Cervical Cancer and Black Women: When to Get Screened, Signs and Symptoms to Look Out For

Black women dying from cervical cancer at disproportionate rates to white women isn’t biological or genetic. Historically marginalized women, women of color, women from lower socioeconomic status, and women without health insurance continue to face structural barriers which impact their abilities to live happy, healthy lives.

According to the World Health Organization (WHO), cervical cancer is the fourth most common cancer among individuals with a cervix globally. Cervical cancer is not only preventable if caught early, but it can be cured and managed.

Despite this, Black individuals with a cervix are more likely to die from late-stage cervical cancer than any other racial or ethnic group in the United States. Factors like barriers to healthcare, racial discrimination, and distrust of the medical field prevent individuals from seeking care that could save their life.

This can lead to patients being diagnosed too late, leaving fewer options for treatment of this disease.

Statistically, where you live is an alarming factor in higher cervical cancer incidences and mortality among Black patients. These areas in the U.S. include:

For example, in Georgia, though cervical cancer diagnosis rates are nearly the same for both white and Black individuals with a cervix, data shows that Black patients are 1.5 times more likely to die from cervical cancer than white patients. Furthermore, Black individuals with a cervix over 70 are three times more likely to die from cervical cancer.

Black individuals with a cervix in Georgia are more likely to never have been screened for cervical cancer. Also, they are more likely to:

According to some studies, Black women with the same median household income as white women continue to die at higher rates. This is linked to:

In some cases, Black patients will see their provider, but they do not return for a follow-up. With cervical cancer being largely preventable, missing follow-ups can greatly impact prognosis. But gaps in education, misinformation, inaccessibility, and fear contribute to patients not returning.

Genital human papillomavirus (HPV) infection is the leading cause of cervical cancer. For about half of cervixes with HPV infection, the immune system can clear the HPV virus within six months, and in up to 90% of women within two years. But a persistent infection from high-risk human papillomavirus (hrHPV) infection causes cervical cancer.

Other risk factors include:

Because cervical cancer is largely preventable if addressed early, knowing the signs and symptoms is essential.

Tamika Felder is the chief visionary at Cervivor, a national nonprofit dedicated to cervical cancer advocacy and support. In 2001, at the age of 25, she was diagnosed with stage 2A cervical cancer.

“I lost my fertility after a radical hysterectomy, chemo, and radiation therapy,” Felder says. Although devastating, cervical cancer can be managed by medical interventions when diagnosed early.

Felder is active in educating on the signs and symptoms of cervical cancer. Signs and symptoms include:

Being proactive with screening is also extremely important.

“The body doesn’t always whisper or give warnings,” Felder says.

So, while there are symptoms like bleeding during or after intercourse, the best way to identify signs of cervical cancer is to get screened by your healthcare provider.

Kecia Gaither is a double board-certified physician in obstetrics and gynecology (OB/GYN) and maternal fetal medicine. She uses guidelines from the American College of Obstetricians and Gynecologists (ACOG) when screening her patients.

“Screenings are predicated on age and underlying comorbidities,” Gaither says.

ACOG recommends the following regarding screening:

“Patients with prior abnormal Paps, those with AIDS/HIV or other high-risk factors may require more frequent evaluation,” Gaither says.

Forming a relationship with your primary care physician (PCP) can be beneficial in identifying these underlying health conditions, so you and your PCP are aware of the increased risk of cervical cancer.

The additional role of nurses and nurse practitioners is to educate and provide information on prevention, screening, and treatment options.

“Nurses are trusted messengers,” Yolanda Lawson, MD, says. “Often their families, communities, and patients look to them for advice and guidance.”

Nurses and nurse practitioners are first-line providers for patients. Specifically for women’s health, the process of Pap tests and gynecological exams should be explained beforehand to the patient, so there are no surprises.

The processes should be reinforced by the provider performing the exam.

“The patient should understand the ‘when’s, what’s, how’s, and whys’ of the procedure,” Gaither says.

Lawson and Gaither suggest other ways nurses can advocate for their patients. They can:

There is already anxiety and fear surrounding a gynecological visit. Historically, minority populations also distrust the healthcare establishment.

“Increasing diversity in the healthcare workforce is an important factor to improve trust and communication,” Lawson says.

Nurses and nurse practitioners can also provide culturally competent nursing care while easing anxiety and fear. Culturally competent care can also improve outcomes, Lawson points out.

Nurses can provide culturally competent care in several ways:

Patients express anxiety as a reason to forego gynecological appointments. Nurses and nurse practitioners can help patients to follow-through with follow-up visits by:

To prevent cervical cancer, regular OB/GYN appointments and Pap tests are necessary. Three doses of the HPV vaccine are also recommended for individuals ages 15-45 years. The vaccine is given at 0, 2, and 6 months.

Researchers are also developing self-collected sampling as an option. It would serve in prevention and screening, especially for underscreened patients with a cervix.

The WHO created a plan on how to eradicate cervical cancer. By 2030, each country must achieve the following global points:

The deaths of 4,290 patients with a cervix in 2021, including disproportionately high numbers of Black individuals with a cervix, could have been prevented. These preventable deaths highlight the need for the federal, state, and local governments to support and guarantee that the human rights of future individuals are honored and protected.