BURLINGTON - When Allison Hicks was diagnosed with stage IIA cervical cancer in October 2004, members of her extended "tribe" in the Burlington area rallied to her aid. Her friends ran her errands, cooked her meals, cleaned her apartment and raised thousands of dollars at fundraisers to help her through the difficult months of recovery from radiation, chemotherapy and a radical hysterectomy.
Two years later, the 31-year-old labor and post-partum doula is once again healthy, and she's resumed her preferred role as nurturer and caregiver. This time, she's organizing the fundraisers to help other Vermont women avoid a similar fate. Hicks is founder of the Allison Hicks Foundation, the nation's first nonprofit devoted exclusively to the eradication of cervical cancer. On Saturday, January 20, the foundation is sponsoring a free cervical cancer screening day at Maitri Health Care for Women in Burlington. The event is part of a larger, statewide campaign to raise awareness of the prevalence of this deadly disease.
Vermont's rate of cervical cancer is significantly higher than the national average, according to figures from the Vermont Department of Health. While the number of actual cases is relatively small - approximately 31 women per year in the state - as many as one in three will die from the illness. And, bucking the national trend, older Vermonters appear to be contracting cervical cancer in ever-growing numbers.
Health-care experts say they were initially alarmed by those statistics, especially among women who are beyond childbearing age. At last count, 94 percent of the newly diagnosed cases in Vermont were among women 30 or older, and the highest rate was found among women between 75 and 79.
Still, Vermont Health Commis-sioner Sharon Moffatt sees reasons for optimism. For one, Vermont's high cervical cancer rate doesn't appear to be linked to any environmental factors unique to the state, or to a lack of quality gynecological services or public programs to help women pay for them. The single most important factor in addressing this problem seems to be educating women of all ages about the importance of regular pelvic exams and pap smears. This is especially vital because the likelihood of surviving cervical cancer, as with most other forms of the disease, increases with early diagnosis.
"I think to a large degree, it's all about education," says Dr. Julia Brock, an OB/GYN at Maitri. "Quite frequently, we see women who are done childbearing who think they don't need to be screened anymore."
On Saturday, Maitri is offering about 40 free pelvic exams and pap smears, along with a limited number of vaccines for human papillomavirus (HPV), the virus directly associated with cervical cancer. The Gardasil vaccine is highly effective against four types of HPV, including the two strains that cause about 70 percent of cervical cancer, according to the U.S. Centers for Disease Control and Prevention.
HPV is now the most common sexually transmitted infection in the United States. More than 20 million men and women are currently infected, with about 6.2 million new infections each year. It's most common in sexually active women and men in their late teens and early twenties. At least 80 percent of women will have acquired an HPV infection by the time they're 50.
One problem with the virus, Brock explains, is that it's typically asymptomatic - most women who have it don't even know it. This year, the state legislature will most likely debate whether to recommend making the HPV vaccine mandatory for all girls before they register for public school. The CDC now recommends it for all girls and women aged 11 to 26. (Currently, the vaccine is not considered effective in boys or men.)
However, a critical factor is the vaccine's high price tag. Unlike other childhood vaccines, which can cost less than $20 per shot, this one runs $360 for a series of three shots administered over a year. This weekend, the Allison Hicks Foundation is paying for 10 free vaccines. Merck, which manufactures the vaccine, also offers a program for subsidizing the cost.
The state's cervical cancer task force, of which Hicks is a member, is expected to issue a report to the legislature by February 1. Moffatt won't say whether it will recommend making the vaccine mandatory. Doing so could open up a number of other funding streams - private insurance, Medicaid and other public health programs - to help stop this deadly, but easily preventable, disease.