In January 2005, Governor Mark R. Warner issued Executive Directive 5, creating a task force to study the problem of cervical cancer among women in the Commonwealth. Jane H. Woods, Secretary of Health and Human Resources, chaired the task force which consisted of 20 individuals including physicians, college professors, and Virginia Department of Health (VDH) staff. The task force report was issued in November 2005, and included five recommendations. One of the recommendations was to “request the Joint Commission on Health Care to further study racial, ethnic, and cultural disparities in cervical cancer incidence to identify causes and develop a plan to address findings."

Rates of cervical cancer, though decreasing for women of all racial/ethnic groups, are still higher for minority women and the incidence of cervical cancer continues to increase with age for minority women whereas the incidence of cervical cancer for White women peaks in the mid forties. Further, Black women in our State are more likely to be diagnosed at an advanced stage of disease and have twice the mortality rate from cervical cancer compared to White women.

Higher rates of cervical cancer and mortality are primarily a result of racial and ethnic minorities being more likely to have lower socioeconomic status, lower levels of education, and, for some minority groups, a higher likelihood of cultural norms that discourage women from having regular Pap tests and pelvic exams. The result is a lower probability of initial screening and diagnostic follow-up which can lead to higher incidences of cervical cancer, a later stage of diagnosis, and ultimately the increased likelihood of mortality for minority women. Strategies which could significantly reduce these disparities include the school mandate for the human papillomavirus (HPV) vaccination, educational programs designed to be culturally appropriate for specific minority communities, and greater access to screening and treatment through such programs as Virginia’s “Every Woman’s Life." Based on the study findings, JCHC voted to take no action at this time.

On behalf of the Joint Commission and staff, I would like to thank Dr. Jennifer Young, Fellow of Gynecologic Oncology at the University of Virginia Health System, for her presentation, “HPV Vaccination of Women Aged 16-26 in Virginia" and Dr. Carl Armstrong, Office of Epidemiology, Virginia Department of Health, for his presentation on the current status of the HPV vaccine. Information from both presentations is included in the final report.

Kim Snead
Executive Director
June 2008