In Uncertain Time for Health Care, Study Finds Cervical Cancer Death Rates Higher Than We Thought

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NFL sideline reporter and “Dancing With the Stars” host Erin Andrews has publicly shared the news that she dealt with cervical cancer in late 2016 — the same week a study was published that found cervical cancer rates are actually much higher in the U.S. than previously thought.

In a moment of uncertainty surrounding health care — and particularly women’s health care — in the U.S., these two pieces of news are particularly jarring and act as a spotlight on the importance of regular cervical cancer screening tests and follow-up.

The study, published January 2017 in the journal “Cancer,” aimed to uncover accurate mortality rates for cervical cancer. Previous estimates failed to subtract women whose cervixes had been removed during hysterectomy (called a “total hysterectomy”), which eliminates the risk of cervical cancer. After this adjustment, the study’s authors found that death rates were much higher — especially for black women.

"Prior calculations did not account for hysterectomy because the same general method is used across all cancer statistics," Anne Rositch, assistant professor of epidemiology at Johns Hopkins Bloomberg School of Public Health in Baltimore and lead author of the study, told CNN.

For black women, the cervical cancer mortality rate nearly doubled from previous estimates, from 5.7 deaths per 100,000 women to 10.1 per 100,000 women. For white women, it increased from 3.2 deaths per 100,000 women to 4.7 per 100,000 women. Black women over the age of 85 had the highest mortality rate at 37.2 deaths per 100,000 women.

The good news is that the study still found that cervical cancer death rates were decreasing overall, at a rate of 0.8 percent per year for white women and 3.6 percent per year for black women, thanks in huge part to the use of the Pap test in cervical cancer screening.

The CDC calls cervical cancer “the easiest gynecologic cancer to prevent, with regular screening tests and follow-up.” Adhering to screening guidelines can help detect cervical cell changes early enough that they can be stopped before they become cancer.

But according to the American Cancer Society, women who do not have health insurance are less likely to have cervical cancer screening — most cases of cervical cancer are found in women who have not had a Pap test recently or who have never had one. Additionally, low-income women, women of color, and immigrant women are more likely to be uninsured.

For cervical cancer mortality rates to keep declining, continued and even increased access to screening is essential. President Donald Trump’s recent statements on his health care policy have left that accessibility up in the air.

In an interview with ABC’s David Muir in the first week of his presidency, Trump was clear that he aimed to replace the ACA but was vague on the details.

“Obamacare is a disaster. We are going to come up with a new plan, ideally not an amended plan, because right now if you look at the pages they're this high,” he told Muir. “We're gonna come up with a new plan that's going to be better health care for more people at a lesser cost.”

But when Muir asked whether Trump could promise that no one who has health insurance through the ACA will lose their insurance completely or end up with anything less than what they already have, Trump did not answer the question directly.

For low-income and uninsured women, Planned Parenthood is one popular source of affordable cervical cancer screening and follow-up treatment — but Planned Parenthood’s future is in uncertain territory as well: Trump has said that he plans to defund Planned Parenthood because of the abortion services it also provides. According to Planned Parenthood, only 3 percent of the services it provides are abortion services; it provides 270,000 Pap tests per year.

Cutting federal funding would, according to Planned Parenthood officials, result in patients being turned away and many programs being shut down, blocking some patients’ access to cervical cancer screening. And without cervical cancer screening, abnormal cervical cells can progress, unchecked, and become cancer, increasing rates of cervical cancer across the country.

Unfortunately, until the Trump administration’s policy becomes more apparent, the future of cervical cancer screening accessibility remains unclear.

For certain low-income and uninsured women, the CDC’s National Breast and Cervical Cancer Early Detection Program may be a solution. You can find out if you qualify for free or low-cost cervical cancer screening through the program on the CDC’s website.