PILOT PROJECT #2

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Cervical Cancer and the HPV Vaccine. Racial disparities in cervical cancer in the US are evidenced by higher cervical cancer incidence and mortality rates for 2001-2005 in African American women than non-Hispanic White women (Ries et al., 2008). In Tennessee, during 2001-2005 the cervical cancer incidence was 10.7 per 100,000 for African American women compared to 7.8 per 100,000 for White women (data provided from TN Cancer Registry, 2009). From 1998 to 2003, cervical cancer mortality in Tennessee decreased by 25% among Whites, but increased 22% among African Americans (Whiteside et al., 2007). Persistent infection with high-risk types 16 and 18 of HPV is known to cause 70% of cervical cancers. Since 2006 the FDA has approved two vaccines developed to prevent cervical cancer caused by these high-risk types of genital HPV (Gardasil and Cervarix), which are nearly 100% efficacious in preventing infection of HPV types 16 and 18, precancerous cervical disease, and resulting cervical cancer (FUTURE II Study Group, 2007; Rumbout et al., 2007). In other words, 7 out of 10 new cases of cervical cancer could be prevented by vaccinating girls before they become sexually active and are exposed to HPV. The Centers for Disease Control and Prevention (CDC, 2007) recommends the HPV vaccines for females ages 11-26 to prevent the majority of cervical cancers for those who are vaccinated before infection with one of the high-risk types of HPV. The vaccines (3 doses across six months) are available for free to all girls through age 18 under private insurance, Medicaid and/or the Vaccines for Children (VFC) program. In the 2009 National Immunization Survey, rates of initiation of the HPV vaccine were similar for African American and white girls (about 44%), but the rate of completion of the three required doses was lower for African American versus White girls (23% and 29%, respectively). In Tennessee, 43.6% of adolescents aged 13-17 years had received one or more HPV vaccine doses, similar to the national rate of 44.3% (CDC, 2010).