May 28, 2018
Racial Gap in Cervical Cancer Deaths
Health News

Racial Gap in Cervical Cancer Deaths

by Diane Domina  

The cervical cancer mortality rate in the United States is higher than previously estimated—and the disparity in death rates between black women and white women is wider, according to a recent study in the journal Cancer.

For the study, researchers used information about cervical cancer deaths in the U.S. from 2000 to 2012 from the National Center for Health Statistics. Unlike in previous analyses of the same data, however, the researchers excluded women who had undergone hysterectomy, which in almost all cases takes out the cervix and thus eliminates a women’s risk of cervical cancer.

Using this method, the researchers found cervical cancer mortality rates in black women to be 10.1 per 100,000 rather than 5.7 per 100,000, as previously estimated; rates in white women were determined to be 4.7 per 100,000 instead of 3.2 per 100,000. Black women older than 85 had by far the highest death rate from the cancer: 37.2 per 100,000. The hysterectomy-corrected death rates put black American women on par with women in some underdeveloped countries, according to the analysis.

The death rate from cervical cancer has declined annually in both black and white women over the last decade. But the new study shows both that the rate is higher than previously thought, and that there’s a wider disparity between black and white women than earlier estimates had shown. The study didn’t address reasons for the racial disparity, but our experts say they may include lack of access to and education about cervical cancer screening within the African American community. Screening is remarkably effective at preventing the cancer (by finding pre-cancers so they can be removed) or catching it in its early stages.

About 12,000 women in the U.S.—most of them over the age of 30—get cervical cancer each year, and about 4,200 will die from it in 2017, according to the American Cancer Society. Cervical cancer is one of five main types of gynecological cancer (that is, cancers that affect the female reproductive tract). It originates in the cervix—the lower portion of the uterus that connects the organ to the vagina.

Cervical cancer is highly treatable when it is found and treated early. It’s also the easiest gynecological cancer to prevent, because, unlike with most cancers, excellent screening methods are available. These include the Pap test (Pap smear) and the HPV test. Pap tests detect abnormal cervical cells, including a condition called cervical dysplasia, which may become precancerous or cancerous (malignant). The HPV test is used to detect human papillomavirus, a sexually transmitted virus that causes most cases of cervical cancer.

What to do

Cervical cancer screening is critical because the condition usually doesn’t cause symptoms in its early stages. Talk to your health care provider about which screening option—Pap or HPV test—is best for you. The answer may vary by age, personal preference, and other factors. Generally speaking, the guidelines below are reasonable for most women:

  • Women ages 21 to 29 should have a Pap test every three years.
  • Women under 21 should not be screened for cervical cancer. Women under 30 should not be screened for HPV.
  • Women ages 30 to 65 should have a Pap test every three years or be “co-tested” with an HPV and Pap test every five years. The latter is “preferred” by the American Cancer Society, American Society for Clinical Pathology, and the American Society for Colposcopy and Cervical Pathology.
  • Women over 65 should stop routine screening if they’ve had normal results in recent years and are not at increased risk, as should women who have had a hysterectomy with removal of the cervix for reasons other than cancer.

Also see Is the Pap Test Passé? and The Social Dynamics of Health.