With January designated as Cervical Cancer Awareness Month, we’re taking a closer look at that cancer, especially disparities among racial and ethnic minorities. Cervical cancer is largely preventable and highly treatable when detected early, but significant disparities in incidence and outcomes exist among racial and ethnic minorities due to various socioeconomic, cultural, and healthcare access factors (American Cancer Society, 2023).
Understanding disparities in cervical cancer
Did you know?
Henrietta Lacks, an African American woman from Baltimore, made one of the most significant contributions to cancer research and modern medicine without ever knowing it. In 1951, doctors took a sample of her cells during treatment for cervical cancer. Unlike typical cells, which quickly die outside the body, Lacks’ cells, known as HeLa cells, continued to grow and multiply. These “immortal” cells have since played a vital role in medical breakthroughs, including cancer research, the polio vaccine, and even COVID-19 treatments. Lacks’ story also raised important discussions about ethics in medical research and patient rights. Her legacy lives on impacting countless lives worldwide (Skloot, 2010).
Key statistics
With one death occurring every two minutes, cervical cancer is responsible for more than 270,000 deaths worldwide each year (Gaffney et al, 2018).
Higher incidence in minority groups: Black, Hispanic, and Native American Indian women in the United States experience higher cervical cancer rates than non-Hispanic white women (CDC, 2022).
- Black women are almost twice as likely to die from cervical cancer as non-Hispanic white women (National Cancer Institute, 2023).
- Hispanic women have the highest incidence rates among racial/ethnic groups in the U.S. (American Cancer Society, 2023).
- Native American Indian women in the Great Plains have a 50.5% chance of testing positive for HPV, with 17.6% testing positive for high-risk HPV types, which are strongly linked to the development of cervical cancer. (Lee, et al., 2019).
- Transgender men and non-binary individuals with a cervix are 37% less likely to be compliant with screening recommendations than their cis counterparts, thereby increasing their risk of cervical cancer (Dhillon, et al, 2020).
Contributing factors to disparities
1. Access to screening and treatment
Lower screening rates result from limited healthcare access, particularly for uninsured and underinsured women. Language barriers and a lack of culturally sensitive healthcare prevent regular screenings among some groups (CDC, 2022; Dhillon, et al, 2020).
2. Socioeconomic challenges
Those with a cervix in low-income communities may lack access to preventive care and timely treatment. Transportation, childcare needs, and the inability to take time off work hinder regular screenings and follow-ups (National Cancer Institute, 2023).
3. HPV vaccination disparities
Minority groups often have lower HPV vaccination rates, which increases cervical cancer risk. Limited access to the vaccine, along with cultural hesitancy, contributes to these disparities (American Cancer Society, 2023).
4. Awareness and education
Limited awareness about cervical cancer, screening guidelines, and HPV vaccination options exists among certain minority communities. The absence of targeted education campaigns addressing cultural values and language barriers exacerbates the issue (CDC, 2022).
Impact of disparities
- Diagnosis at later stages: Minorities are more likely to be diagnosed with cervical cancer at advanced stages due to barriers in accessing routine Pap tests and HPV tests (National Cancer Institute, 2023).
- Higher mortality rates: Late diagnosis and lower quality of care contribute to higher mortality rates among minorities, particularly Black and Hispanic populations (American Cancer Society, 2023).
Efforts to reduce disparities
- Community-based interventions: Programs that offer free or low-cost screenings, educate communities on prevention, and train healthcare providers in culturally competent care have shown success (CDC, 2022).
- Expanded HPV vaccination campaigns: Targeted efforts to promote HPV vaccination in minority populations are essential to cervical cancer prevention (National Cancer Institute, 2023).
- Policy initiatives: Programs such as the National Breast and Cervical Cancer Early Detection Program provide crucial screening and diagnostic services to underserved women (American Cancer Society, 2023).
Key messages
- Cervical cancer affects anyone with a cervix including transgender males, non-binary, and those born female at birth that still retain a cervix.
- Early detection saves lives: Regular Pap and HPV testing are critical for early detection.
- HPV vaccination is preventive: The vaccine can prevent up to 90% of cervical cancers and is recommended for both males and females (CDC, 2022).
- Accessible resources: Free or low-cost screening programs are available in many communities; women should consult their healthcare provider or local health department (American Cancer Society, 2023).
Addressing cervical cancer disparities in minorities requires comprehensive efforts that include education, access to preventive care, and policy changes. Increased support for culturally tailored interventions and healthcare provider training can bridge the gap in cervical cancer outcomes for minority women (National Cancer Institute, 2023).
Resources & continued learning
- Cervical Cancer Fact Sheet: Current vaccination and screening recommendations (ACIP, 2019)
- Cervical Cancer Elimination Initiative - Knowledge Repository (searchable data repository)
- Cervical Cancer: A preventable disease (Video)
References
American Cancer Society. (2023). Cervical Cancer Facts & Figures 2023. Retrieved from American Cancer Society.
Centers for Disease Control and Prevention (CDC). (2022). Cervical Cancer Awareness and Screening. Retrieved from CDC.
Dhillon, N., Oliffe, J. L., Kelly, M. T., & Krist, J. (2020). Bridging Barriers to Cervical Cancer Screening in Transgender Men: A Scoping Review. American journal of men's health, 14(3), 1557988320925691. https://doi.org/10.1177/1557988320925691
Gaffney, D. K., Hashibe, M., Kepka, D., Maurer, K. A., & Werner, T. L. (2018). Too many women are dying from cervix cancer: Problems and solutions. Gynecologic Oncology, 151(3), 539-545. https://doi.org/10.1016/j.ygyno.2018.09.016
Lee, J., et al. (2019). Human Papillomavirus Prevalence Among American Indian Women of the Great Plains. The Journal of Infectious Diseases, 2019:219, 908-915. doi:10.1093/infdis/jiy600
National Cancer Institute. (2023). Cancer Disparities Research. Retrieved from National Cancer Institute.
Skloot, R. (2010). The Immortal Life of Henrietta Lacks. New York, NY: Random House
