No woman should die of cervical cancer, a preventable and (if detected early) treatable disease, yet a new study found that women in the U.S. are dying from it at much higher rates than previously thought.
The study, led by researchers at Johns Hopkins Bloomberg School of Public Health and published in the journal Cancer on Monday, reexamined health data from 2000 to 2012. Previous studies showed mortality rates for black women in the U.S. was 5.7 per 100,000 and for white women, 3.2 per 1000,000. After this latest analysis excluded women who had hysterectomies (because a hysterectomy almost always removes the cervix, and thus they could not get cervical cancer), the numbers grew to 10.1 and 4.7, respectively.
That's a rate of 77 percent higher for black women and 47 percent higher for white women. Black women 85 years old and up had the highest mortality rate.
To add some perspective, the rate at which black women are dying is comparable to that of women in many poor, developing nations.
Cervical cancer is known as a silent killer because for most women, there are no obvious symptoms. It usually progresses slowly and starts from the cervix, also known as the neck of the womb, which connects the birth canal to the upper part of the uterus. In its later stages, symptoms may include abnormal bleeding or discharge.
Almost all cervical cancers are caused by the human papillomavirus, or HPV, which usually has no symptoms so it's hard for women to tell if they have it. That's why it's important for women to get regular Pap smears, which looks for precancerous cell changes on the cervix. There is also an HPV test that looks for the virus that you can talk to your doctor about and HPV vaccines, which prevents many cervical cancers.
But as the study shows, it is a myth that women over 65 do not have less risk of developing cervical cancer.
"These data tell us that as long as a woman retains her cervix, it is important that she continue to obtain recommended screening for cervical cancer since the risk of death from the disease remains significant well into older age," said Anne F. Rositch, lead researcher and assistant professor in the Department of Epidemiology at the Bloomberg School.
I have even more concerns going forward, with the (expected) repeal of the Affordable Care Act, which covers screening, and the closing of family planning clinics, which do much of that screening,
The study didn't explore why there's such a huge gap between white and black women, but some doctors think factors could include unequal access to screening and insurance coverage. The disparity also raises alarm for poor women of color.
"We have screenings that are great, but many women in America are not getting them. And now I have even more concerns going forward, with the (expected) repeal of the Affordable Care Act, which covers screening, and the closing of family planning clinics, which do much of that screening," Dr. Kathleen M. Schmeler, an associate professor of gynecologic oncology at the University of Texas M.D. Anderson Cancer Center, told the New York Times.
About 2.6 million black Americans gained health care coverage under the Affordable Care Act between early 2014 and late 2015. The overall uninsured rate declined from 22.4 percent to 12.1 percent for black Americans and 18.9 percent to 10.9 percent for women. President Donald Trump vowed to gut the ACA but we have yet to see an affordable and more accessible replacement. Repeal of the health law could cost 18 million people their insurance within a year.
If that happens, this really would be a matter of life and death for many women.