What Group Gets Cervical Cancer Twice as Often?

This type of cancer is the leading cause of death among Hispanics—and tragically, it is almost completely preventable.

'Cervical cancer death is almost entirely preventable with Pap smears, but the incidence is much higher in Hispanics and they are more likely to die of it,' says Dr. David Wetter, an expert in health disparities.
Shari Roan is an award-winning health writer based in Southern California.

In this, the fourth in our month-long series on the disparities and inequities of cancer in the U.S. and beyond, we look at the group of American women who are especially hard hit by cervical cancer.

There's good reason to pay close attention to cancer statistics among Hispanics in the United States: Hispanics are the fast-growing minority population in the country. According to U.S. Census Bureau 2010 statistics, more than 50.5 million people identify themselves as Hispanic. That's 16 percent of the population and a 43 percent increase over the past decade. By 2050, about 30 percent of Americans will be Hispanic.

That means more new cases of cancers will be among Hispanics.

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Moreover, unlike whites and blacks, cancer is the leading cause of death among Hispanics. (Heart disease is the leading cause of death in the other groups.) There are several reasons for this, experts say. Two big ones: Lower incomes and reduced access to healthcare. About 27 percent of Hispanics are poor compared to 10 percent of whites. And about 31 percent of Hispanics are uninsured compared to 12 percent whites.

Hispanics also have lower cancer screening rates, which means the disease is more likely to be diagnosed at a later stage, when it’s less curable. Nowhere is that fact more apparent than among Hispanic women with cervical cancer. Here are some sobering stats from the Centers for Disease Control and Prevention (CDC):

•   The number of new cases of cervical cancer among Hispanics is 11.9 per 100,000 women—nearly double the number in white women (6.2 per 100,000).

•   The rate of cervical cancer among Hispanics is 11.8 per 100,000 compared to 7.1 per 100,000 among whites.

•   The death rates from cervical cancer among Hispanics is 3.0 per 100,000, compared to 2.1 per 100,000 in whites. The five-year survival rate for cervical cancer is 75 percent among Hispanic women and 71 percent among non-Hispanic whites.

What's so disturbing about the high toll of cervical cancer among Hispanic women is that the disease can be largely avoided altogether with vaccines, and deaths could also be avoided in women who develop cancer if more of them detected the disease early through Pap smears, says Dr. David Wetter, a professor in the department of Health Disparities Research, Division of Cancer Prevention and Population Sciences, at the University of Texas MD Anderson Cancer Center, in Houston.

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"Cervical cancer death is almost entirely preventable with Pap smears, but the incidence is much higher in Hispanics, and they are more likely to die of it," he says. "This is a cancer we could prevent in Hispanic women if they got the same opportunities for screening as other women."

It's estimated that as many as 80 percent of deaths from cervical cancer could be prevented by regular screening coupled with good follow-up and treatment. But too often Hispanic women don't go back to the doctor when they get an abnormal result from their Pap test. This seems to be a big reason why so many more Hispanic women die, says the American Cancer Society.

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The three-shot HPV (human papillomavirus) vaccine—now recommended for girls ages 11 and 12, although it can be given up to age 26—prevents infection from the major strains of HPV that cause cervical cancer. But HPV vaccination rates in Hispanic girls trail behind whites, with almost 75 percent of white girls ages 13 to 17 completing the three-dose series compared to just under 70 percent of Hispanic girls, according to the CDC.

The problem of cervical cancer in the United States is, in part, an extension of the crisis south of the border, experts say. Women in Mexico and Central and South America experience approximately triple the cervical cancer incidence and mortality rates of women in the U.S., largely due to a lack of access to screening in these countries. The highest rates of cervical cancer in the U.S. are among Hispanic women in the Midwest, likely due to large numbers of new immigrants from these countries.

How can we get more Hispanic women screened for cervical cancer earlier and encourage them to follow up if they get an abnormal Pap test result? Why do you think more Hispanic girls aren’t getting the full HPV vaccine?  

Shari Roan is an award-winning health writer based in Southern California. She is the author of three books on health and science subjects.

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