The XX Factor

The U.S. Cervical Cancer Death Rate Is Much Higher Than Previously Thought

When access to preventive vaccines and cancer screenings are cut, black women bear the brunt of the consequences.

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The U.S. rate of deaths from cervical cancer is much higher than originally estimated, according to new research published in the journal Cancer. The study found that racial disparities in cervical cancer death rates are also significantly wider than previously thought: Per this new study, black women face a cervical cancer mortality rate nearly twice as high as researchers previously believed.

Researchers from Johns Hopkins and George Washington University found that cervical cancer rates have been drastically underestimated because previous data analyses have included women who’ve undergone hysterectomies. These women no longer have cervixes, so they’re not at risk of developing or dying from cervical cancer. Since death rates are calculated by comparing the number of people who die from a disease to the number of people who possibly could contract and die from it, it doesn’t make sense to include women without cervixes in the population of those who are potentially at risk.

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“We don’t include men in our calculation because they are not at risk for cervical cancer,” the new study’s lead author told the New York Times, “and by the same measure, we shouldn’t include women who don’t have a cervix.” According to the Centers for Disease Control and Prevention, about 600,000 hysterectomies are performed each year in the U.S., mostly for uterine fibroids, menstrual disorders, uterine prolapse, and endometriosis.

The new research used data from the National Center for Health Statistics, collected between 2000 and 2012. It puts the cervical cancer mortality rate for black women at 10.1 per 100,000, a rate comparable to those of nations without anything close to the wealth and health care infrastructure of the U.S. The previous accepted rate for black women, uncorrected for women who’ve undergone hysterectomies, was 5.7 per 100,000.

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The death rate for white women rose from 3.2 per 100,000 to 4.7 per 100,000 when corrected. That means earlier estimates were underestimating the racial disparity in cervical cancer mortality by 44 percent.

These findings point to a lack of access to prevention and treatment among black and low-income women. Deaths from cervical cancer are almost entirely preventable when the highly effective HPV vaccine is paired with regular screenings, but parents of all races still aren’t reliably vaccinating their kids against the cancer-causing virus, in part because of puritanical beliefs about teens and sex. And for people without access to quality medical care, preventive measures like optional vaccines and routine screenings are some of the first procedures to fall off a patient’s priority list.

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As reproductive-health advocates and medical practitioners prepare for the likely repeal of the Affordable Care Act and congressional Republicans’ promised attack on Planned Parenthood funding, this study is a reminder that not all women suffer equally when reproductive health care gets more expensive and less accessible. When Planned Parenthood clinics close because federal funding gets cut, there will be fewer places for vulnerable women to access the cancer screenings they need. Insurers must cover all preventive care with no cost to the patient under the ACA. If it’s repealed, women of color and low-income women will bear the brunt of the dropoff in care, with deadly consequences.

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