The study found that previous estimates of cervical cancer death rates didn’t account for women who had their cervixes removed in hysterectomy procedures, which eliminates the risk of developing the cancer.
“Prior calculations did not account for hysterectomy because the same general method is used across all cancer statistics,” said Anne Rositch, assistant professor of epidemiology at Johns Hopkins Bloomberg School of Public Health in Baltimore and lead author of the study.
That method is to measure cancer’s impact across a total population without accounting for factors outside of gender, she said.
‘A better understanding of the magnitude’
The data were limited to only 12 states in the country, but the researchers noted that the data still provided a nationally representative sample of women.
Before the adjustment, the data showed that the cervical cancer killed about 5.7 out of 100,000 black women and 3.2 per 100,000 white women. After adjusting for hysterectomies, the rate was 10.1 per 100,000 black women and 4.7 per 100,000 white women.
The data showed that the racial disparity seen in cervical cancer death rates for black and white women was underestimated by 44% when hysterectomies were not taken into account.
“We can’t tell from our study what might be contributing to the differences in cervical cancer mortality by age and race,” Rositch said. “Now that we have a better understanding of the magnitude of the problem, we have to understand the reasons underlying the problem.”
“Racial disparity may be explained by lack of access or limited access to cervical cancer screening programs among black women when compared to whites,” said Dr. Marcela del Carmen, a gynecologic oncologist at the Massachusetts General Hospital Cancer Center, who was not involved in the new study.
“This gap and disparity need to be addressed with initiatives focusing on better access to prevention or screening programs, better access to HPV vaccination programs and improved access and adherence to standard of care treatment for cervical cancer,” she said.
The new findings add to the current understanding of cervical cancer’s impact on different communities, said Dr. John Farley, a practicing gynecologic oncologist and professor at Creighton University School of Medicine at St. Joseph’s Hospital and Medical Center in Arizona.
“Those who get cancer, many times, do not have access to screening,” he said.
Even though cervical cancer mortality rates are higher than previously thought, Farley said that he thinks the current screening recommendations for cervical cancer are still adequate. However, he added, more women should have access to screenings and other preventive measures.
Rositch said, “It may be that some women are not obtaining screening according to our current guidelines, not necessarily that guideline-based care is insufficient.”
How to prevent and screen for cervical cancer
“We have a vaccine which can eliminate cervical cancer, like polio, that is currently available, and only 40% of girls age 13 to 17 have been vaccinated,” said Farley, co-author of the editorial. “This is an epic failure of our health care system in taking care of women in general and minorities specifically.”
“Male HPV vaccination may have a greater effect on HPV transmission and cancer prevention in men and women than previously estimated,” the researchers wrote in that study.