Bill in Alabama could help prevent cervical cancer and save lives of women

Selma, AL

Cervical cancer claimed an estimated 3,870 women nationwide this year with another 11,070 reported cases, according to the National Cancer Institute.

Cervical cancer is a disease in which malignant cells form in the tissues of the cervix, located at the lower end of the uterus, leading to the vagina, or birth canal. Infection of the cervix with human papillomavirus (HPV) is the most common cause of cervical cancer, but it’s important to know that not all women with HPV infection will develop cervical cancer.

State Rep. James Gordon, D-Mobile, has pre-filed a measure in the Alabama House that would require the State Board of Health to provide each parent or guardian of a female student entering the sixth grade information about infection and the immunization against HPV. Further, the measure would require each school that enrolls a sixth grade female to have the parents or guardians furnish to the school by the 20th day of the new school year a written statement to reflect the parent or guardians had received the information; the student has received or is receiving the immunization or the parent/guardian has decided not to have the student’s information handed over to the school.

Knowledge can save lives. Gordon’s attempt at educating Alabama parents and guardians is on target.

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California legislature passes HPV vaccine coverage bill

Sacramento, CA

The Legislature passed a bill Thursday to require insurers to cover vaccinating young women against the virus that causes cervical cancer.
The vote was 49-26, according to the announcement. The bill now heads to the governor's desk.

"This vaccine saves lives," said Assemblywoman Noreen Evans,

D-Santa Rosa, who represents Vallejo and was the bill's co-author. "California has more cases of cervical cancer than any state in the country. We routinely vaccinate our youth for other diseases. It's foolish not to add this vaccine to that list."

Assembly Bill 16 also requires health plans and insurers that include coverage for the treatment of cervical cancer to provide coverage for an annual cervical cancer screening test. The bill would expand existing preventative care coverage requirements to include vaccination for the human papillomavirus which causes most cervical cancer cases.

Approved by the Food and Drug Administration in 2006, the vaccine is 98 percent effective when administered to patients with no prior HPV exposure, Evans' office notes.

Current law fails to protect millions of women within the full age range - 11 to 26 - recommended by the FDA for receiving the vaccine, Evans' office added. The vaccine is administered in three doses over six months and costs about $360.

The American Cancer Society estimates that more than 11,000 new cases of invasive cervical cancer will be diagnosed in the United States this year. In California, almost 1,400 women will be diagnosed with the disease and nearly 400 will die from it.
AB 16 passed the Senate 25-13 last month. AB 16 mirrors Evans legislation that was vetoed by the governor last year.

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Pathologist lobbies congressman for local lab testing of Pap smear tests

Local lab makes its pitch when congressman comes calling.

Fredricksburg, VA

With a congressman in the house, Dr. Paul Hine lobbied for his laboratory.

His message: "The best practice is local practice."

Hine is chairman of the Department of Pathology and Laboratory Medicine at Mary Washington Hospital. Yesterday he and the laboratory staff hosted 1st District Rep. Rob Wittman, a Republican from Westmoreland County.

The Fredericksburg hospital officials talked with Wittman about federal funding for the Medicaid program, and about the testing requirements for laboratory technologists.

But the focus was on the benefits to patients of using a local, rather than national, laboratory. And to illustrate, the staff demonstrated for Wittman how it reviews Pap smears.

A Pap smear checks for cervical cancer and is usually part of a woman's annual gynecological exam.

Specimens are collected in doctors' offices and sent to laboratories such as Mary Washington's. There, slides are prepared and examined under high-powered microscopes.

A technologist peers through the microscope to find any abnormal cells. Hine compared it to hovering in a helicopter over a mall parking lot.

"Your task is to find which, if any, cars have left their doors open," he said.

Some of the slides are chosen randomly for a second look, and abnormal ones are checked by a pathologist.

"Over 50 percent of all slides are read by more than one person," Hine said.

The Pap test is seen as an effective way to identify abnormal cells that can become cancerous. Hine said it has been more than a year since he saw a slide from a patient with invasive cancer.

"The reduction in women's cervical cancer is phenomenal," he said.

Mary Washington's laboratory reviews 5,000 Pap tests each year. Yet that represents only 10 percent of the local market.

The rest are sent by doctors' offices to national laboratories such as LabCorp and Quest Diagnostics.

Patients have little choice in where the laboratory work is done. Health insurance companies, such as Anthem, believe they can get quality work at a lower price by contracting with national laboratories.

But Hine and Cindy Huffman, laboratory director, argued that patients and physicians benefit from the interaction that occurs at a local laboratory.

Huffman said it is common for a doctor to call or walk into Mary Washington's lab and ask the staff, "Can you pull this slide?"

"We believe quality is best measured by local knowledge," Hine said. "We're accountable to people in this community."

Wittman did not offer an opinion on the use of national laboratories, though he did appear comfortable in the hospital laboratory. He has an undergraduate degree in biology and worked for 26 years in the seafood safety division of the Virginia Department of Health.

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Cancer prevention advocates fight New Hamopshire budget cuts

Concord, NH

The American Cancer Society and other groups are asking Gov. John Lynch to preserve funding for smoking cessation and cancer screening programs.

The state had planned to spend $2 million on the programs, but that total was trimmed to $250,000 as part of the governor's broad budget cuts. The cancer society is fighting back with ads arguing that this is no time to retreat in the fight against cancer.

The bulk of the money was supposed to be used for tobacco prevention and cessation programs. The plan also called for establishing a free colorectal cancer screening program for people with little or no health insurance coverage and expanding a similar screening program for breast and cervical cancers.

Lynch has made $50 million in cuts across the state budget after determining that state revenue would not meet his original budget predictions. Though the cuts affect programs in the 2008 fiscal year, estimates suggest the shortfall for the next fiscal year may be more significant. Advocates are concerned that $4 million funding slated for next year may suffer a similar fate.

"It was a little disheartening to see that what can be given can be taken away really suddenly," said Peter Davies, a spokesman for the cancer society.

A spokesman for Lynch says the governor supports the cancer programs but faced tough choices in trying to balance the books.

"It's a good plan, a good program," said Colin Manning. "It was new money included in the budget, and unfortunately, we're faced with this economic downturn that's impacting revenues."

But Peter Ames, the cancer society's director of government relations, said New Hampshire is going to have to deal with cancer a lot longer than it will deal with a short-term budget shortfall.

"This was really a long-term investment in the state," he said.

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Mandatory HPV / cervical cancer vaccine moves forward in Iowa

Only two steps remain in Iowa's legislative quest to require insurance companies to provide coverage of vaccinations for the human papillomavirus, the major cause of cervical cancer.

The proposed bill was passed by an 81-16 vote of the Iowa House last week and referred to the Senate Human Resources Committee. All 16 House members opposing the measure were Republicans, six of them women.

Tuesday morning, the Senate committee, chaired by Assistant Majority Leader Joe Bolkcom, D-Iowa City, approved the measure and sent it on to the full Senate floor. The bill will need to pass through the Senate -- something that is considered likely -- and will need to be signed by Gov. Chet Culver. The law would take affect for third-party payment provider contracts, policies or plans delivered, continued or renewed in the state after Jan. 1, 2009.

"Cervical cancer is preventable," Bolkcom said. "The HPV vaccine is the best defense. This bill will ensure that health insurers make the HPV vaccine available and affordable to Iowa women. I expect the Senate to approve this bill soon." More >>

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Cervical cancer vaccine plan wins preliminary approval in Missouri Senate

Kansas City, MO

Thousands of parents would receive information about the availability of a cervical cancer vaccine under a plan that received preliminary approval Tuesday in the Senate.

The proposal, sponsored by Democratic Sen. Jolie Justus of Kansas City, would require state health officials to distribute the information to the parents of all girls entering the sixth grade in Missouri public schools.

The plan represents a major compromise between health advocates seeking to reduce the incidence of cervical cancer and religious conservatives who feared that the vaccine could lead to increased promiscuity among teen-agers.

The original proposals introduced last year would have required the immunization of 11-year-old girls against the human papilloma virus, just as children are now required to be vaccinated against polio, mumps, tetanus and other diseases.

U.S. Food and Drug Administration approved the vaccine in 2006, finding that it was effective in blocking four strains of the virus that cause some 70 percent of cervical cancers and 90 percent of genital warts. But because the papilloma virus is transmitted by sexual contact, many conservatives objected to the treatment. More >>

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