1. OVARIAN AND CERVICAL CANCER: ARKANSAS STATISTICS Nancy Andrews Collins, M.D., MBA Associate Professor Department of Obstetrics and Gynecology College of Medicine University of Arkansas for Medical Sciences (UAMS)

2. OVARIAN CANCER 3 Main Categories with 30 different types 1. Epithelial 2. Germ Cell 3. Sex Cord - stromal

3. RISK FACTORS 1. Age 2. History of infertility 3. Personal history of breast or colon cancer 4. Family history (first degree relative) with ovarian cancer 5. Obesity

4. OVARIAN CANCER Incidence Rates by Race and Ethnicity Death Rates by Race and Ethnicity CDC 2013

5. OVARIAN CANCER STATISTICS 9 th most common cause of cancer death in women New cases per year: 22,240 in United States 2013 (3% of all new cancer cases in women) 188 were in Arkansas Deaths per year: 14,030 deaths in United States in 2013 (5% of all cancer related deaths in women) 150 of theses deaths were in Arkansas American Cancer Society 2013, Survellance Research

6. OVARIAN CANCER INCIDENCE RATES, ARKANSAS

7. OVARIAN CANCER INCIDENCE RATES

8. OVARIAN CANCER SIGNS AND SYMPTOMS Vague complaints 1.Bloating 2.Loss of appetite 3.Gas, indigestion and nausea

9. CERVICAL CANCER Most common of the Squamous Easy to detect Caused by: HPV (90%)

10. CERVICAL CANCER STATISTICS New Cases per year 12,340 new cases in the United States in 2013 150 were in Arkansas Crude death rate 3.7 and age adjusted rate is 3.3 (per 100,000) Arkansas Cancer Registry and American Cancer Society, 2013

11. CERVICAL CANCER INCIDENCE RATES, ARKANSAS

13. CERVICAL CANCER Incidence Rates by Race and EthnicityDeath Rates by Race and Ethnicity CDC, 2013

14. PAPSMEAR SCREENING From 2006-2010 Mortality rates from cervical cancer in women >50 DECREASED by 1.2%/year because of the Pap test National Cancer Institute

15. OPPORTUNITY IS KEY WITH HPV

16. PROGRESSION OF DISEASE

17. HPV VACCINATION HPV discovered in 1956 HPV linked as cause of cervical cancer in 1984 First vaccine approved by FDA in 2006 National Vaccination rates in 2012 = 53% in Arkansas = 41% (1 dose) and 18% for all 3 doses

19. CERVICAL CANCER EDUCATION AND PREVENTION PROGRAM 1. FY11 – Take Education and vaccine clinic to the community Participants mostly had never heard of HPV Parents stated they were not told to give the participant the vaccine 2. FY12 – ACIP recommendations changed, BOYS were added Consider school based clinics (increase capture per clinic) 3. FY13 – Central High School clinic well established 4. FY 14 – i. Survey physicians about vaccinations and documentation Add additional schools with 2-3 schools ready to start by FY 15 Pine Bluff High School approval received from Pine Bluff School District Education program held with 619 students participating First vaccination clinic – 96 vaccinated

20. PINE BLUFF HIGH SCHOOL HPV EDUCATION SEMINAR

21. THANKS TO ARKANSAS CANCER COALITION FOR THEIR SUPPORT