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Cervical cancer is one of the world’s most preventable cancers. And yet, every year, it continues to kill more than 340,000 women around the globe. Its rampage shows no sign of abating. Recent developments in medical science have given us the means of eliminating this cancer, including an HPV vaccine with a record for preventing up to 90 percent of cervical cancer, increasingly effective screening tests for detecting it as pre-cancer, and – should cervical pre-cancer progress to cancer – sophisticated treatment methods for extending and even sparing lives. But the vast majority of lower-income countries and regions within higher-income countries either know little about this cancer or lack the resources or infrastructure to stop it. Without greater awareness and a global willingness to intervene, hundreds of thousands more persons with cervixes will die. It will require a passionate, sustained, collective effort to save them.
One of the great myths of cervical cancer is that it only strikes women in impoverished countries like Somalia or Sierra Leone – countries that struggle to feed their people, let alone inoculate them against cancer. And to some degree, it’s true: cervical cancer kills more poor women than wealthy ones. Yet, even amid affluence, cervical cancer assails women no matter where they live. Persons with cervixes in the United States and other higher-income countries are routinely denied the means or knowledge for protecting themselves against this disease – even while sharing space with some of the world’s wealthiest inhabitants. In fact, those with female reproductive systems are marginalized everywhere, and thereby receive unequal access to the interventions for preventing this deadly cancer. The sound science for ridding the world of cervical cancer requires universal intolerance of the inequities that flourish in every corner of the globe. The political, social, cultural, and financial obstacles for eliminating this cancer must be addressed and removed, one by one, in order to give all persons with cervixes a fighting chance.
If cervical cancer ravages a woman’s body like fire, then screening acts like a smoke alarm – detecting and even stopping that fire before it starts. Cervical screening tests also save hundreds of thousands of lives every year, are generally more affordable, and target a much greater age range than HPV vaccination. Still, limited access to comprehensive screening and follow-up leaves women across the world vulnerable to being burned by cervical cancer. In Africa, India, and parts of Asia and South America, less than 10 percent of women receive any screening at all. Higher-income countries, where cervical screening is widely available, face innumerable obstacles to increased participation. Screening is available in name only in many U.S. states, which limit eligibility for public health insurance or withdraw funding for low-cost clinics. In higher-income countries, non-White, immigrant, or low-income women typically receive less screening. Researchers attribute low uptake to racial biases, geographic challenges, medical illiteracy, and cultural irrelevancy. But as long as citizens tolerate inequity, thousands of persons with cervixes will forgo lifesaving screening measures.
Cervical cancer is a disease of inequity. Ethnic minorities – regardless of where they live – are screened less often, diagnosed later, and die more often from this preventable cancer. While most cervical cancer deaths happen in lower-income countries, persons with cervixes are increasingly dying in marginalized communities within higher-income countries. In these parts of the world, preventing and treating cervical cancer is considered a privilege rather than a right – a lofty ideal rather than a budget staple. The COVID-19 pandemic only exacerbated disparities in cervical cancer prevention and care, as fighting this illness took priority over issues like cervical screening and HPV vaccination. The pandemic laid bare the fragile state of women’s reproductive health care: how easily it could be disrupted by global public health emergencies. And yet, until global citizens call attention to worldwide political and financial disparities, it’s clear that geography, skin color, and the most emergent global health priority will continue to foster a wholly unacceptable rate of death by cervical cancer.
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