African-American women in South Carolina more likely to have cervical cancer than white women

Dec 11 2009

African-American women in South Carolina are 37 percent more likely to have cervical cancer than white women and have a death rate that is about 61 percent higher, according to a study by researchers at the University of South Carolina's Arnold School of Public Health.

South Carolina ranks 14th in the nation in deaths from cervical cancer.

The study also found that African-American women in rural South Carolina are among the least likely to get recommended screenings, including the Pap test, that are key to the early detection and treatment of cervical cancer.

The findings from the study are reported in the December issue of the Journal of the South Carolina Medical Association, which has a series of articles and studies on cervical cancer in South Carolina.

The journal represents one of the first comprehensive statewide reports on cervical cancer incidence and mortality, said Dr. Saundra Glover, an Arnold School researcher and director of the Institute for Partnerships to Eliminate Health Disparities.

"This is a landmark, a stepping stone for us as we address cervical cancer among minority women," she said.

Eliminating health disparities is complex and involves many factors, including access to screening and follow-up treatment, Glover said.

"South Carolina has some of the greatest health disparities in the nation," she said. "This report gives us a better understanding not only of cervical cancer incidence and mortality among African-American women, but also shows the critical role that community groups have in working with doctors and other healthcare professionals and leaders to ensure that women receive screenings and follow-up care."

The report is timely, given the recent guidelines from the American College of Obstetricians and Gynecologists that called for less frequent cervical cancer screening among some age groups, Glover said.

Arnold School researcher Dr. Heather Brandt said that, although cervical cancer deaths nationwide have dropped 75 percent since the Pap test was introduced for screening, not all women have benefited equally from advancements in screening.

"Cervical cancer is a disease of poverty," she said. "Women of color, women living in rural areas and women living in poverty continue to develop cervical cancer and die at much higher rates.

"The reports in this journal highlight the challenges that we continue to face in addressing cervical cancer in the United States and around the world," she said.

A critical need in meeting these challenges is having community partners work with women in cities and rural areas around the Palmetto State.

Social worker Tiffany Stewart, a community liaison, said, "When community residents, community-based organizations and institutions that will be affected are involved in initiating and promoting a call to action, then permanent, successful change is more likely to occur."

One such effort is the Zeta Phi Beta Sorority Z-HOPE (Zetas Helping Other People Excel through Mind, Body and Spirit) Program, which is focused on increasing cervical cancer awareness among college students.

Among the findings reported in the journal:
• S.C. women who did not receive a Pap test were more likely to be over age 65, unmarried, have less than a high-school education and be from a non-Hispanic race group, including African Americans.
• Nearly one-fourth of women not receiving a Pap test lacked healthcare coverage and nearly 20 percent were unable to see a healthcare provider because of costs.
• A telephone survey of African-American and white women found that about half of the study's 1,002 respondents had "high" levels of knowledge about the human papillomavirus, a sexually transmitted infection that has been linked to cervical cancer. However, African-American women knew less about the virus than white women.
• A study of young women, ages 14 - 20, found that about 34 percent would not get the HPV vaccine because of cost.
• A study on the Upstate Witness Project, which addresses breast cancer and cervical cancer among African-American women, found that training "witnesses" and lay health advisers to be an effective method to reach women. The program was tested in African-American churches in Greenville, Spartanburg, Anderson and Pickens counties.
• A study of Latina women in South Carolina found that very few understood the purpose of the Pap test. Most Latina women sought healthcare for prenatal services.

Glover said the scientific articles, reports on community programs and editorials highlight the challenges of addressing cervical cancer in the Palmetto State.

"This journal is an important step in our efforts. The work reported here by scientists, doctors and community healthcare providers will enable us to enhance our efforts to address cervical cancer in South Carolina and throughout the United States," she said.

http://www.sph.sc.edu/health%5Fdisparities/