[Thorpe] Welcome to Beyond the Data.
I'm Dr. Phoebe Thorpe, and here
with me today is Dr. Francisco Garcia,
the chief medical officer for Pima County in Arizona.
Thank you so much for joining us.
[Garcia] I appreciate the invitation.
[Thorpe] Today's session was on cervical cancer, and we heard
that 4,000 women each year, American women,
lose their lives to cervical cancer.
And it's the fourth leading cause
of death worldwide, yet it's preventable.
Your program has had made great strides
in detecting cervical cancer early.
Can you tell us what are some of the secrets of your success?
[Garcia] Well Phoebe, one of these I would tell you is
that that committee-based cervical cancer prevention is a
team sport.
And it starts off by bringing together local partners,
and it starts off by engaging with the state health department
who has been absolutely critical in our success,
the federally qualified health centers.
Fundamental to this is the big CDC investment
in the national breasts
and cervix cancer early detection program
which really has sort of created standards for us.
All those are elements to what is a community-based
comprehensive cervical cancer prevention approach.
[Thorpe] And you have community health workers too?
[Garcia] Yes.
You know, at that middle of everything,
in the middle circle, is the individual woman
and her peer group and her community and her neighborhood
and her family, and so for us committee health workers
and engaging with committee-based organizations
that do community health work
and community health outreach is really essential.
We believe that women are at the center of this,
and that they should drive the conversation.
[Thorpe] Excellent.
And you also.
Your programs have a lot of success
with vaccination rates for HPV.
What what are you what can you share with us
from that you've learned from there?
[Garcia] You know,vaccination has been a critical component
to everything that we've done in the space gosh
since before the vaccine was licensed, and one of the one
of the needs that we heard from our community
of women was the desire and the need to get more knowledge
about how HPV vaccination worked, about safety issues,
about acceptability issues, about side effects.
That happened at the same time
that we were developing our screening efforts
and strategies, and so, I think it was a bit
of serendipity honestly.
But I think because of that, we were able to make sure
that we had messaging
about vaccination very early on in the process.
[Thorpe] And so in the session today we heard
that it's a it's a complementary both screening and vaccination.
How do those two strategies work together?
[Garcia] You know in in the ideal sort
of setting you are screening the right women,
and you are vaccinating the right children.
For us, it's meant sort of really focusing
on the younger age demographic for that vaccination component
because because that way we can get away
with a two dose vaccine strategy and age-appropriate screening
for women over the age of 21.
Really sort of focusing in working
with committee-based organization
with federally qualified health centers with providers
to make sure that people are are being screened in a way
that is appropriate for their age.
[Thorpe] Okay.
So in your opinion, what else what else do we need
to to conquer cervical cancer?
[Garcia] If you think about cervical cancer prevention
in this country and if you think
about cervical cancer prevention worldwide, it will be a work
in progress for the near future.
We are constantly being challenged with issues of access
to care, with issues of insurance coverage,
with issues of social and cultural norms
that were changing, with issues of patient acceptability.
And very much in the same way
that our iPhones are constantly being updated, I think we need
to be updating our strategies.
The the key for us has been to to work with our partners
to be aware of what the Francis Medicaid rules are
with private insurance coverage requirements are to make sure
that we are able to deliver services
in a way that makes sense.
Ultimately there will always be a sub segment of folks
who are not benefit eligible, and at least in our case,
we will need to try to figure out how
to service that group of folks.
[Thorpe] That so everybody gets what they need.
[Garcia] Exactly.
[Thorpe] Yeah, yeah.
Lovely yeah.
If somebody wanted to know more
about the how they could contribute
to preventing cervical cancer where would you tell them to go?
[Garcia] So you know, I have really boring resources
that I usually direct people to with regards
to cervical cancer prevention.
I actually think that the the CDC resources are really
excellent, and I really credit the breast
and cervical cancer early detection program is really one
of the key fundamental foundational elements
in in the national strategy.
The other piece that I think is really excellent is the American
Cancer Society.
Very very excellent source for cancer prevention information
and for providers specifically for providers who are wrestling
with some of the clinical nuances the American Society
for colposcopy and cervical pathology I believe has really
really excellent apps.
Has really excellent materials tools that providers can use
to make sure that they are using evidence-based strategies
in the management of their abnormal screening results.
[Thorpe] Up-to-date too.
[Garcia] Absolutely.
[Thorpe] Like you said changing strategies.
Everybody's got to keep up-to-date.
[Garcia] Absolutely.
[Thorpe] Thank you so much for joining us.
[Garcia] Oh, thank you for having me.
[Thorpe] Yeah.
[Garcia] Appreciate it.
[Thorpe] Thank you for joining us for Beyond the Data.
See you next month.