[Congressional Record Volume 150, Number 55 (Tuesday, April 27, 2004)]
[Extensions of Remarks]
[Page E660]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]


                NATIONAL CERVICAL CANCER SCREENING MONTH

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                         HON. MICHAEL G. OXLEY

                                of ohio

                    in the house of representatives

                        Tuesday, April 27, 2004

  Mr. OXLEY. Mr. Speaker, in honor of National Cervical Cancer 
Screening Month in January, I would like to bring attention to the 
tremendous opportunity our country has to make cervical cancer the 
first real victory in the war on cancer. For the first time in over 50 
years, we have a new screening approach that offers great hope for 
finally eliminating cervical cancer. We must seize this opportunity by 
ensuring that all women have access to the best tests available.
  Worldwide, cervical cancer is the second most-common cancer among 
women. Approximately 470,000 women are afflicted and 230,000 die each 
year, according to the World Health Organization. In the United States, 
incidence and deaths from cervical cancer have decreased by almost half 
since the early 1970s, largely due to widespread screening with the Pap 
test, according to the American College of Obstetricians and 
Gynecologists. However, research shows that cervical cancer rates have 
remained steady for the past few years. According to the American 
Cancer Society, over 10,500 American women will be diagnosed with 
cervical cancer this year and 3,900 will die.
  No American woman, however, should die of cervical cancer because it 
is nearly 100 percent preventable. It is a slow-developing disease that 
can usually be treated easily before abnormal cells develop into 
cancer. According to the American Cancer Society, when detected at an 
early stage, cervical cancer has one of the highest 5-year survival 
rates of all cancers. The key to prevention and successful outcomes is 
to screen women early using the best screening approaches possible.

  While the Pap test has gone a long way toward reducing cervical 
cancer rates, it is not perfect. It relies upon a visual examination of 
cervical cells, and errors in collecting the cells or interpreting them 
can lead to false-negative results. According to the Agency for 
Healthcare Research and Quality, the accuracy of the conventional Pap 
smear at identifying women with cervical cancer or precancerous 
conditions was only 51 percent. Newer, improved Pap tests bring that 
accuracy up to a range of 61 percent to 95 percent, depending upon the 
study cited.
  While imperfect, the Pap test has been so successful to date largely 
because it is done with high frequency. If cervical cancer or its 
precursors are missed in one screening round, they are likely to be 
detected in a subsequent screening round. At the same time, women who 
receive ``false-positive'' results from the Pap test usually undergo 
necessary follow-up Pap tests or other procedures.
  We know that a virus, human papillomavirus, (HPV) is the cause of 
cervical cancer. Studies show that it is found in 99.7% of cervical 
cancers and must be present for the disease to develop. Most people 
will be infected with HPV at some point in their lives, but their 
body's immune system will clear the virus without any noticeable 
symptoms. However, persistent infection over several years with high-
risk types of HPV can lead to cervical cancer in women. Persistent HPV 
infections are more likely to be found in women aged 30 and older.
  In 2003, a DNA test for HPV was approved by the U.S. Food and Drug 
Administration for routine screening in women aged 30 and over in 
conjunction with a Pap test. Numerous studies show that adding an HPV 
test to a Pap test can increase to almost 100 percent the ability to 
identify women with cervical cancer or precursor conditions. 
Additionally, HPV testing gives clinicians important information: the 
ability to identify which women are at increased risk of cervical 
cancer and who should therefore be monitored more closely to ensure 
that cervical cancer is not missed. Women who test negative with both 
tests can be better reassured, while reducing their need for 
unnecessary, invasive exams.

  Since its approval last year by the FDA, HPV testing has gained rapid 
acceptance in the healthcare community. Already, leading medical 
organizations, including the American College of Obstetricians and 
Gynecologists, the American Cancer Society and the Association of 
Reproductive Health Professionals, have updated their screening 
guidelines to include HPV testing in routine screening for women aged 
30 and over.
  These groups' guidelines recommend that, because HPV testing is so 
sensitive and because cervical cancer develops so slowly, that women 
can be safely screened with the combination of a Pap test and an HPV 
test every three years. Research shows that this can also result in 
lower long-term costs. With this approach, however, it is important 
that we not confuse infrequent cervical cancer screening with 
infrequent gynecologic visits. This essential annual exam also screens 
for such conditions as breast cancer, hypertension, osteoporosis and 
STDs. For many women, the gynecologic exam is their only opportunity 
each year for routine, preventive medical care.
  Major private insurers now reimburse for HPV testing as well as 
covering a woman's annual gynecologic exam. These include Aetna, Cigna 
and many Blue Cross Blue Shield plans. Last month, Kaiser Permanente, 
the nation's leading health maintenance organization, announced that 
its largest region will now offer HPV testing, along with a Pap test, 
as standard-of-care cervical cancer screening for all women aged 30 and 
over. Earlier this month, the nation's largest women's health practice 
in the country also announced that it will offer HPV testing to all of 
its patients who are 30 and over as part of their routine cervical 
cancer screening program.
  As the private healthcare system brings newer and better technology 
to women, we must make sure that all women have access to these 
advanced screening techniques. All women deserve to benefit from the 
most effective screening technologies available. Having advanced 
testing technology is the first step in eliminating cervical cancer.

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