Cervical cancer is a common cancer that occurs when abnormal cells begin to grow in the cervix. Several factors can put women at risk, but the main cause of cervical cancer is a persistent infection by the Human Papillomavirus (HPV). While about 90% of women clear the cervical HPV infection on their own, there is a small percentage of women in which the virus will persist and lead to pre-cancer and cancer.

Compared to most other cancers, cervical cancer can usually be prevented through HPV vaccination and screening. Children as young as nine years old can receive the HPV vaccination, which prevents them from acquiring the virus, and women between the ages of 21 and 65 should get screened for cervical cancer.

In addition to educating the public regarding the importance of the HPV vaccine and regular screenings, it is vital that we, as a department, train future providers to implement proven research and apply evidence-based practices for our cervical cancer patients as well as those patients around the world.

The UAB Department of Obstetrics and Gynecology (OB/GYN) is committed to eliminating cervical cancer as a public health problem through unparalleled education, innovative research, and changing the public health practice in Alabama, the U.S., and globally.

Training Future Physicians

UAB OB/GYN’s Division of Gynecologic Oncology serves as a major referral center for patients with gynecologic cancer in the state of Alabama as well as the Southeast. Under the direction of our board-certified, award-winning faculty, residents and fellows have an unmatched opportunity for comprehensive, in-depth training with a large volume of patients – many of whom have cervical cancer.

“The prevention of cervical cancer depends on training tomorrow’s women’s health care physicians, including OB/GYNs and pediatricians, to ensure that, in addition to appropriate cervical cancer screenings, HPV vaccination occurs in a timely fashion,” says Charles A. Leath III, M.D., MSPH, professor and division director of the Division of Gynecologic Oncology.

Weekly, the department supports a referral clinic for women from across the state with abnormal cervical cytology results that need either additional assessment or minor office-based treatment biopsies.

The department also offers a well-established fellowship in gynecologic oncology. Upon completion of the program, fellows have the necessary skills to evaluate and manage patients with a variety of malignant and complex gynecologic conditions, including cervical cancer.

Research/Public Health Practice

Not only are our renowned Division of Gynecologic Oncology faculty members vital to the hands-on education of our trainees, but they also have an extensive portfolio of funded basic, translational, and population-based research from prevention to survivorship when it comes to cervical cancer. Much of this research has informed major changes in clinical and public health practice in the U.S. and globally.

The Department of OB/GYN has a bi-directional approach to global and rural health, creating opportunities to extend women’s health research and resources to other countries, take what is learned, and apply it in our own backyard. Likewise, the department uses what is learned from local studies to impact women around the world. The department’s cervical cancer research directly influences global and rural health practices that impact women’s lives through primary prevention, screening, and management.

Prevention

The department played a critical role in the development of the HPV vaccine. Dr. Warner Huh, M.D., professor and chair of the UAB Department of OB/GYN, originally helped evaluate the four-valent HPV vaccine known as Gardasil in 2006. He then went on to be one of 26 authors involved in the nine-valent HPV vaccine study that has proven to dramatically reduce the rates of cervical cancer and the number of cervical exams a woman must have in her lifetime.

“Now, we have a second-generation vaccine that protects against 90 percent of the HPV types that cause cervical cancer,” says Huh.

Isabel Scarinci, Ph.D., MPH, professor and vice-chair for Global and Rural Health for the UAB Department of OB/GYN, has been actively involved in the development, implementation, and evaluation of evidence-based strategies to promote the uptake of HPV vaccination. She has also played a role in establishing guidelines for HPV vaccination across different settings around the world based on the availability of resources.

Screening

Scarinci is leading a collaborative effort to end cervical center in Sri Lanka by means of HPV vaccination and screening. This is a project that led to her being named one of Rotary International’s six People of Action: Champions of Health for 2021. The project also includes training midwives to guide women during the cervical cancer screening process through a partnership between the Rotary Club of Birmingham, Rotary Club of Colombo, Sri Lanka Ministry of Health, and UAB.

“The impact of this project could transform cervical cancer screenings going forward – both globally and locally,” says Scarinci.

Additionally, Scarinci and colleagues were pioneers in exploring the acceptability and implementation of self-sampling for HPV testing among women who are reluctant to come to the clinics for cervical cancer screenings, and, subsequently, found that this approach is not only efficacious but also cost-effective.

To further promote cervical cancer screenings, in 2015, Huh led a group of cervical cancer screening experts in writing new interim guidance for women in the U.S. between the ages of 21 and 65 about the health advantages of using an HPV test alone, rather than the customary Pap smear, as the primary screen to find cervical cancer or its precursors.

Management

Leath is currently the Cervical Cancer Chair for NRG Oncology and the National Principal Investigator on GY006 - a clinical trial working to improve the effectiveness of chemoradiation for women whose cervical cancer is too large for a hysterectomy.

As a founding member of the National Cancer Institute (NCI) funded Gynecologic Oncology Group (GOG), the division offers patients access to cutting edge clinical trials sponsored by the NRG Oncology/GOG and other leading pharmaceutical companies.

The division is also well known for its expertise in cervical cancer prevention and treatment. It currently holds, in collaboration with Johns Hopkins, the only NCI funded Cervical Cancer SPORE.

“In conjunction with experts at Johns Hopkins University, we have the only Cervical Cancer SPORE in the country,” says Leath. “We are continuing to evaluate novel vaccination and treatment approaches not only for prevention of cervical cancer but to improve clinical outcomes for women that develop cervical cancer.”

Through unrivaled education and training, groundbreaking research opportunities, and the use of evidence-based approaches to change clinical and public health practice, the UAB Department of OB/GYN is leading the way for cervical cancer awareness, prevention, treatment, and survivorship in the U.S. and globally.