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Black Women in America and Cervical Cancer Prevention

NNPA NEWSWIRE — African American women are twice as likely as Caucasian women to be diagnosed with invasive cervical cancer and 2-3 times more likely to die from this diagnosis. Before we examine why this health disparity exists, let’s explore the historical gains that lead to the reduction of invasive cervical cancer diagnosis and deaths.

Published

8 years ago

February 25, 2019

Oakland Post

By Dr. Anisa Shomo, Director of Family Medicine Scholars at the University of Cincinnati in Cincinnati, Ohio and Health Columnist for the NNPA.

Many people may believe that cervical cancer is a problem of the past. Prior to the 1940s, it was a major cause of death of women of childbearing age. According to the National Institute of Health, invasive cervical cancer is now considered to be the 14^th cause of cancer deaths in women in the US. That accounts for approximately 4,000 deaths of women each year.

African American women are twice as likely as Caucasian women to be diagnosed with invasive cervical cancer and 2-3 times more likely to die from this diagnosis. Before we examine why this health disparity exists, let’s explore the historical gains that lead to the reduction of invasive cervical cancer diagnosis and deaths.

Before the 1940s, it was difficult to diagnose cervical cancer unless accompanied by significant symptoms such as bleeding, pain, and nausea were occurring, which caused women to present in the later stages. In 1943, Dr. George Papanicolau published a paper on his work to identify cervical changes as normal or cancerous via a microscope before invasive cancer occurred in an article titled “Diagnosis of Uterine Cancer on Vaginal Smear.”

In 1954, Dr. Papanicolau published his atlas for labs to learn how to identify cervical cancer using his method and this is now called a Papanicolau test or “Pap” smear. We now use this to screen for cervical cancer and catch it in its early stages. Cervical cancer caught in the early stages can be removed with very minor surgeries and in many cases, hysterectomy can be avoided.

In the 1970s, the HPV virus was being extensively researched as a possible link to cervical cancer. In 1984 Dr. Harald zur Hausen discovered that HPV 16 and 18 were major causes of cervical cancer. He later won a Nobel Prize in Science for this discovery. In the 1990s, Dr. Lowy and Schiller began working to create an HPV vaccine that could help prevent cervical cancer altogether. In 2006 the FDA approved the first HPV vaccines.

We now use the HPV vaccine to help prevent cervical cancer in the first place. This is especially important internationally since currently 500,000 women are diagnosed with cervical cancer each year and 275,000 of them will die of their disease due to low access to screening and treatment.

Cervical cancer has had such great advancements in treatment and diagnosis in the United States that even one death from this disease could be considered a failure of the system. But an estimated 700 African American women still die of cervical cancer each year. The three main reasons are: later stage at diagnosis, less aggressive treatment, and more barriers to care once diagnosed.

One reason cited for lack of timely screening is confusion of Pap smear with a pelvic exam causing a person to think that they have already been screened, although they may have had this exam for a different reason. Many African American women do not receive treatment due to comorbid conditions, advanced cancer, or refusal to be treated. In 2016, Nardi et al detailed some of the findings of multiple studies that indicate that lack of knowledge about cervical cancer may be the largest barrier to screening and treatment of cervical cancer in African American women.

Many women do not know that a Pap smear is a cervical cancer screening and do not realize that HPV is a known risk factor. They also may believe that if they are no longer sexually active, they no longer need to be screened which may contribute to presenting with cervical cancer in the later stage. There was also discussion that women feared hysterectomy would be needed and they did not desire to have this performed so they avoided screening.

In 2012, the American College of Obstetricians and Gynecology drastically changed the guidelines for cervical cancer screening. As of September 2017, the guidelines are:

Screening starting at age 21 with a Pap smear
Screening is now every 3-5 years with a Pap Smear and depending on age, HPV testing
HPV testing is recommended to start at age 30 but many physicians perform it at ages 21-29 with Pap smear

These changes have caused further confusion about the importance of cervical cancer and when a person’s next pap smear is due. This change occurred due to research demonstrating that yearly Pap smears were not better at decreasing cancer rates than when performed every 3 years. There was also concern about damaging the cervix with unnecessary procedures if screening too often.

The HPV vaccine has been FDA approved since 2006. It is currently recommended for use in all genders aged 11-26 and it was most recently approved to be extended for use up to age 45. The vaccine has been shown to be effective in preventing an estimated 90% of HPV related cancers. In 2015, the CDC studied the percent of women aged 19-26 who received at least 1 dose of the vaccine and it was found that African American women were 10% less likely to have started that vaccine.

Despite the many advances in cervical cancer screening, treatment, and prevention, African Americans women are more likely to be diagnosed with invasive cervical cancer and death as a result of late diagnosis. Increased knowledge about the purpose of a Pap smear and how often it is needed, the new treatments available that may prevent need for hysterectomy, and the purpose of the HPV vaccine may help reduce this health disparity in the future.

For Black American women receiving updated information about how to prevent cervical cancer is a matter of life or death. If our Black families and communities are made more aware of the advantages of early detection and diagnosis concerning cervical cancer, the current disproportionate mortality rates for Black women with this health problem in America will be dramatically reduced.

Dr. Anisa Shomo is the Director of Family Medicine Scholars at the University of Cincinnati in Cincinnati, Ohio and is a health columnist for the NNPA. She can be reached at drshomoknows@gmail.com

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Here is what you need to know about finding unique white elephant gift ideas that everyone wants to steal

The best white elephant gift ideas are funny enough to get a reaction but useful enough that people actually want to steal them. Look for gifts with a surprise factor, broad appeal, an inside joke, and just enough personality to spark some friendly competition. The wrapping paper comes off, the room goes quiet for half […]

Published

2 weeks ago

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Oakland Post

The best white elephant gift ideas are funny enough to get a reaction but useful enough that people actually want to steal them. Look for gifts with a surprise factor, broad appeal, an inside joke, and just enough personality to spark some friendly competition.

The wrapping paper comes off, the room goes quiet for half a second, and suddenly everyone wants the same gift. That is the sweet spot. A great white elephant pick should make people laugh, lean in, and start plotting their next steal before the turn is even over.

Should a White Elephant Gift Be Funny or Useful?

A white elephant gift can be funny or useful, but the strongest choices usually give people a reason to laugh and a reason to keep the item. A practical gift with an odd design, unexpected feature, or playful theme can get a reaction without becoming something the recipient immediately wants to give away.

The right balance depends on the group. Close friends and family members may enjoy a ridiculous gag gift because they already understand one another’s sense of humor.

A workplace exchange, neighborhood party, or mixed-age gathering usually calls for something with broader appeal. In those settings, humor works better when it is built into an item people could still use afterward.

It also helps to think about how quickly the gift will make sense once it is opened. A strangely shaped kitchen tool, oversized mug, quirky desk accessory, or unexpectedly fancy everyday item can create an immediate reaction. Guests understand the joke right away, while the item still has enough practical value to attract a steal.

Pure gag gifts can be harder to pull off. Something that exists only for the punchline may get a big laugh during the reveal and then sit untouched for the rest of the game. If the goal is to bring one of the gifts everyone keeps fighting over, usefulness gives the joke staying power.

Memorable Present Ideas: Creating Inside Joke Gifts

Inside joke gifts can make a white elephant exchange feel much more personal, especially when most of the group shares the same stories. The trick is choosing a reference that people will recognize quickly instead of building the entire joke around something only two guests understand.

You can turn a memorable vacation mishap, office catchphrase, family story, or long-running group joke into the theme of the gift. A personalized comic book can work especially well when it turns familiar people or a ridiculous shared moment into part of the story.

Think carefully about who the joke involves before ordering anything permanent. The gift should make the person feel included in the fun, not singled out for the wrong reason.

Can You Bring Something You Already Own?

Holiday gift exchanges can be a good place to re-gift something you never used, especially if it is unopened and clean.

The following can all work if they still look presentable:

A duplicate kitchen gadget
An untouched game
A decorative item
A sealed gift set
An unopened candle
A new travel accessory

The goal is to give the item a second chance, not use the exchange as an excuse to clear out damaged or unwanted clutter.

Take a close look at the packaging before wrapping it. Faded boxes, missing pieces, visible wear, or anything that looks obviously used can make the gift feel careless.

Wrapping Budget-Friendly Gifts

Wrapping can make gifts more entertaining before anyone even knows what’s inside.

Misdirection works especially well for fun party games. Put a small gift inside a much larger box. Use packaging from an unrelated household item.

Add harmless weight so guests cannot guess what they are holding. The reveal becomes part of the joke without changing the gift itself.

You can also lean into the theme of the exchange. Bright paper, oversized bows, reusable bags, or deliberately over-the-top wrapping can make an ordinary item feel more memorable. If the gift itself is already funny, simple wrapping may work better so the surprise stays hidden until the last second.

Frequently Asked Questions

Is Picking Last an Advantage in White Elephant?

Picking last can be an advantage because you get to see almost every gift before making your move. Instead of choosing blindly from the remaining wrapped presents, you can steal something that has already caught your attention if the rules still allow it.

That advantage depends on the house rules. Some games limit how many times a gift can be stolen.

Others lock an item once it reaches a certain number of steals. If the most popular gifts are already unavailable, the final player may have fewer strong options than expected.

The first player can also get another turn at the end in some versions of the game. That rule can balance things out, since the person who started with the least information may get one final chance to steal.

How Do You Plan White Elephant for a Large Group?

For a large white elephant exchange, set a firm spending limit and establish the stealing rules in advance.

Create a clear turn order before the game begins. Drawing numbers as guests arrive can save time once everyone is ready to start.

Keep the number of steals per gift limited so the game does not drag on. It also helps to have one person track which creative holiday presents have been stolen and when they are locked, especially if dozens of people are participating.

Can You Play White Elephant Virtually?

A virtual white elephant exchange can work over a video call, with one person keeping track of the turn order and each steal. Guests can either mail physical gifts ahead of time or use digital gifts that can be delivered once the game ends.

Set the spending limit and stealing rules before everyone joins. It also helps to decide how gifts will be revealed and who is responsible for sending each one afterward so the exchange does not become confusing.