America’s Cervical Cancer Crisis

Why Low-income and Medically Under-served Women Are Bearing the Burden and How to Improve Access to Care.

Each year thousands of US women die needlessly from cervical cancer, a highly preventable disease. Most of the burden falls on medically under-served communities – including low-income, black, Hispanic, Native American, and incarcerated women who face barriers to access care.

When it comes to saving their lives from cervical cancer, not all women in America have equal access, or equal opportunity to appropriate health care. Recent research has shown women from ethnic minorities in America suffer from cervical cancer incidence and mortality rates that are significantly higher than white women. Despite the national increase in cervical cancer screening over the last half century, which has led to a 75% decline in mortality from the disease, rates of cervical cancer deaths among women in under-served populations remain vulnerable. Of those American women who will be diagnosed with cervical cancer at some point during their lifetime, and the thousands who die each year from the disease, a disproportionate burden falls on medically under-served communities who face economic, cultural, linguistic or location-based barriers to care, such as in inner-city or rural areas.

As a virus-associated disease, cervical cancer spreads throughout a population propelled by the Human Papillomavirus (HPV). While the virus itself is randomly distributed throughout the population, shockingly,a 2017 study found black women and white women in the United States are dying from cervical cancer at rates 77% and 47% higher than previously thought, respectively. Furthermore, black women are being diagnosed at a later age than white women which has been attributed to lack of access to “timely, appropriate and high-quality care.”4 Most alarmingly, black women are dying of cervical cancer at a rate 41% higher than white women.

Meanwhile, Hispanic women, referring to persons of Mexican, Cuban, Puerto Rican, South or Central American, Dominican, or other Spanish descent, have the highest incidence of cervical cancer in the United States, especially around the Texas-Mexico border, lower Mississippi valley and southern Appalachia, with rates 40% higher than those in non-Hispanic whites. Native American women are nearly twice as likely to develop cervical cancer as white women.9 For these women, the remarkable success of the Pap smear at curbing cervical cancer as experienced by white urban women is still out of reach.

We believe there is an end in sight to these tragedies. From our experience, building digital tools for healthcare providers in 26 countries around the world, it is possible to address the lack of culturally-appropriate education about cervical health, and the constraints on resources for healthcare outreach that further entrench these seemingly intractable disparities in a cost-effective manner for high-quality health care

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