OB-GYN doc travels to White House to speak on HPV

For Dr. Linda Eckert, the reality of cervical cancer, and the inequity of it, hit home about 40 years ago when she was a medical student working in Liberia. 

A middle-aged woman, known to Eckert only as “Mama,” had come in at her son’s urging to find out why she felt like she was “dying inside.” The attending doctor made a quick diagnosis: cervical cancer. He could try to help manage the woman’s pain, but little more. 

Eckert, a UW Medicine OB-GYN, will speak at a White House conference about cervical cancer and its cause in most cases, the human papillomavirus (HPV). She wishes that scenarios such as Mama’s were no longer the case in Liberia and other low-resource countries, or even in the United States. But the reality is sadly different. 

“We have a preventable cancer which strikes women. It has continued mostly because of the inequity, the stigma, and the value of women in our cultures,” Eckert said. “In the United States, a woman is dying every two hours of a cancer. We have the tools, right now, to eliminate this statistic. We must do better.”

Eckert will discuss the health inequities of this disease at a White House Cervical Cancer Forum on Jan. 25 in Washington, D.C. The inaugural forum, part of the Biden Cancer Moonshot, is drawing leaders in the field. 

The event’s initial segment will be live-streamed. Smaller breakout sessions to follow will discuss priority challenges and potential solutions. 

“Women are the bedrock of our society,” Eckert said. “So many people have told me, when they were interviewed, that if this cancer had struck down men, it would have been gone 10 years ago.”

For the past two decades, she has worked to advance policy and prevention of the disease. 

Cervical cancer is nearly 100% preventable, Eckert noted, and can be treated if detected early. Yet it remains one of the most common cancers in women. The American Cancer Society estimates that 14,000 new cases are diagnosed and 4,000 women succumb to the disease every year in the United States. Global deaths attributed to the disease amount to about 342,000 per year, according to the World Health Organization, or around one person every two minutes.

Almost all cases start with HPV infection. Although there are many strains of HPV, roughly 70% of cervical cancer cases globally are attributed to two high-risk strains, known as HPV 16 and HPV 18.  

“By the time people have had three sexual partners, 50% will have an HPV infection. By the time people are adults, 80% will have had an HPV infection,” Eckert said.

Usually, the body’s immune system clears the infection on its own. However, if an infection involves a high-risk strain that persists for years, usually asymptomatically, it can lead to precancerous tissue changes and, potentially, cancer. 

That’s why routine screening is crucial, Eckert said. 

Screening includes a Pap smear to examine cervical cells to see if any are precancerous or cancerous. There’s also the HPV test, which detects infections caused by a high-risk HPV linked to cervical cancer.

Following up is also key, but the cost, which can run upward of $1,000, is beyond the means of some patients, she said. Or patients simply don’t understand its importance, Eckert added.

“We have a real breakdown between screening and follow-up care. We’re losing a lot of people.” 

And because HPV is a sexually transmitted infection, it still carries stigma in some circles, which can keep people from seeking the HPV vaccine and undergoing routine screening and keep parents from having their teens vaccinated. 

With vaccination, the right screening and free or low-cost follow-ups, “we have a real chance to make a difference. We really could eliminate this cancer,” Eckert said.

Material from this Right as Rain report was included in this release.

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