The phrase “health disparities” is in the news a lot these days, mostly – and understandably – in relation to Covid-19 and its impact on underserved communities and people of color. But it’s not a new concept. Health disparities – differences in health status between certain populations compared to more advantaged populations – impact communities across many diseases and pose a real-life danger to patients unless we act on them with the same urgency.
Take the day-to-day realities of my job, for example. As a physician specializing in obstetrics and gynecology, I know the incidence rate of cervical cancer among Hispanic women is 22% higher than it is for white women, and for African American women, it’s 14% higher.[i] Black women in the U.S. are not only two times more likely to die from cervical cancer than white women; [ii] in fact they are more likely to die from it than any other racial or ethnic group.[iii] This is all the more unfortunate because cervical cancer is preventable and, when diagnosed, highly treatable.
I see the impact of health disparities in cervical cancer every day, as well as a lack of understanding about what perpetuates it. As with so many issues, we can’t begin to solve the problem until we understand it better. A recent article in Contemporary Ob/Gyn noted that a significant contributor to health disparities in cervical cancer is access to, and options for, screening. That’s why it’s so disappointing that amid society’s growing awareness of health disparities, the American Cancer Society recently changed its guidelines on screening, which now advises fewer screening options and delaying the age to begin screening. They would no longer combine both the Pap test and HPV testing, called co-testing, which when used together screened for more cancers. For Hispanic and Black women whose cervical cancer rates are far too high, and whose screening rates too low, we need to make sure each cervical screening visit is as comprehensive as possible. It may save their life.
For women 21-29, Pap testing remains crucial. Since it was introduced in the 1950s, the Pap test has contributed to a decline in cervical cancer rates of more than 70%.[iv]
Despite the many advances we’ve made, more than 4,000 women in the U.S. still die of cervical cancer each year, and women of color are at unacceptably high risk. Cervical cancer is a threat that needs to be taken seriously through co-testing with the Pap test and HPV test. We know how to do better and these tests are better together. Let’s do them together – co-testing saves lives!