Gynecologic cancer confers a large burden among women in the United States. Several evidence-based interventions are available to reduce the incidence, morbidity, and mortality from these cancers. The National Comprehensive Cancer Control Program (NCCCP) is uniquely positioned to implement these interventions in the US population. This review discusses progress and future directions for the NCCCP in preventing and controlling gynecologic cancer. Gynecologic Cancer in the United StatesA pproximately 84,000 new cases are diagnosed and about 28,000 deaths occur each year from gynecologic cancer among women in the United States.1 Five cancers account for the vast majority of gynecologic cancer cases: cervical, ovarian, uterine, vaginal, and vulvar. Uterine cancer diagnoses are common; uterine is the fourth highest incident cancer among women in the US after breast, lung, and colorectal cancers.1 Ovarian cancer is the eighth most common cancer diagnosed; however, it is the fifth leading cause of cancer death among US women. Cervical, vaginal, and vulvar cancers are relatively less common than uterine and ovarian cancers; however, diagnoses and deaths from these three cancers still number in the thousands each year.1 The economic burden of gynecologic cancer is substantial in the US. In a single state (California) during a 1-year period, cervical, ovarian, and uterine cancers accounted for $624 million in direct health care costs and lost productivity due to premature death.2 Ovarian cancer was the most costly ($292 million), followed by cervical cancer ($206 million) and uterine cancer ($126 million).

Cancer is the second leading cause of the death in the United States (U.S.). The National Comprehensive Cancer Control Program (NCCCP) is a national, public health practice program funded by the U.S. Centers for Disease Control and Prevention. The NCCCP has been planning and implementing interventions to reduce the burden of cancer since 1998. Interventions are implemented across three areas primary prevention, early detection, and survivorship using health systems and environmental changes to promote sustainable cancer control. The aim of this chapter is to provide a summary of the NCCCP, and highlight specific examples of interventions and successes to aid cancer planning in other countries. Cancer plan analyses show that all NCCCP participant cancer plans address reducing tobacco use for cancer prevention and 98% contain activities to increase colorectal cancer screening. The vast majority implement activities to improve the quality of life following a cancer diagnosis (94%). Relatively fewer cancer plans contain activities to reduce radon exposure (42%), promote human papilloma virus vaccination (62%), and incorporate the use of genomics in cancer control (56%). The examples of NCCCP activities demonstrate success in controlling cancer and other non-communicable diseases through public health practice.