access to care is discrimination and bias. Homophobia at the doctor’s office is unfortunately common, and a great detractor to queer women seeking care. This then affects access to preventive care – women who have sex with women are at risk for cervical cancer, and research suggests that queer women who report positive attitudes about their providers are more likely to have had a recent pap. Transphobia is also a concern, and especially for highly gendered health services such as Pap smears, a huge barrier to access. In fact, in a recent survey about the experiences of transgender people with discrimination, nearly a quarter of trans Latin@s reported having been denied medical services due to their gender identity, and 36% reported delaying needed medicals services for fear of bias.

Discrimination at the doctor’s office is only part of the problem, however. While person-to-person discrimination is an issue, the systematic oppression and marginalization of LGBTQ communities plays a role in LGBTQ Latin@s’ ability to afford care, research and knowledge about LGBTQ health, and clinicians’ training on treating LGBTQ patients. Existing research suggests that LGBTQ communities are disproportionately poor, and the Latin@ respondents of the Transgender Discrimination Survey reported high rates of both unemployment and harassment at work due to gender identity. This means that health care is often out of reach for these communities, especially non-emergency and preventive care such as Pap smears. But even if LGBTQ people are able to afford care, most physicians are woefully unprepared to treat LGBTQ patients due to a lack of training on relevant issues.

We are seeing progress, however. Reproductive justice activism is incorporating the needs of LGBTQ communities, and the LGBTQ advocates are beginning to consider reproductive rights issues as ones that are relevant to their base. Every day we are seeing research on LGBTQ health grow. And last November, in a historic move, the American College of Obstetricians and Gynecologists released a statement urging their members to be prepared to treat transgender patients. It’s a long road ahead, but as long as we don’t forget our LGBTQ herman@s in the fight to bring down cervical cancer deaths to zero, we are moving forward.

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January is Cervical Cancer Awareness Month: please join NLIRH by participating in our blog carnival!

¡Acábalo Ya! Working Together to End Cervical Cancer. This is one fight we can win.

Every year in the United States alone, more than 12,000 women are diagnosed and more than 4,000  die of cervical cancer, a disease that is 100% preventable. A disproportionate number of those who suffer from this deadly disease are Latinas and other women of color. This is unjust and unacceptable. We believe the number of deaths from cervical cancer should be zero, and we invite you to join us in making this a reality.

Starting next week on January 9th, we will be hosting a blog carnival, “¡Acábalo Ya! Working Together to End Cervical Cancer.” This effort is aimed at educating Latinas about this disease and how to protect our health, raising the profile of cervical cancer prevention as a national reproductive justice and women’s health priority, and advocating for greater access to the tools and care needed to prevent, detect, and eventually end cervical cancer.

We hope you will be able to join us!

What can you do? Write a post on your blog (or a guest post on ours) that answers the question: “What will it take to end cervical cancer?” Examples of topics include: combating barriers to prevention, diagnosis and treatment; the unique challenges faced by women of color, immigrants, queer women, and transgender men in accessing the care they need; the HPV vaccine; HPV stigma; and the potential impact of the Affordable Care Act on reducing cervical cancer incidence and death. Need more ideas? Contact us and we’ll provide resources and info.

How? Email Natalie D. Camastra, Policy Fellow, at natalie@latinainstitute.org with the link to your blog post. If your organization does not have its own blog, please contact Natalie via email or at (202) 621-1434 and we will work with you to get your contribution posted.

When? Blog posts will be accepted and links posted from January 9-13. The earlier you can submit, the better!

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According to the New York Times, the Advisory Committee on Immunization Practices  (ACIP) of the Centers for Disease Control and Prevention (CDC) has released a set of recommendations for administering the human papillomavirus (HPV) vaccine to boys and men. These recommendations will have a wide impact, as both private health insurance companies and Medicaid usually follow suit and offer vaccines as a result of this panel’s recommendations.

The recommendation is that boys ages 11 and 12 should receive vaccine, which was first approved by the Federal Food and Drug Administration in June 2006 to protect against 4 strains of HPV.  Additionally, the vaccine has been recommended to males aged 13 to 21 who have not received the full three-part vaccine as well as boys as young as 9 and men between 22 and 26.

This is great news as early vaccination is critical to securing the HPV vaccine’s effectiveness in preventing cancers for both men and women.

Why is early vaccination key?

HPV, which is spread through skin-to-skin contact, particularly during sexual contact,  is widespread, easy to contract and can lead to a very serious cancer diagnosis. There are no cures or treatments for HPV, and often no symptoms, which increases one’s likelihood of spreading the virus.  Also, we know that while most high school freshman have not become sexually active, by the time they graduate 7 in 10 and 44% of Latinas will have had sexual intercourse.  Therefore, getting vaccinated before beginning sexual activity is absolutely vital.

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“Statistically significant”

“Accurate denominator”

“Barrier vs. non-barrier population”

This is what I heard as I sat in a gloomy conference room today during an agency committee meeting about who classifies as a medically underserved population and where health professional shortages exist.

The committee’s job is to build a model that the federal Department of Health and Human Services’ (HHS) will use to allocate money to populations that lack medical services.

I was at these same meetings in November and realized that the deliberations lacked the human stories needed to make an accurate model. We know that certain elements have the biggest impacts on underservice such as race, ethnicity, culture, language, sexual orientation, and gender identity. So we joined forces with other organizations including the National Asian Pacific American Women’s Forum (NAPAWF) and the National Immigration Law Center to express our concerns.

With these organizations, we submitted written comments to the committee and then I gave public testimony today about these issues. I know that by opening up this conversation, giving strong examples of the problems, and offering solutions we have made an impact in that committee’s focus. They asked us to remain a resource for their future efforts and several committee members thanked me for our participation and expressed that they have tried to elevate these concerns but that it has been difficult. These issues are not easy to raise. They make finding a clean model very difficult. But they are critical in designing a model that is effective at figuring out who really is underserved. I hope, and believe, that our work on this issue has elevated underserved voices and will make a difference in the committee’s deliberations.

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I grew up next door to my grandmother and for hours, she would keep my sisters and I hostage to talk to us about recipes. I’d watch her do all of the preparations for major dishes, like tamales or menudo and she always scolded us for not getting the right ingredients or measurements. Oh abuelita! The desire to keep her memory alive made me think about those sweet adolescent years. Suddenly, I remembered the recipes, taquitos, arroz, chile reyenos, were all about consumption and not a single one on PREVENTION. Of all the things my grandma talked to us about, there was never one conversation on things like sex or cervical cancer.

January was cervical cancer awareness month, but it shouldn’t be the only time we talk about it. The fact that any woman who has ever had sex can get HPV (human papillomavirus) is a reason to talk about cervical cancer with your amigas, comadres, moms, sisters, and abuelitas.  It is important to note that while not all HPV infections lead to cervical cancer (in fact, most don’t!), the possibility is there and we must discuss these links.  So pongansen las pilas, prevention needs to be part of the conversation about cervical cancer.

Did your mom or abuelita ever throw a dicho at you growing up? – mas sabe el diablo por viejo que por diablo (the devil knows more for being old than for being devil), meaning that experience means more than just a position. We know through other women’s experiences that cervical cancer can be detrimental to one’s life. Por ejemplo, approximately 4,000 women die of cervical cancer annually with Latina deaths at a proportion nearly 40% higher than that of non-Hispanic White women. What’s more striking, 80-85% of cervical cancer deaths could have been prevented. But when we talk about health, often, we don’t talk about cervical cancer, and when we do, it’s too late and the cancer has spread to lower portions of the vagina or other parts of the body. That’s why we need to talk about prevention.

To start the screening guidelines say Pap smears should start when a woman turns age 21 or after first sexual intercourse. But what is it about Latinas that make us more susceptible to cervical cancer than women of other racial/ethnic groups? Cervical cancer prevention has traditionally relied on pap smears and HPV tests for early detection and treatment.

A pap smear does not identify HPV directly, but rather can look for symptoms of HPV. Once symptoms are discovered, an HPV test will determine exactly which type of HPV is present. Therefore, women must have regular pap tests to look for symptoms of HPV and, once symptoms are found an HPV test can be performed to find out if she has a high-risk strain, which can lead to cervical cancer.

What’s striking about Latinas, is that often we forgo these exams due to limited access to adequate healthcare and barriers associated with cost, health insurance, embarrassment, and lack of knowledge about cervical cancer. This is why prevention and conversation on this issue can make a world of difference for Latinas. NPR recently ran this story about this challenge in the Latina community.

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By Myra Guevara, Research Intern

UPDATE: This post originally titled: “FDA approves new cervical cancer screening technology,” incorrectly implied that the FDA had approved the screening technology. In actuality, it has only been approved for review.

“Receiving the ‘suitable for filing’ letter from the FDA is the first significant milestone in the regulatory review process and means that our application was sufficiently complete and is ready for substantive review,” said Mark L. Faupel, Ph.D., President and CEO of Guided Therapeutics.  “This brings us one step closer to realizing our goal of improving the early detection of cervical disease and reducing the false positives and unnecessary biopsies that result with the current standard of care.”

Guided Therapeutics, Inc. recently received a premarket approval from the FDA for a new technology that could improve the manner in which cervical cancer is screened and tested. The new device, called LightTouch uses biophotonic technology which claims to be painless and can detect cancer earlier than the current methods of cervical cancer screening. According to Biomedreports:

“The National Cancer Institute-sponsored clinical trial demonstrated that Colposcopy failed to detect 33% of high-grade precancerous lesions in women referred with questionable Pap results.”

Biophotonic technology uses light to create images of cervical cells’ biochemical and morphological changes. LightTouch does not require laboratory testing and analysis, which would not only save time but money. Additionally, it is designed to provide immediate results, is more accurate than pap smears and HPV tests, and painless. Early detection is a major component in reducing the mortality of cervical cancer.

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Today, the CDC published a rule that finalizes a set of criteria for evaluating whether vaccinations recommended by the CDC’s Advisory Committee for Immunization Practices should become automatic requirements for immigrants.

Starting December 14, 2009, the human papillomavirus (HPV) vaccine will no longer be a required vaccination for immigrant women and girls.

NAPAWF, NLIRH and CLRJ opposed the mandatory vaccination requirement when it took effect in July 2008, and worked together with national, state and local partners in the reproductive justice, women’s health, immigrant rights, medical and public health movements to remove the mandate. Organizations from around the country sent letters to the CDC opposing the rule and submitted comments in support of the proposed criteria. This was an important victory for the reproductive justice movement and showcased the power of cross-movement building strategies to secure reproductive justice and bodily autonomy for the most vulnerable women and girls.

Read the full press release here.

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The Center for Disease Control (CDC) and Prevention Advisory Committee on Immunization Practices is scheduled to debate whether HPV vaccination of boys with Merck’s human papillomavirus vaccine Gardasil will be cost-effective and a route worth exploring, reports NPR’s All Things Considered.

The FDA approved Gardasil in 2006 as a method to prevent HPV strains 16 and 18 which cause70% of cervical cancer cases. Additionally, Gardasil also prevents two other strains of HPV that cause 90% of genital warts. From the National Partnership for Women & Families:

The Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices on Wednesday recommended GlaxoSmithKline’s human papillomavirus vaccine, Cervarix, for routine use in vaccinating girls and young women to prevent cervical cancer, the AP/New York Times reports.

The CDC panel also recommended optional vaccination with Gardasil for boys and young men to protect them from genital warts, although they stopped short of recommending its routine use in boys, as CDC recommends for girls, the Times reports. FDA approved Gardasil for use in boy and men ages nine through 26 last week.

Neal Halsey, a professor at the Johns Hopkins Bloomberg School of Public Health, argued that the most effective way of preventing HPV  “would be to immunize both men and women, boys and girls.” He added that the “right thing to do—from a scientific standpoint, ethical standpoint, in terms of shared responsibility—is to immunize all boys, all girls.”

Harvard University research argues that vaccinating boys is not cost-effective if the majority of women are already vaccinated. A Gardasil regimen consists of three doses priced at $130 per dose. Immunizing boys as young as 9, the study states, would prevent HPV if fewer girls had the treatment. The CDC study shows that 37% of U.S. girls ages 12 through 17 have received at least one dose of Gardasil. In the United Kingdom, close to 80% of girls in have received the HPV vaccine.

It is extremely heteronormative to assume that simply by vaccinating girls, boys will be immediately protected from HPV. This leaves out the number of boys who might be gay or bisexual, or have same-sex sexual experiences. If they are not vaccinated, then they are at just as much a risk getting genital warts, anal cancer and other illnesses from HPV. The Harvard Study also places a sense of pressure of women who are made to feel like the must get vaccinated. It poses the question: why are women given the added responsibility of receiving Gardasil?

In debating cost-effectiveness of the vaccine, it is important not to forget the significance of Gardasil—this is one of the first vaccinations known to prevent HPV, a known cause of cancer. Whether it is cost-effective or not is irrelevant, providing it for both men and women as a means of protection is both unassuming and necessary.

By Carlos Blanco, Community Mobilization Intern

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Jessica Gonzalez-Rojas, Director of Policy and Advocacy at NLIRH, wrote this piece for RH Reality Check in response to the new requirements:

This July, the U.S. Citizenship and Immigration Services (USCIS) announced new requirements, including five new vaccinations for individuals seeking adjustment of immigration status. One of these vaccinations is Gardasil, the human papillomavirus (HPV) vaccine. Gardasil, manufactured by Merck, is the only HPV vaccine in the U.S.–also the most expensive vaccine on the market and the only vaccine to be approved for use in only one sex. The CDC’s Advisory Committee on Immunization Practices (ACIP) is the only federal body that makes recommendations about immunizations; the committee’s recommendations serve as the template that USCIS uses to determine immunization requirements for immigration procedures. These new requirements put increased barriers and additional burdens on women’s access to adjustment of immigration status and applications for visas to enter the U.S. and stoke the already reverberating anxieties among communities of color about the HPV vaccine.

Instead of mandating vaccines for immigrant women’s bodies, the U.S. government should increase access to health information and services that are unbiased, age-appropriate, culturally-competent and non-coercive.  Mandating a vaccine that specifically targets young non-citizen women is both sexist and xenophobic.  It will only add to the current anxieties among many communities of color about the vaccine and the government’s interest in vaccinating a particular community, in this case, immigrant women.

You can read the whole piece here. For more information on the HPV vaccine, including a Frequently Asked Questions document, see our campaign page.

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The New York Times, in an article on August 20, 2008, questioned drug companies’ push of the HPV vaccine. The article looks at the extensive marketing campaign and lobbying efforts taken on by the makers of the HPV vaccine. The article states that indeed, “in many states where cervical cancer legislation has been considered, there have been ties between drug makers and members of government.”

 

The cost of the vaccines and their accessibility to developing countries was also explored:

And why the sudden alarm in developed countries about cervical cancer, some experts ask. A major killer in the developing world, particularly Africa, where the vaccines are too expensive for use, cervical cancer is classified as very rare in the West because it is almost always preventable through regular Pap smears, which detect precancerous cells early enough for effective treatment. Indeed, because the vaccines prevent only 70 percent of cervical cancers, Pap smear screening must continue anyway.

One of the issues raised in the article is the unanswered question about how long the immunity will last.

 

Dr. Harper said that in the data from Merck’s clinical trials, which she helped conduct, the vaccine was no longer protective after just three years in some girls. “The immunity of Gardasil will not last — that is dangerous to assume,” she said.

The article brings to light many issues surrounding the vaccine. We at the Latina Institute think it is important for Latinas and their communities to have as much information as possible to make an informed decision about the HPV vaccine. Despite the U.S. being a developed country, the fact still remains that Latinas have the highest incident rate of cervical cancer amongst all groups of women and have the second highest mortality rate from cervical cancer. Knowing this fact, we as Latinas, owe it to ourselves and to our hermanas to take care of ourselves and each other, by getting yearly pap smears and fighting for those hermanas who may not have access to reproductive health care, and by getting as much information as possible about the HPV vaccine to make informed decisions. Cuídate. Ármate. Edúcate.

Contributed by Maria Elena Perez, Director of Community Mobilization

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