Leadership void, not lack of money, slows efforts to address cervical cancer

"We focus on cervical cancer because it is likely the 'low-hanging fruit' opportunity to beat a cancer in this generation," said Beth Meyerson, a health policy expert at the IU School of Public Health-Bloomington. "We have the tools of HPV vaccination, screening and treatment; but uninsured women and women of color experience huge health disparities. This is the signal that we have a health system problem."

Meyerson and her research colleagues conducted interviews with 15 professionals working in programs involving cervical cancer. These included federal and state government breast and cervical cancer programs; women's health and cancer control; national advocacy organizations engaged in sexual health and cancer; legislative affairs; researchers working in cervical cancer intervention and evaluation; state coalitions engaged in cervical cancer efforts; and partners from industry working on diagnostics, therapeutics or vaccines.

The researchers identified numerous obstacles, including "paucity of state-level coordination exacerbated by a lack of cervical cancer inter-agency/program influence" that prevented comprehensive, streamlined systems of care.

A possible solution would establish state-level coordinated efforts across agencies, as done in Kentucky. Those involved would meet to set strategic goals that would align policies and programs. This would include agencies such as the state departments of health and state Medicaid programs. Addressing this likely would cost very little, Meyerson said, but the benefits would be substantial.

"The challenge is to help separately funded programs work together -- a very tall charge and one that public health administration grapples with perennially," she said.