Study Finds That Cervical Cancer Mortality Rates Are Much Higher Than Previously Estimated

A recent study finds that the death rate from cervical cancer in the United States is considerably higher than previously thought and the disparity in death rates between black and white women is dramatically wider. The researchers state that the rate at which African-American women are dying from the condition is comparable to that of women in many poor developing nations, and what makes the findings especially disturbing is that when screening guidelines and follow-up monitoring are pursued, cervical cancer is largely preventable.

"This shows that our disparities are even worse than we feared," said Dr. Kathleen M. Schmeler, an associate professor of gynecologic oncology at the University of Texas M. D. Anderson Cancer Center. She added that the screenings are available, but many women in America are not getting them. It will draw more concern especially with the expected repeal of the Affordable Care Act, which covers screening, and the closing of family planning clinics, which conduct most of the screening.

Previous studies were not able to discover this racial disparity, as it was believed to have narrowed because cervical cancer death rates for black women were declining. However, this new study suggests that the gap is far greater than previously estimated.

Previous studies had placed the mortality rate for black women at 5.7 per 100,000 and 3.2 per 100,000 for white women but the new analysis places it the mortality rate for black women at 10.1 per 100,000 and 4.7 per 100,000 for white women. The new figures do not suggest a rise in death rate, which was recently placed at more than 4,000 a year in the U.S., but comes from a re-examination of existing figures, in an adjusted context, according to New York Times.

The death rates for cervical cancer are calculated by assessing the number of women who die from the condition against the general population at risk for it. The researchers only analyzed health data from 2000 to 2012 and excluded women who had hysterectomies. Hysterectomy is a procedure that removes the cervix and thus, the possibility that such woman will develop cervical cancer is sealed.

"We do not include men in our calculation because they are not at risk for cervical cancer and by the same measure, we should not include women who do not have a cervix," lead author and assistant professor of epidemiology at the Johns Hopkins Bloomberg School of Public Health, Anne F. Rositch noted. The study did not check reasons for the racial disparity, but some healthcare practitioners believe it could be the unequal access to screening, ability to pursue early warning test results and insurance coverage.

 A recent study, published in the journal Gynecologic Oncology, was conducted on 15,194 patients who have advanced cervical cancer. The researchers found that more than half of the participants did not receive treatment that meet the standard of care, and were mostly black and poor women.

The hysterectomy-corrected mortality rates show a correlation between African-American women with women living in some underdeveloped countries in Asia, Latin America, and Africa. Removing women who had hysterectomies from the analysis had a significant effect. Up to 20 percent of women in the United States have a hysterectomy, usually for problems unrelated to cancer, like excessive bleeding and fibroids which is prevalent among black women than white. Mortality and incidence rates are estimated to decline as more women receive HPV vaccines, which prevents cervical cancers, few years to come.

With the recent recognition of the slow progression of the condition, the success of the vaccine and more screening tests, guidelines for cervical cancer assessments have changed, with some women being screened every five years, depending on the circumstances. The guidelines states that screening should end at age 65 for women who have had two or three consecutive negative results, but the new study finds that higher mortality rates hit black women 85 years and older. Experts explained that the new findings do not necessarily suggest the need to alter the guidelines.

Even if the cervical cancer mortality rates are higher than previously estimated, the current screening recommendations for the condition are still adequate and more women should have access to screenings and the necessary preventive measures, says 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, according to CNN.

The condition progresses so slowly, with so many warning stages, which makes it highly unlikely that a 65-year-old woman who had met the requirements would subsequently develop the disease. The researchers published their findings on Monday in the journal Cancer.