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Cervical Cancer Disparity Facts

Compared with White women, Black women are:
  • more likely to be diagnosed with cervical cancer
  • more likely to be diagnosed at a later stage of cervical cancer
  • less likely to receive optimal treatment
  • nearly twice as likely to die of cervical cancer
Compared with White women, Hispanic women are:
  • more likely to be diagnosed with cervical cancer
  • more likely to die of cervical cancer

NA=Native American 10.1, H=Hispanic 10.0,
B=Black 9.0, W=White 7.1, A=Asian/Pacific Islander 6.3
Source: National Cancer Institute Cancer
Stat Facts: Cervical Cancer

B=Black 3.4, NA=Native American 3.1,
H=Hispanic 2.5, W=White 2.0, A=Asian/Pacific Islander 1.7
Source: National Cancer Institute Cancer
Stat Facts: Cervical Cancer

Incidence

Black women. The incidence rate of cervical cancer is 22% higher in Black women than in White women. However, the disparity is much wider when rates exclude women who cannot develop cervical cancer because of a hysterectomy (removal of uterus and cervix), a procedure more common in Black women. One study found that after correcting for hysterectomy, incidence for cervical cancer was approximately 40% higher in Black than White women. From 2009-2018, cervical cancer incidence rates among Black and White women were stable.
Source:  American Cancer Society Cancer Facts & Figures for African American/Black People 2022-2024.

Hispanic women. The cervical cancer incidence rate among US Hispanic women is nearly 40% higher than among white women.
Source: American Cancer Society Cancer Facts & Figures for Hispanics/Latinos 2018-2020. Atlanta: American Cancer Society, 2018

Hispanics have a higher rate of cervical cancer compared with Whites. Hispanic women have an approximately 43 percent higher risk of cervical cancer incidence compared to White women.
Source: American Association for Cancer Research Cancer Disparities Progress Report 2022.

Hispanic women have a significantly higher incidence rate of cervical cancer and slightly higher mortality rate, with especially high rates occurring along the Texas-Mexico border.
Source: U.S. Preventive Services Task Force. Cervical Cancer: Screening (2018) 

American Indian/Alaska Native.  Compared to White people, AI/AN people had a higher incidence rate during 2014-2018 for cervical cancer.
Source: American Association for Cancer Research Cancer Disparities Progress Report 2022.

Screening

Black women. Several studies have found that African American women are screened for cervical cancer at rates similar to those for white women and that inadequate follow-up after screening and differences in treatment may be important contributing factors for their greater rate of mortality.
Source: American Cancer Society. Cancer Facts & Figures for African Americans 2019-2021. Atlanta: American Cancer Society, 2019

Asian American women.  Asian women also have lower screening rates, especially those who have recently immigrated to the United States and may have language or cultural barriers to screening.
Source: U.S. Preventive Services Task Force. Cervical Cancer: Screening (2018)

Strains of HPV

Hispanic women. Cervical cancer is caused by persistent infection with certain strains of HPV. These carcinogenic strains of HPV have a higher prevalence among Hispanic women.
Source: American Association for Cancer Research Cancer Disparities Progress Report 2022.

Tumor type

Black women.The higher mortality rate in African American women may be attributable, in part, to the higher than average rate of adenocarcinoma, which carries a worse prognosis than the most common type of cervical cancer (squamous cell carcinoma).
Source: U.S. Preventive Services Task Force. Cervical Cancer: Screening (2018)

Stage at diagnosis

Black women.  Racial differences in stage at diagnosis may be due to differences in the quality of screening and/or follow-up after abnormal results. Black women have lower survival than White women for every stage of diagnosis, likely reflecting disparities in access to care and receipt of high-quality treatment. 
Source: American Cancer Society. Cancer Facts & Figures for African American/Black People 2022-2024.

 

Black women are more likely than white women to be diagnosed with regional- or distant-stage disease. This may be due to differences in the quality of screening and follow-up after abnormal results. Lower socioeconomic status and lack of health insurance are also associated with lower screening rates and increased risk of late-stage diagnosis.
Source: American Cancer Society. Cancer Facts & Figures for African Americans 2019-2021. Atlanta: American Cancer Society, 2019

Hispanic women. The proportion of Hispanic women with cervical cancer who are diagnosed with localized disease is slightly lower than that in non-Hispanic whites (42% versus 44%, respectively).  
Source: American Cancer Society. Cancer Facts & Figures for Hispanics/Latinos 2018-2020.  Atlanta: American Cancer Society, 2018

Treatment

Black women. Black women have lower survival than White women for every stage of diagnosis, likely reflecting disparities in access to care and receipt of high-quality treatment. For example, one study found that among people diagnosed with early-stage disease, 17% of Black women did not receive surgery compared to just 9% of White women. Further, Black women are less likely to receive recommended radiation therapy for every stage of disease. 
Source: American Cancer Society. Cancer Facts & Figures for African American/Black People 2022-2024.

Treatment differences accounted for 47% of black-white differences in cervical cancer mortality. Lack of health insurance may explain 19% of the excess risk for blacks. Among early-stage cervical cancer patients, a greater proportion of black women (17%) failed to receive surgery, which is the standard of care, compared to white (9%) and Hispanic (12%) women.
Source: American Cancer Society. Cancer Facts & Figures for African Americans 2019-2021. Atlanta: American Cancer Society, 2019

5-year survival

Black women. The overall 5-year relative survival rate for cervical cancer among Black women is 56%, compared to 67% among White women, partly because Black women are more likely to be diagnosed with regional- or distant-stage disease.
Source: American Cancer Society. Cancer Facts & Figures for African American/Black People 2022-2024.

Hispanic women.  Five-year survival for cervical cancer is 72% among Hispanic women and 70% among non-Hispanic whites.
Source: American Cancer Society. Cancer Facts & Figures for Hispanics/Latinos 2018-2020.  Atlanta: American Cancer Society, 2018

Mortality

Black women. Cervical cancer death rates have declined steadily since the 1970s , mostly as a result of screening. Rates in Black women continued to decline by 2% per year from 2010 through 2019, but have stabilized in White women in recent years. Despite this progress, Black women remain 65% more likely to die from cervical cancer than White women, with an even larger disparity after rates are corrected for hysterectomy prevalence.
Source: American Cancer Society. Cancer Facts & Figures for African American/Black People 2022-2024.

The overall mortality rate from cervical cancer among African American women is more than twice the rate among white women (when adjusted for hysterectomy rate since this procedure removes the cervix). Mortality is higher among older African American women. 
Source: U.S. Preventive Services Task Force. Cervical Cancer: Screening (2018)

Hispanic women.  Despite steady declines, death rates in Hispanic women during 2012-2016 remained 26% higher than those in whites. 
Source: American Cancer Society. Cancer Facts & Figures for Hispanics/Latinos 2018-2020.  Atlanta: American Cancer Society, 2018.

Hispanic women have about a 20 percent higher risk of death from cervical cancer compared to White women.
Source: American Association for Cancer Research Cancer Disparities Progress Report 2022.

White women. Although white women overall have the lowest mortality rate from cervical cancer, white women living in geographically isolated and medically underserved areas (particularly Appalachia) have much higher mortality rates than the US average.
Source: U.S. Preventive Services Task Force. Cervical Cancer: Screening (2018)

American Indian/Alaska Native women.  American Indian/Alaska Native women have higher rates of cervical cancer mortality than the US average. Factors driving this higher rate may include (1) lower screening rates, with 16.5% of American Indian/Alaska Native women in 2012 reporting not receiving a Pap test in the past 5 years and (2) inadequate follow-up. 
Source: U.S. Preventive Services Task Force. Cervical Cancer: Screening (2018)

An average of 11 women die of cervical cancer each day in the United States. Half of them are in their 50s or younger.

Source: Cancer statistics, 2022. American Cancer Society. 

Why are Black women more likely to die from cervical cancer?

“There really isn’t a genetic difference that is causing Black women to die at higher rates of cervical cancer,” says Olivia Cardenas-Trowers, MD, a Mayo Clinic urogynecologic surgeon.

“It really has to do more with systemic racism. These disparities started way back when and have infiltrated the healthcare system and affected women’s access to resources and the health care that they need. This trickles down into poor outcomes.

Things that you might not even think of, like transportation, health literacy, even trust in their provider because of injustices that have happened in the past. These things affect their health care.

They may not undergo the typical screening that could catch a abnormality earlier and therefore these cancers may be diagnosed at later stages when the likelihood of mortality is higher. Also, they may have problems getting access to treatment. They may not have the finances to be able to undergo surgery, or chemo or radiation. So all of these can factor into the increased mortality in Black women.”

A 7-minute video from the Mayo Clinic

“There are not enough Black women sharing their stories, and I get why because there’s so much stigma involved”

“When I was a little girl growing up, I didn’t think one day I’m going to be  talking about HPV and cervical cancer,” Tamika Felder says about being a 22-year cervical cancer survivor.

Felder is one of thousands of Black women diagnosed with cervical cancer.  Black women are 22% more likely to develop cervical cancer than white women.

Unlike other cancers, where the cause is unknown, healthcare professionals know what causes cervical cancer, how to prevent it, and the risk factors. But Black women are 65% more likely to die than white women from this type of cancer due to stigma, lack of access to healthcare services, and biases.

“There are not enough Black women sharing their stories, and I get why because there’s so much stigma involved in it,” she says. “When we talk about vaginal health … in a lot of cultures and communities, it’s taboo to talk about those things. But the problem when we don’t talk about them is that more people are dying.”

Dr. Karen Patricia Williams, a preventative care cancer researcher who has spent more than 15 years educating women on cervical and breast cancer, says two things can be done to lower the risk of cervical cancer for Black women. The first is the healthcare system has to follow up with women who have abnormal Paps, and women should try not to jump to conclusions about what an abnormal test result means.

“It doesn’t mean that you are a whore,” she says. “At the end of the day, who cares what these people think because you’re talking about your health.”

Source: “What Black Women Need to Know About Cervical Cancer” on the Word in Black website (September 12, 2022)

Some Reasons for Higher Death Rates in Black Women

“We do think there are reasons why Black women have higher rates of cervical cancer mortality,” says Jennifer Caudle, MD, of the Rowan University School of Osteopathic Medicine in New Jersey.

“Access to care, the ability to get screened early, to get screened period. The type of cancer Black women get vs White women and the types of treatment they’re offered.”

“Those are some of the things that have been proposed as possibilities as to why we see these discrepancies.”

A 2-minute video from the PBS News Hour.

Where Rates of Cervical Cancer Are High

Cervical cancer rates have been dropping in the United States over the past several decades. But some groups continue to have high rates.

These include Black women in the South, Hispanic women along the US-Mexican border, and White women in Appalacia.

Also specific groups of Native Americans, Asian Americans, Alaska Natives and Pacific Islanders have higher rates. This is due in part to lack of access to screening programs.

A 3-minute video from the National Cancer Institute.

 

Alabama Has Highest Rate of Cervical Cancer Deaths

In Alabama, the rate of cervical cancer deaths is higher than in any other state.

Black women are twice as likely as White women to die from cervical cancer in Alabama.

Some of the barriers to access to care for women, particularly in Alabama, are access to consistent coverage for insurance. Also, there just aren’t enough doctors in rural Alabama. And because there aren’t enough doctors, transportation to the health system becomes a significant barrier.

A 5-minute video from Human Rights Watch.

"Some women didn’t talk to doctors about their reproductive health"

“I conducted over 20 interviews with Black women from South Georgia about their experiences accessing reproductive healthcare, as well as their knowledge about the cervical cancer disease and prevention,” says Olivia Coley Pearson.

“As I anticipated, lack of medical insurance, as well as lack of reproductive and obstetrical and gynecological services located in rural counties were among the substantial barriers faced by most rural women with limited or no reliable transportation, as well as inadequate broadband (if at all) and other sources of public information.

However, I was continuously astonished by stories that revealed the extent to which women were traumatized by the worst kind of neglect and abuse at the hands of physicians who were less compassionate or lacked the resources and training needed to equitably treat all patients.

Internalized trauma has led to decades of generational mistrust and fear. Some women shared that they didn’t talk to doctors about their reproductive health because of mistrust of doctors and the system.”

Pearson, a community-based researcher for Southern Rural Black Women’s Initiative and Human Right Watch, is the first Black woman elected city commissioner of Douglas, Georgia.

Source: Black women die disproportionately from preventable cervical cancer.

Hispanics and Cervical Cancer

Why Hispanic Women Are Still Dying From A Curable Cervical Cancer

by Sarah Felbin

A lack of health insurance prevents some from regular physician visits. Language is often another obstacle. For women who aren’t proficient in English, medical jargon and pamphlets can be frustrating to receive.

Girls grow up without receiving proper sex education, resulting in a lack of self-care, a lack of information towards their body, and their overall health.

There’s also the cultural expectation that a woman’s role is to be in charge of the household. Especially in the Latino community, you do everything, you put yourself last, you have to take care of everyone else’s needs.

See: “Why Hispanic Women Are Still Dying From A Curable Cancer” by Sarah Felbin on the Women’s Health magazine website (October 15, 2021)

"There are glaring racial disparities in cervical cancer deaths in the U.S."

“Although almost no one should die from cervical cancer, some groups—those that are historically marginalized and neglected in the US, including women of color, women living in poverty, and those without health insurance—die more often than others.

There are glaring racial disparities in cervical cancer deaths in the US and Black women die of the disease at a disproportionately high rate. Black women have a higher risk of late-stage diagnosis, and they are more likely to die from the disease than any other racial or ethnic group in the country.

In the state of Georgia, Black women are almost one and a half times as likely to die of cervical cancer as white women and these disparities increase at alarming rates as they age. Black Georgian women are more likely to have never been screened for cervical cancer, are diagnosed at a later stage, and have lower five-year survival rates.”

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