THE UNMET NEEDS
Cervical cancer is still the leading cause of women's deaths from malignant diseases worldwide. Every year about 500,000 women get cervical cancer and 250,000 die. There are 1.7 billion women at risk in the world, but only 10%, at average, get cervical cancer screening protection.

In developed countries women are much better protected from cervical cancer with regular Pap test screening. For example, 50 million Pap tests are performed each year in the US, a cancer control measure that dramatically has reduced the mortality from this disease. However, there are still 20% women at risk in the US who do not participate. This Global Academy for Women's Helath is currently conducting a survey to assess the reasons why these American women do not get cervical cancer protection although (according to the survey) more than 95% of them are aware of Pap test and have real opportunity to get screening. We hope that women’s answers and their opinions about the current situation will help us to find the reasons and suggest ways to further improve the outreach. The situation is quite different in developing countries. There are still objective barriers for world-wide mass cervical cancer screening, e.g., cost of the test, lack of infrastructure to perform Pap test, no access for testing, fear of testing, lack of knowledge about cervical cancer and the possibility to prevent it (Pap test), uncomfortable pelvic exam and various cultural/religious restrains to visit gynecologist. As a result, in these areas only 1.2 % women at risk get cervical cancer prevention (according to data from 2005). These numbers are changing recently, but most of deaths from cervical cancer are still registered in the low-resource areas of the world. Apparently, further improvements of the Pap test are necessary to make it available and affordable for global cervical cancer screening.

In 2006 and 2007 the major breakthrough in the prevention of cervical cancer was achieved with the FDA approval of the fist HPV vaccine which, in short, it is saying that the vaccine could prevent infection with oncogenic HPV strains, which could cause a persistent HPV disease that could lead to the appearance of genital warts (condyloma acuminata) and/or cervical cancer. Although very conditional, this definition has raised our hopes that cervical cancer could be prevented by eliminating HPV infection as one of the main risk factors that intertwine with other risk factors, such as irresponsible sexual behavior or other sexually transmitted diseases. This perception has influenced health policy makers and has directed medical products industry towards development of new vaccines (to cover more HPV strains), new HPV tests (to detect minimal disease), and to education of public (to accept mandatory vaccination) and women (to accept change of sexual behavior).

We cannot overemphasize the importance of health education. The recently advertised HPV vaccination is creating dilemmas (particularly in the developed countries) who and when should be vaccinated, how long the vaccines are protective, and whether to replace the Pap test with vaccination and/or HPV testing alone. In the beginning of 2006, US Federal agencies regulating the cervical cancer screening and the manufacturers of HPV vaccines and HPV diagnostic tests, have issued information emphasizing the role (current and future) of cytological screening for cervical cancer, and giving the Pap test credit not only for what this test has done (reduction of mortality from cervical cancer for more than 85% between years 1955 and 2005), but also for its future role in an environment with HPV vaccination available. Women should continue with regular Pap test screening even if they have received the HPV vaccination.

To meet the educational needs, we have undertaken a serious task to prepare and publish a book on the issues related to cervical cancer. The book "What Every Woman Should Know about Cervical Cancer" was prepared by The Global Academy team and published by Springer (see below). This book is providing scientifically proven and medically correct facts should be one of these educational tools that can help women to make their own decision on this and similar dilemmas they may have about cervical cancer prevention, control diagnosis and treatment.

Nevertheless to all good intentions and efforts given to improve the safety of women against cervical cancer danger, there are still barriers for worldwide mass Pap testing, e.g., cost of the test, lack of infrastructure to perform Pap test, access for testing, fear of testing, uncomfortable pelvic exam, concerns from false-negative results of Pap test, or cultural/religious restrains to visit gynecologist. Even the most developed countries are not free of such barriers. Further improvements of the Pap test are necessary, but the education of women also remains very effective and least expensive prevention available.

The Global Academy for Women’s Health, Inc. is promoting education of women as the most affordable tool against cervical cancer. The true education is based on facts and the ability to separate reality from wishful thinking. Better education on cervical cancer is a general still unmet need. Insufficient understanding of this disease may cause unexpected problems – second epidemics instead of eradication. The permanent education is necessary for everybody, even for educators themselves.

Here is an example: The modern strategy for prevention of cervical cancer assigns equal weight to cancer prevention and cancer control measures. Because of these new hopes against cervical cancer, the huge infrastructure that has been built up to maintain millions of Pap tests for cervical cancer control is currently undergoing a pressure to “improve” the value of Pap test and to transform this “most successful screening test” into a diagnostic test that could provide more information as for guiding clinical actions. Such a pressure has added new methods to be performed on the same sample, and has increased the cost per test. The health insurance companies responded to the increased cost by extending the insurance-covered periods between tests from annual to 2-3 years, and are justifying this extension with statistical data based on different end-points (very few based on the survival).

Because this trend could continue, and fewer women could be subject to regular annual cervical cancer control, we have recommended that a new risk factor for cervical cancer be introduced. This risk factor is the absenteeism from regular screening. For details on this “policy-induced risk factor,” please see the book "What Every Women Should Know about Cervical Cancer". The Global Academy team believes that it is important to allow women to learn the truth about different options and to help them making educated decision when necessary. In spite of thousands of information provided almost daily by multiple media, we think that single, comprehensive, reference health-education information is still needed.

EDUCATION AS A TOOL FOR CERVICAL CANCER PREVENTION
As a part of its educational activity, The Global Academy for Women's Health has supported the preparation of the book “What Every Woman Should Know about Cervical Cancer,” which has been accepted by Springer Science, a well-known publisher of health education books, for publishing and distributing worldwide. The book will be available in the US in July 2008. (http://www.springer.com/
biomed/cancer/book/978-1-4020-6936-9). Springer is offering visitors to this site a 20% discount on the book when ordered at www.springer.com. To order at the discounted rate, you will need to enter the Springer Token: S2RAFs6e8w9G2Hy. For detailed instructions on how to use the Springer Token, please click here.

Members of The Global Academy team, Dr. Nenad Markovic and Dr. Olivera Markovic authored this book, which summarizes the current views of cervical cancer prevention, control, diagnosis and treatment, presenting them in a language understandable for general public. The book is aimed to bring to the readers the rationale for optimism and to provide guidance as how to gain knowledge and skills for critical thinking and making an educated decision when it will be necessary in their lives.

Click here to view the full text of the Introduction, Content and Afterward.

The book is intended to educate the general population of women about true and false information on cervical cancer, HPV infection and vaccines, responsible sexual behavior, other sexually transmitted diseases, cervical cancer detection methods, and the advantages and disadvantages of diagnostic and therapeutic methods as well as holistic medicine available to women worldwide. The purpose of this book is to improve education and reduce risk factors, to improve awareness of cancer control measures and to improve the outreach of women participating in screening. Its purpose is also to reduce fear of unavoidable death in women who face failure or preventive measures, get cancer and are facing fight against the progress of this disease.

However, this book also teaches women about reproductive system and its function, how to increase their level of wellness across all the six dimensions of health, about strategies for stress release applied in health and disease, emphasizing the humane side the fears and despair when women get “bad” results, and where to search for help; precisely, the book is intended to stimulate women to learn more and to actively participate in their treatment--to become advocates of their own health. Authors believe that this book will become a women's companion to turn to when they are motivated to increase their wellness and become healthier, as well as when they are frightened and insecure to learn more and need to diffuse the fear. "Knowledge is power", says one contributor in the "Real People Stories" section of this book; she is suggesting that women must learn more to control better their lives.

Although written in understandable terms and devoted primarily to general public (healthy women at all ages and their spouses, girls, parents with female children, women suffering from cervical dysplasia, cervical cancer, their families and caregivers), we hope that throughout the 250 pages there is lot of information that could well serve students and their instructors at colleges and universities, as well as health professionals involved in women’s health. We expect that the book will bring all readers the rationale for optimism and will provide guidelines as how to gain knowledge and skills for critical thinking and making educated decisions.

The Global Academy for Women's Health is planning to open an interactive page on this web site to enable readers of the book to exchange their thoughts, experience and questions. We would appreciate to hear from you whether such a page will be welcome. Please write to us via the e-mail address provided on the Contact page.

RESEARCH TARGETED TO ERADICATE (?) CERVICAL CANCER
Eradicating cervical cancer in the 21st Century is the motto of the newest worldwide campaign against cervical caner. The Global Academy is working hard to contribute to this great and noble cause.

As a part of its research activity related to the advancement of women’s health, The Academy is closely following BioSciCon’s R&D activity on the development of MarkPap® technology for cervical cancer control.

The biomarker-based MarkPap technology is developing in this spirit to provide a low cost, fast and reliable cytological screening easily applicable to large populations particularly in low-resources areas. At this moment of development, in addition to the first line of products (biomarker-based test, kit, collecting solution, control slides), the technology is promising new tools for improvement of HPV disease detection, simplification of specimen collection via home-testing, and automation of specimen reading and interpretation via telemedicine (telecytopathology systems). When these promises became reality, their combined advantages may dramatically increase the outreach for Pap test (or the improved alternatives) worldwide and save many more lives.

The Global Academy for Women's Health is following this women’s health related scientific research and the technology development and participates actively with advices and with limited support for presentations of the newest achievements at the national scientific meetings. The Academy is planning to participate in the cost of other health education publications and to further advise BioSciCon managers on important women’s health issues. The Global Academy current strategic goal is to join efforts to eradicate cervical cancer in 21st Century. The position on the issues related to the protection of cervical cancer is summarized in the book “What Every Woman Should Know about Cervical Cancer.”