Huntsville doctor leads effort to improve gynecologic cancer care

Alabama Study Commission for Gynecologic Cancers releases report
Dr. Tyler Kirby
Dr. Tyler Kirby(Source: WAFF)
Updated: Mar. 12, 2019 at 9:48 PM CDT
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HUNTSVILLE, AL (WAFF) -A Huntsville Hospital doctor who oversaw a state commission on gynecologic cancers is speaking about some of their alarming findings.

Their report highlighted key issues faced by patients and provided recommendations.

Dr. Tyler Kirby with Tennessee Valley Gynecologic Oncology at Huntsville Hospital led a state commission to evaluate the status of gynecologic cancers in Alabama and compare it to national standards.

“What we were trying to find out is if there’s any weaknesses within our cancer care in the community, and areas we could improve to improve survival for women with gynecologic cancers such as cervical cancer, ovarian cancer, uterine cancer, etc.,” Dr. Kirby said.

The commission met monthly for the last year, compiled list of recommendations and presented them to Governor Kay Ivey and key members of the legislature last week.

“We found that unfortunately Alabama ranks next to last in most measures of gynecologic cancer outcomes and survival. At least 40 percent of patients with gynecologic cancers in Alabama never see a gynecologic cancer specialist,” Kirby stated.

That due to a number of factors, including a lack of knowledge from referring physicians and patient education as well as issues with transportation and access to care.

“A large majority of patients have to travel over 100 miles to get access to a gynecologic cancer specialist. It’s also caused by issues with funding and inability to pay for transportation to get cancer care,” Dr. Kirby explained.

Alabama is ranked very low in HPV vaccination rates but the state also ranks first in mortality from cervical cancer.

“Our goal from this point forward is use this as a launching pad to develop measures and ways to address these deficiencies that we have. The hope is that we’ll enact legislation or improve support from Blue Cross and other payers in Alabama to provide better care for patients with gynecologic cancers,” Dr. Kirby added.

(Source: WAFF)

Here's more on the issues and recommendations:

Issue: Prevention – 99% of cervical cancers and 90% of vulvar and vaginal cancers could be prevented through HPV vaccination. Alabama is ranked 45th in the country in HPV vaccination rates, with only 40% of teens age 13-17 having completed the vaccination series. Alabama also ranks first in mortality from cervical cancer. Recommendation: 1) Increase adolescent HPV vaccination rates through continuation of the Alabama Adolescent Vaccine Task Force, education of parents and providers, and consideration of innovative strategies to increase vaccination access across the state.

Issue: Early Diagnosis and Treatment – Treatment by a gynecologic cancer specialist improves patient outcomes and reduces mortality, yet 40% or more of Alabama patients are not referred to a GYN oncologist.

Recommendation: 1) Educate physicians to increase their knowledge about gynecologic cancers and to effect clinical changes for reducing delays in diagnosis and implementing standards of care.

Issue: Access to Care – Access to a gynecologic cancer specialist is geographically distant for many Alabama women – over 65% of Alabama patients have to travel over 100 miles to access the closest GYN oncologist.

Recommendations: 1) Increase access to non-emergency medical transportation. 2) Consider innovative strategies to decrease geographic distance as a barrier, including telemedicine and outreach clinics.

Issue: Awareness – Awareness of GYN cancer risk factors, prevention information, and signs and symptoms, is low among the general public. Many women mistakenly believe the pap smear screens for cancers other than cervical.

Recommendation: 1) Increase funding for and awareness of the Alabama Breast & Cervical Cancer Early Detection Program. 2) GYN cancer advocacy groups and healthcare providers should work in coordination with the Alabama Department of Public Health to increase public awareness.

Issue: Patient Support and Resources – Many GYN cancer patients in Alabama are not receiving resources for optimal survivorship, including genetic testing and counseling, patient navigation, survivorship planning, financial counseling, emotional support and hospice/palliative care.

Recommendation: 1) Health care providers and advocacy groups should coordinate to effect changes necessary to address these inadequacies where possible.

About the Alabama Study Commission for Gynecologic Cancers: Alabama Act 201886 established the commission in February of 2018. Members consisted of GYN cancer survivors, caregivers, medical and research specialists, and advocates. The commission was charged with studying the efficacy of existing efforts for data collection, early diagnosis, and treatment, as well as identifying unmet needs of patients and families, and issuing a report at the end of one year. On Tuesday, March 5th, the commission’s report was delivered to the Governor, the President Pro Tempore of the Senate, the Speaker of the House of Representatives, the House Chair of the Health Committee, and the Senate Chair of the Health and Human Services Committee.

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