warning Hi, we've moved to USCANNENBERGMEDIA.COM. Visit us there!

Neon Tommy - Annenberg digital news

Health Care Access Highlights High HPV, Cervical Cancer Rates In Los Angeles

Benjamin Gottlieb |
January 6, 2011 | 1:46 p.m. PST

Senior News Editor

Los Angeles women are at a higher risk of contracting HPV and developing cervical cancer than the rest of the county, according to a 2010 report by the Los Angeles County Department of Public Health.

Highest among Latina women, the cervical cancer rate in L.A.’s Latina population is almost twice the national average – 14.3 per 100,000 women versus 8.1 per 100,000 women nationwide – according to data from a 2003-2007 SEER study and the 1998-2007 USC Cancer Surveillance Data Survey. 

Researchers say the increased cervical cancer rate is linked to healthcare access issues and a lack of sexual education, particularly about the cancer’s leading cause, the human papillomavirus or HPV.

A papsmear with healthy cells (blue) and HPV-infected cells (pink). Photomicrograph by Ed Uthman, MD. Creative Commons.
A papsmear with healthy cells (blue) and HPV-infected cells (pink). Photomicrograph by Ed Uthman, MD. Creative Commons.

“There is evidence that rates of cervical cancer are higher, particularly amongst Latina and Asian-Pacific Islander women in Los Angeles than the rest of the country,” said Dr. Beth Glenn, co-author of a recent study examining HPV vaccinations in low-income families.

The study, presented at the 2010 Annual American Public Health Association Exposition, found that only 29 percent of L.A. County parents, grandparents and guardians from low-income homes have had their daughters inoculated with at least one dose of the HPV vaccination. Vaccine uptake was significantly higher among those that had discussed the vaccine with a physician (81% vs. 19%) and had been offered the vaccine (97% vs. 3%), highlighting the importance of doctors in preventing cervical cancer.

Prevalent in most cases of cervical cancer, roughly 90 percent of all HPV strands are preventable by current FDA approved vaccinations.

Dr. Robert Kim-Farley – director of communicable disease control and prevention for the L.A. Department of Public Health – said the high level of cervical cancer incidents in L.A.’s Latina population is directly correlated to untreated HPV.

“There is a disproportionate level of screening for HPV in many population groups, including Hispanics, due to medical care access… especially those who do not have insurance,” Kim-Farley said.

Commonly referred to as the “common cold” of sexually transmitted infections, at least 20 million Americans are currently infected with HPV, according to the National Institute of Allergy and Infectious Diseases NIAID. Although there are 200 different known stains of HPV, the virus is often asymptomatic, increasing the importance of current vaccinations.

Kim-Farley said that there are roughly 12,200 new cases of invasive cervical cancer per year and 4,200 cervical cancer related deaths.

“The use of HPV vaccinations can prevent some 70 percent of all cervical cancers that we are seeing,” Kim-Farley said.

According to a 1999 study in the Journal of Pathology, “the presence of HPV in virtually all cervical cancers implies the highest worldwide attributable fraction so far reported for a specific cause of any major human cancer.” Additionally, the study shows that the extreme rarity of HPV-negative cervical cancers reinforces the rationale for HPV testing.

“The HPV vaccination is a pretty easy way to prevent a something that can be deadly,” said Liz Stillwell, a women’s health nurse for the L.A. Department of Public Health. “If it’s a preventable disease, why not get your daughter inoculated?”

Researchers recommend that all young women ages 9-26 be inoculated for HPV, regardless of sexual history.

There are currently two different HPV vaccinations approved by the FDA that are known to prevent many strains of HPV and cervical cancer: Cervarix a bivalent HPV2 vaccine that contains two types of virus antigen or killed viruses and Gardasil, a quadrivalent HPV4 vaccine which contains four types of virus antigens. To combat the disease, the vaccines initiate an immune system, anti-body response to the virus without infecting the patient.

The cost of the vaccine is about $120 per dose, or $360 for the full series and covered by Federal health programs and by many large insurance companies. However, the NIAID said that the current vaccines will not prevent about 30 percent of cervical cancers and 10 percent of genital warts caused by HPV.

Glenn said her team’s study suggests that education would greatly diminish the high HPV and cervical cancer rates amongst L.A.’s low-income families.

“Our research suggests that there is a lower awareness about the [HPV] vaccination amongst these families in Los Angeles County,” said Glenn, who also teaches at the UCLA School for Public Health. “We know that its one of the most effective ways to prevent cervical cancer at this time.”

The collaborative study was produced by the Los Angeles Office of Women’s Health and UCLA.

Although 2010 U.S. Census data shows that Latino families make up 48 percent of the total population of Los Angeles County, 34.6 percent of those families are uninsured, the largest percentage amongst ethnic groups in the county. Nearly half of Latino adults have not heard of the HPV vaccine, according to a 2010 report by the Los Angeles County Department of Public Health.

The report also highlights that Latinas report the poorest self-rated health status amongst all ethnic groups.

“In Los Angeles, too many women forgo basic health care – such as annual Pap smears – because they cannot afford it or because they lack health insurance,” said Sam Wald, Public Affairs Coordinator for Planned Parenthood Los Angeles.

Wald said the clinic’s 17 health centers across L.A. County accept patients of all incomes and ethnicities, regardless of insurance or ability to pay for services.

Although HPV is directly correlated to cervical cancer in women, Dr. Dennis Kelly, a men’s health care physician at the University of Southern California, said it is also possible for men to contract cancer from exposure to HPV.

“Whether you’re sexually active or not, everyone should be vaccinated to protect against HPV because it’s a preventable disease,” Kelly said. “With that said, the virus is directly linked to cervical cancer, another reason to be vaccinated… and in men, it can cause anal warts and cancer.”

When asked about the high rate of infection amongst Latina women, Kim-Farley echoed the need to educate not only low-income families, but also healthcare providers on the dangers of HPV.

“There has been a decrease in invasive cervical cancer amongst women as a whole over the past 50 years, but we are not seeing a similar trend in Hispanic families,” Kim-Farley said. “We need to continue to educate both families and vaccine providers that are seeing pediatric and young adults of the dangers of HPV and available vaccinations.”

 

To reach Benjamin Gottlieb, click here.

Follow him on Twitter @benjamin_max.



 

Buzz

Craig Gillespie directed this true story about "the most daring rescue mission in the history of the U.S. Coast Guard.”

Watch USC Annenberg Media's live State of the Union recap and analysis here.