Women, especially black women, might face a greater chance of dying of cervical cancer than previously thought, according to a study published Monday in the journal Cancer.
Estimates from previous studies may have been artificially low because they included women who had had hysterectomies, a procedure to remove the uterus. The new study suggests that black women are dying at a rate 77 percent higher, and white women are dying at a rate 47 percent higher, than researchers had previously thought. After adjusting for hysterectomies, cervical cancer killed 10 out of every 100,000 black women and approximately 5 out of every 100,000 white women.
“Your risk of cervical cancer is much lower after a hysterectomy, which generally removes the cervix,” Dr. Douglas Levine, the director of the division of gynecologic oncology at NYU Langone’s Perlmutter Cancer Center, who was not associated with the new study, told The Huffington Post.
Nearly 12,000 women were diagnosed with cervical cancer and 4,000 died of the disease in 2013, according to the U.S. Centers for Disease Control and Prevention.
The biggest risk factor for cervical cancer is contracting human papillomavirus, a sexually transmitted infection that most people get at some point during their lives. Other risk factors included smoking, using birth control pills for five or more years and having several sexual partners, according to the CDC.
Cervical cancer was one of the leading causes of cancer death among women until pap smears were introduced in the 1950s, according to the National Institutes of Health. In fact, cervical cancer incidence and death rates tumbled by more than 60 percent between 1955 and 1992.
Racial disparities in cervical cancer death rates persist
The new study didn’t examine why black women are more likely than white women to die of cervical cancer.
“Our research highlights the high rates and the disparities by age and race — now we need to figure out how to further reduce deaths due to this preventable disease in all women,” Dr. Anne Rositch, the lead study author and assistant professor of epidemiology at Johns Hopkins Bloomberg School of Public Health, told HuffPost. “Is it that they are less likely to be adequately screened or followed-up [with] after any abnormal screening test, or receive less effective treatment?”
An editorial that ran in Cancer alongside the new research indicates that might be the case. “Access to cervical cancer screening has been investigated as a significant contributor to racial disparities,” it reads.
And lack of access to regular screenings can also mean that cancer isn’t detected in its early stages, Levine said.
“Black women may be receiving less-than-standard treatments if they come from resource-poor communities where correct radiation therapy and chemotherapy may be difficult to deliver,” he said.
Black women also face higher rates of mortality for breast cancer than white women.
“The advancements in screening tools and treatment which occurred in the 1990s were largely available to white women, while black women, who were more likely to be uninsured, did not gain equal access to these life-saving technologies,” Bijou Hunt, an epidemiologist at Mount Sinai Hospital in Chicago, told Reuters in 2014.
HPV and cervical cancer are preventable
Although HPV is common, contracting the disease doesn’t have to be an inevitability ― especially since the advent of the HPV vaccine, which the Food and Drug Administration approved in 2006 for girls and in 2009 for boys.
Doctors and public health experts are frustrated because the HPV vaccine has been unpopular with squeamish parents who don’t vaccinate their kids because they don’t want to think about them having sex.
Approving the vaccine for girls before approving it for boys also may have created the false impression that the vaccine was gender-specific.
Men who contract HPV can spread the infection to their sexual partners, and are also at risk for HPV-related health problems, including penile, oral and anal cancers, according to the CDC.
That misperception may have hurt HPV vaccination rates among boys. In 2015, just 28 percent of 13- to 17-year-old boys had received all three doses of the vaccine.
Getting vaccinated is the easiest and most effective way to stave off potentially deadly HPV-related diseases, doctors say.
“Cervical cancer is generally a preventable disease with the combination of HPV vaccination and pap smear screening,” Levine said. “There is no reason why so many women need to be diagnosed with cervical cancer. “