Narrator: Coming up on Mayo Clinic Q&A, cervical cancer is
one of many health outcomes that disproportionately affects women
based on racial and ethnic backgrounds. The incidence of
cervical cancer is greater in black and Hispanic women
compared to white women. Today we'll examine these disparities
and learn the steps that all women can take to prevent and
treat cervical cancer.
Dr. Olivia Cardenas-Trowers: To help them get the best care,
establishing care with a gynecologic provider or primary
care provider that you trust is very important because if you're
able to dialogue with somebody that you trust, you feel more
comfortable sharing things that can help prevent you from
getting certain conditions, and they can help you navigate the
system better.
DeeDee Stiepan: Welcome, everyone to the Mayo Clinic Q&A
podcast, I'm DeeDee Stiepan, sitting in for Dr. Halena
Gazelka. While the rate of cervical cancer has been
declining for decades in the United States, health
disparities persist. According to the American Cancer Society,
Hispanic women have the highest incidence rate of cervical
cancer followed by non-Hispanic black women, and black women are
more likely to die from the disease than women of any other
race or ethnicity. Here to help us understand disparities and
cervical cancer is Mayo Clinic women's health provider and
urogynecologic surgeon, Dr. Olivia Cardenas-Trowers.
Welcome to the program. Great to have you.
Dr. Olivia Cardenas-Trowers: Thank you. I'm happy to be here.
DeeDee Stiepan: Why are non-Hispanic black women more
likely to be diagnosed with cervical cancer than
non-Hispanic white women?
Dr. Olivia Cardenas-Trowers: That's a great question. And I think
the best way to answer that is to remind people of a couple of
things. First of all, that race is a social construct. So, there
really isn't a genetic difference that is causing black
women to unfortunately die at higher rates of cervical cancer.
It really has to do more with historical background with
things like racism, and now systemic racism, these
disparities that started way back when and that have
infiltrated the healthcare system and have affected these
women's access to resources and therefore, some of the health
care that they need. And this trickles down into poor
outcomes, essentially.
DeeDee Stiepan: Black women are more likely to die from cervical
cancer than women of any other races or ethnicities. Why is
that?
Dr. Olivia Cardenas-Trowers: So, because of systemic factors,
like systemic racism and disparities, this affects
various things from these women's access to health care
systems in general, things that you might not even think of like
transportation, health literacy, even trust in their provider
because of injustices that have happened in the past. So,
because of these things, as you can imagine it affects their
health care. They may not undergo the typical screening
that could catch an abnormality earlier. And then therefore,
these cancers may be diagnosed at later stages. And, of course,
if that happens then the likelihood of mortality is
higher. Also, they may have problems getting access to
treatment. They may not have the finances to be able to
undergo surgery, or chemo/radiation. So, all of
these can factor into the increased mortality in black
women.
DeeDee Stiepan: What can black women do to reduce their risk of
cervical cancer?
Dr. Olivia Cardenas-Trowers: That's a good question. I think there's
two ways to kind of approach this question. One is what can
we do to decrease black women's risk of dying from cervical
cancer. So again, trying to address the factors that we know
lead to poor outcomes, the systemic racism, the
disparities, again access, so addressing those barriers. And
then from the patient standpoint, once they're in the
system, you know, essentially once they're in the system
supporting them, making sure that they have access to
treatment, the resources they need, the support so that they
can do routine screening so that they have access to the results,
if any follow-up or intervention is needed, being able to provide
that for them, or at least, you know, having some type of
support for them.
DeeDee Stiepan: So, what are the signs and symptoms of cervical
cancer?
Dr. Olivia Cardenas-Trowers: Sure, so for early cervical cancer
there actually really aren't any symptoms. It is not really
until later stages where you may see vaginal bleeding, whether
that's abnormal, so you're if you're still menstruating and it
seems a little bit heavier, or you're menopausal and then you
start bleeding again, or have bleeding after, or pain after
intercourse or pelvic pain, heavy discharge, those are some
of the more common symptoms of later stage cervical cancer.
DeeDee Stiepan: Can you talk about how cervical cancer is
diagnosed?
Dr. Olivia Cardenas-Trowers: Sure. So, cervical cancer is diagnosed
by tissue sampling. So, that's typically a biopsy, however, pap
smear screening can pick up the abnormal cells that can lead to
a diagnosis.
DeeDee Stiepan: And so, if diagnosed with cervical cancer,
what is it that black women can do to ensure that they get the
best possible treatment and care?
Dr. Olivia Cardenas-Trowers: So, in addition to supporting these
women, to help them get the best care, hopefully they are with a
provider that they trust, and essentially working with the
provider, expressing their preferences, their concerns, and
hopefully that provider listens, and also is able to address
those concerns so that the patient can navigate the system
as efficiently and thoroughly as possible so that she gets the
best care.
DeeDee Stiepan: What would you say if you had to say the most
important or one of the most important things that black
women need to know to protect themselves from cervical cancer?
Dr. Olivia Cardenas-Trowers: So, I think everyone should know,
including black women, is that HPV, or human papilloma virus,
is the leading cause of cervical cancer. And that's important
because one there is a vaccine that can be given as early as
nine-years-old, up to 45-years-old. So, even if you've
had HPV before, you can still undergo this vaccine if you're
between those ages. And it's also available for men which is
good. So, protecting yourself by getting the vaccine and then
getting routine pap smears because like I said earlier, you
know, unfortunately, when you're having the symptoms of cervical
cancer it is usually at an advanced stage. So, if we can
catch it with just a screening exam, obviously, outcomes would
be so much better. So, those are my two big things that I would
stress, get the vaccine, and then do routine screening.
DeeDee Stiepan: Both really important things to know. Is
there anything else that you wanted to add?
Dr. Olivia Cardenas-Trowers: You know, establishing care with a
gynecologic provider or primary care provider that you trust is
very important because if you're able to dialogue with somebody
that you trust, they'll be able to help you, you know, feel more
comfortable sharing things that can help prevent you from
getting certain conditions, and they can help you navigate the
system better.
DeeDee Stiepan: Very good. Good information. Our thanks to Mayo
Clinic women's health provider and urogynecologic surgeon, Dr.
Olivia Cardenas-Trowers, for joining us today to discuss
disparities and cervical cancer. Thanks so much.
Dr. Olivia Cardenas-Trowers: Thank you.
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