Reducing Cervical Cancer Inequities

Guest Post by Amelia 'Amy' MacIntyre, Health Research and Policy Analyst

Community Health Centers’ Role in Reducing Cervical Cancer Inequities

1.Which segments of the U.S. population are disproportionately affected by cervical cancer?

The uninsured, the underinsured and those living in underserved communities in which health care services are scarce.  These populations include women in rural areas, the elderly, those with less formal education, and women of color.  For example, the mortality rate for African-American and Vietnamese women continues to be twice as high as for white women – and about 50 percent higher for Latinas.  Meanwhile, in rural communities, uninsured white women have some of the poorest access to routine screening of any patient population.  Thus, cervical cancer incidence rates vividly demonstrate inequities in our health care systems and outcomes.

2. How do Health Resources and Services Administration (HRSA)-supported community health centers address this health disparity?

Community health centers provide preventive health services, including Pap tests and HPV vaccinations, to any female, regardless of insurance status and/or ability to pay. As such, health centers play a vital role in redressing health disparities and delivering care to groups excluded in the health care system such as immigrants.

Here are a few community health center benchmarks related to cervical cancer in 2010:

More than 11 million patients served were women and girls, or 6 out of every 10 patients. Of that population, 69% were women over 20 – comprising the largest single patient-category in the system.

• In addition to HPV vaccines, health centers administered Pap tests to about 1.8 million women, resulting in 120,167 abnormal cervical findings.
• Of the 9,592 attending physicians in health centers, almost 1 in 10 was an OB-GYN specialist, accounting for more than 3 million patient visits-or 9% of the 34 million visits to health centers annually.

To find a HRSA health center near you or to download the free health center app, click here.

3. How does the Affordable Care Act (ACA) aid in these community health centers’ efforts?

Under the Affordable Care Act, cervical cancer screenings are already covered with no cost sharing for new health plans.  Furthermore,

The Affordable Care Act created the Community Health Center fund which will provide $11 billion over a five-year period to assist in the expansion, improvement and creation of new health centers throughout the country.

• In September 2011, the Department of Health and Human Services (HHS) made $700 million of these funds available to health centers: $600 million for current community health centers to expand operations and serve more patients and $100 million to help health centers address immediate needs.
• In August 2011, HHS awarded nearly $30 million to create the New Access Points program, which will help health centers delivery primary and preventive care to an additional 286,000 patients.

4. What does the future hold for increased access to cervical cancer preventive services, especially for the underserved populations that community health centers primarily serve?

Community health centers are poised to play a large role in increasing access to preventive and primary health care. Other provisions of the Affordable Care Act, including no-cost sharing for preventive services under private health insurance plans and non-discrimination protection for women with pre-existing conditions, also serve to bring down barriers to health care for women. Additionally, while greater research is needed, a recent study at the National Cancer Institute suggests that the HPV vaccine seemed to be about as effective whether women had 1, 2, or 3 doses; a development which may increase access to the HPV vaccine for women who seek it. 

With the nation spending over $1.4 billion a year on cervical cancer treatment, these basic preventive services not only provide crucial access to care to the most vulnerable of populations, but also serve to reduce health care costs overall by emphasizing prevention and reducing the need for costly disease treatment and emergency room costs.

Other Useful Links: To learn more about HPV in general, visit http://www.nlm.nih.gov/medlineplus/hpv.html
HPV and Cancer: http://www.cancer.gov/cancertopics/factsheet/Risk/HPV