Say what you want about Chicago’s winter weather, sports teams, crime rate (though it still fails to rank among America’s top 10 most dangerous cities), and eyebrow-raising celebrity exports (we won’t name names, but the list keeps growing), but the city is also increasingly becoming a leader in health advocacy, particularly as it relates to confronting racial disparities in disease. For example, the breast cancer gap for black women in Chicago has narrowed from 68 percent to 39 percent since 2003—still a long way to go in eradicating that disparity entirely, but a literal lifesaver for those it affects.
As the Chicago Tribune reports, those advancements are in large part due to the efforts of the Equal Hope initiative (known as the Metropolitan Chicago Breast Cancer Task Force prior to November of last year), a “health equity nonprofit network of health care providers, community leaders and advocates.” Now, the initiative has added cervical cancer to its focus, with the goal of entirely eliminating the disease within Chicago.
Sound farfetched? Unlike breast and other types of cancers, cervical cancer is largely non-hereditary, almost 100 percent preventable and almost always caused by human papillomavirus (HPV) infections, a virus with over 100 strains, at least 14 of which are cancer-causing, according to the World Health Organization (WHO). Somewhat terrifyingly, HPV can remain dormant in the body and become active up to 20 years after initial contact. Nevertheless, with the advent of the HPV vaccine, available to individuals starting at age 9, the Tribune reports the country/continent of Australia is on track to eradicate cervical cancer by 2028.
But because HPV is a sexually transmitted disease (one that condom use cannot entirely prevent), there is often a stigma in discussing it, despite the fact that an estimated 80 percent of Americans will be exposed to the virus in their lifetimes—in fact, “40 percent of women with just one sexual partner get HPV within two years of becoming sexually active,” reports the Tribune. Men are also susceptible to developing cancers due to HPV and can transmit the virus.
“This is like the common cold,” says Anne Marie Murphy, executive director of Equal Hope.
Nevertheless, historically, Chicago has been worse in addressing the disease than most cities across the nation. According to the National Cancer Institute, the rate of occurrence has been 39 percent higher, while the mortality rate is 60 percent higher. Equally disturbing are the racial disparities within those statistics: “A black woman or Latina in Chicago is almost three times more likely to die of cervical cancer than a white woman,” writes the Tribune, citing data from the Chicago Department of Health’s Chicago Health Atlas.
“A lot of my patients with advanced cervical cancer come through the emergency room, so they come to us already with this giant mass and no idea what’s going on,” says Dr. Summer Dewdney, assistant professor at Rush University’s Medical Center’s Division of Gynecologic Oncology. “[T]his shouldn’t be happening. And it was happening to women of color almost all the time.”
“That, to us, was most striking,” agrees Dr. Nita Lee, assistant professor of obstetrics and gynecology at UChicago Medicine and a board member at Equal Hope. “Young African-American women are dying of this disease, and they shouldn’t be.”
As with most cancers, early detection is key, but in the case of cervical cancer— ironically, the same cancer that killed the “mother of modern medicine” Henrietta Lacks, prevention is paramount. Along with its name change, ahead of Cervical Cancer Awareness Month (January), Equal Hope launched a new campaign in November with the goal of helping “uninsured, underinsured and publicly insured women get quality screenings, diagnoses, and treatment for cervical cancer,” including access to the cancer-preventing vaccine.
Baseline preventive measures should include “a combination of vaccination and regular screenings for precancerous lesions of the cervix starting at age 21 (via Pap smears),” writes the Tribune, upon advice from Drs. Dewdney and Lee. And women over 45 should prioritize regular cervical screenings; most women diagnosed with cervical cancer hadn’t had a Pap smear in at least five years.
“The women that we see with this cancer are either women who haven’t been in for a long time because of (societal) barriers or their lack of thinking that these screenings apply to them,” Lee explains. And even women who’ve had hysterectomies may still be susceptible if their cervixes weren’t removed during the procedure. But as recognized by the CDC, most telling are the demographics, as “more black and Hispanic women get HPV-associated cervical cancer than women of other races or ethnicities, possibly because of decreased access to Pap testing or follow-up treatment.”
“When we find a new cervical cancer diagnosis, one of the questions I ask: ‘Have you been getting routine pelvic exams or Pap smears?’ And close to 100 percent of the time, they say my last Pap was 10 years or 20 years ago,” says Dewdney. “The reasons for that are many: ‘I lost my insurance; I’ve been taking care of my sick parents. I knew there was something abnormal, but I never followed up...Every woman that we see is a missed opportunity that somehow the system has failed. We want every woman to know that they should be screened.”