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The role of STDs in cervical, liver, and other cancers is not well recognized by health professionals and the public, and information regarding this link needs to be disseminated widely.
Therefore, the committee makes the following recommendation:
Government agencies and private organizations concerned with cancer prevention should support STD prevention activities as an important strategy for prevention of STD-related cancers. Agencies and organizations that fund research and other activities in cancer prevention (e.g., the National Cancer Institute at the National Institutes of Health, the American Cancer Society) should support biomedical and prevention-oriented research and programs related to STDs, and they should expand their public education efforts to include prevention of STDs as a means of preventing cervical, liver, and other STD-related cancers. As with the prevention of many cancers, prevention efforts for STD-related cancers should focus on the challenge of linking behaviors initiated during adolescence and young adulthood with health consequences that manifest much later in life.
The committee's discussion of, and recommended tactics for implementing, its four strategies for establishing a national system for STD prevention are now presented.
Promote Healthy Sexual Behaviors
Strategy 1 is to overcome barriers to adoption of healthy sexual behaviors. Barriers to effective STD prevention efforts include biological, social, and structural factors. Biological factors reviewed in Chapters 2 and 3 include preexisting or concurrent STDs, the impact of asymptomatic infections, the long lag time to clinical complications, increased susceptibility of women and female adolescents to sexually transmitted pathogens, lack of curative treatment for viral STDs, lack of vaccines against most STDs, and immunological factors. Many of these factors are difficult to alter. In addition, some social factors, such as poverty, inadequate access to health care, substance use, sexual abuse, and violence, are enormously complex issues, with solutions beyond the scope of this committee. However, the committee believes that the major social factor that contributes to the STD epidemic-the reluctance of American society to openly confront issues regarding sexuality and STDs-can eventually be overcome by a concerted long-term national effort. This issue is a major focus of Strategy 1. Tactics for addressing structural factors, such as the organization of clinical services, are described under Strategy 4.
Under Strategy 1, the committee recommends that (a) a new social norm of healthy sexual behavior be established, (b) knowledge and awareness of STDs be increased; (c) the mass media assist in efforts to reduce risky sexual behaviors;