A new study published in Cancer, the official journal of the American Cancer Society, has found that the cervical cancer death rate is much higher than previously thought. The study also uncovered an alarming disparity between the death rates for black women and white women. Deaths from cervical cancer have always been higher among black women, but flawed methods have prevented health officials from realizing how much higher. Before the study, they estimated the death rate to be 5.7 per 100,000 for black women and 3.2 per 100,000 for white women. After correcting for flawed methodology, researchers have now discovered that the true rate is 10.7 for black women and 4.7 for white women. These results show the lack of effort taken to promote the well-being of women with cervical cancer, as well as the need for new health initiatives aimed at reducing the disparity among cervical cancer patients.
Hysterectomies & the Cervical Cancer Death Rate
Cervical cancer originates in the cells lining the cervix, the narrow opening at the bottom of the uterus that leads to the vagina. Women who have had a hysterectomy are immune to the disease. Hysterectomies are a common procedure in the United States, with as many as 1 in 5 women having had one. In the past, health officials had not accounted for hysterectomies when calculating the cervical cancer death rate. By including women without uteruses, they inadvertently drove down the number of deaths it caused. When researchers removed them from the new study, the true death rate was revealed.
Reasons for the Racial Disparity
Cervical cancer is one of the easiest cancers to prevent. It is caused by the Human Papillomavirus (HPV) and can be easily detected in its early stages by a pap smear. Cervical cancer is a slow-growing disease, so doctors recommend women only get pap smears every 3 to 5 years. If they find any signs of cellular change in the lining of the cervix that could become cancerous, doctors can begin treatment right away and halt the progress of the disease before it threatens a woman’s life.
Unfortunately, low-income women and women who live in rural areas get pap smears far less often than high-income women and women who live in urban areas. Researchers believe this is a cause of the racial disparity between black women and white women. Most women who develop cervical cancer have either never had a pap smear, or have not had one in the past 3 to 5 years.
Twelve percent of black women have also had a hysterectomy, compared with just four percent of white women, which explains the large increase in death rates in the new study.
Challenges for Treating Cervical Cancer
While cervical cancer death rates have been drastically underestimated (by 77 percent for black women and 44 percent for white women), the number of deaths from cervical cancer has been steadily decreasing by roughly two percent per year. Doctors credit the widespread use of pap smears for this decline. However, as demonstrated by the new study, challenges still remain. Efforts to improve the availability of affordable healthcare in black, rural, and low-income communities must increase. A targeted campaign aimed at increasing pap smears and follow-up exams, as well as reducing differences in care, could reduce the racial disparity the study uncovered and reduce death rates from cervical cancer.