Black Women and Cervical Cancer

Disclaimer: The content of this webpage is intended for informational purposes only. We strongly encourage our readers to use this information only as a preliminary resource. We disclaim any liability for the decisions made by anyone based on this information.

FACT: According to the World Health Organization (WHO), cervical cancer is among one of the most highly treatable gynecological cancers.

Black women seem to have more trouble clearing Human Papilloma Virus (HPV)—the virus that causes cervical cancer.

- Karuri, Asok et al. (2018)

“As many as 93% of cervical cancers could be prevented by screening and HPV (human papillomavirus) vaccination.” 

- Centers for Disease Control and Prevention (CDC)

Black women experience a higher mortality and morbidity rate from cervical cancer than any other ethnic group. 

- National Institutes of Health (NIH)

Although Black women have an overall higher rate of reported Pap smears, they have a lower rate of follow-ups for abnormal Pap results. Consistent follow-ups are important to help decrease the incidence of cervical cancer.

- Teresa K.L. Boitano et al. (2022)

What is Cervical Cancer?

Cervical cancer is a type of cancer that affects the cervix–the lower part of the uterus that connects to the vagina. Abnormal cells in the cervical tissue may become cancerous. If not removed, they may start to grow and spread into the cervix and its surrounding tissues. 

According to the American Cancer Society, cervical cancer has the potential to be virtually eliminated if detected and treated effectively. Since the implementation of screenings and vaccinations, the incidence of cervical cancer has decreased. With the proper approaches, the goal of eliminating cervical cancer may be achieved in the near future.

What are the Symptoms of Cervical Cancer?

In the early stages, cervical cancer usually does not cause any symptoms. Symptoms may begin to appear once the precancerous cells have turned into cancer and have begun to invade deeper into parts of the cervix or other pelvic organs. 

Common symptoms among women with cervical cancer in later stages include:

  • Vaginal discharge
  • Abnormal vaginal bleeding
  • Vaginal odor

These symptoms may be caused by cancer or other health problems, so it is important to see your doctor if you have any of these symptoms.

The Four Stages of Cervical Cancer

Cervical Cancer is divided into four stages: 

  • Stage 0: refers to Carcinoma in situ, a group of abnormal cells found in the place they first formed in the body. 
  • Stage I: denotes the presence of cancerous cells in the cervix. 
  • Stage II: signals that the cancer spreads to the upper two-thirds of the vagina or to the tissue around the uterus. 
  • Stage III: develops as the cancer spreads to the lower third of the vagina and/or pelvic wall and/or kidneys. 

Stage IV: occurs when the cancer spreads to the bladder, rectum, and other parts of the body (WHO).

Main Cause of Cervical Cancer

More than 95% of Human papillomavirus (HPV) types are directly linked to cervical cancer (WHO). HPV is a sexually transmitted infection with 14 high-risk types, but types 16 and 18 account for 70% of cervical cancers (Karuri, Asok et al., 2018). According to a study conducted by Duke Medicine (2013), the most frequent HPV types detected among Black women with early precancerous cervical abnormalities were 33, 35, 58, and 68.

Black Women and Cervical Cancer

According to NIH and CDC, Black women have the highest rates of morbidity and mortality from cervical cancer compared to other groups. This includes women with cervical cancers that are more prominent in other ethnicities, like the two major types of cervical cancer: squamous cell carcinoma and adenocarcinoma (ADC). Researchers found that Black women have the lowest incidence of ADC; however, they experience the highest mortality rate from it. 

A study conducted by Anne Rositch et al. from the University of Maryland School of Medicine found that the incidence of cervical cancer rose steadily with age, peaking among women ages 65 to 69, particularly in Black women. This was an 84% increase in incidence than previously reported because the study excluded women who had hysterectomies including the removal of their cervix because they are no longer at risk for cervical cancer. 

Though Black women are more likely to be screened for cervical cancer, they have a higher incidence and mortality rates than their white counterparts. Despite having resources such as screening and prevention available, Black women have to deal with many challenges that create barriers to follow-up procedures. These challenges include, but are not limited to a lack of:

  • Knowledge about HPV and cervical cancer
  • Healthcare coverage
  • Trust in healthcare providers
  • Health information
  • Work-place flexibility / time off
  • Help and support with family obligations
  • Transportation

Another factor that makes Black women more vulnerable to cervical cancer may be the length of time it takes for their bodies to clear the virus on their own. According to a study conducted in 2017 by Asok Karuri et al., Black women take about twice as long to clear their cervix of an HPV infection than their white counterparts. HPV infections usually clear the body within 18-24 months. However, in this study, it took an average of 60 days for 50% clearance of HPV in Black women. This is twice as long in comparison to white women. 

Although this may be a factor that is out of the patient’s control, one barrier that can be addressed in efforts to decrease rates of cervical cancer is to maintain a healthy patient-provider relationship. According to Teresa Thomas et al. (2021), self-advocacy may lead to improved person-centered care, improved management of symptoms, and a better quality of life. Don’t be afraid to advocate for yourself. Ask questions if you don’t understand something or if you feel you’d like to be more involved in your treatment decisions.

Learn more about cervical cancer

The Future of Cervical Cancer

Researchers are working on many fronts to better prevent, diagnose, and treat cervical cancer. They are also working on vaccines to treat cervical cancer, and they are developing surgical techniques that will remove localized cancers while preserving as much tissue as possible.

Clinical Trials

A scientist at University of Pennsylvania, has created a vaccine that is engineered to teach the immune system cells to recognize precancerous and cancerous cells. The study (2015) had promising results as 55% of 114 participants who received at least one vaccine dose showed regression of their precancerous lesions, meaning that the abnormal cells disappeared or converted to low-grade lesions. The regression rate was 49.5% in 107 participants who received the complete treatment of three vaccines. These results can be compared to the control group where 30% showed positive results. Among the participants who received all three injections, scientists could find no trace of HPV in the cervixes of 56 of the 107 women. Not only did the vaccine make their lesions disappear, but it also cleared the virus from their cervix. It was also found that in most unvaccinated patients whose lesions went away, the virus was still present, and many still had low-grade lesions. Therefore, the disappearance of the virus is a major bonus of the vaccine. According to the Wistar Institute, this clinically effective DNA vaccine for HPV cervical cancer has moved into a licensure trial. 

The approval of the vaccine would essentially stop the disease in a significant number of people while also keeping fertility intact.

Cervical Cancer Treatment