Cervical Cancer Disparities | Key Factors for Black and Latinx Patients
Dr. Abigail Zamorano of McGovern Medical School at UT Health Houston discusses disparities in cervical cancer treatment among Black and Latinx communities. She highlights key barriers—access to care, transportation, and caregiving—and shares strategies for patients and providers to improve treatment access and continuity of care.
[ACT]IVATION TIP
“Speak up about barriers—patients should seek support and resources, while providers must anticipate challenges and involve caregivers in care planning.”
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Transcript:
Lisa Hatfield:
Dr. Zamorano, what disparities have you observed in the treatment of cervical cancer among different demographic groups? And can you provide an overview of key barriers for Black and Latinx communities? And how can patients avoid or address these barriers?
Dr. Abigail Zamorano:
I say that the most significant barriers are also what are causing the disparities. The most significant barriers are typically in a patient’s ability to identify a problem and then to access a provider for a diagnosis and then ultimately access a provider team for treatment.
This is a multi-step process that really relies on patients’ ability to access care whether through a hospital setting, an emergency room or a provider if they have insurance or a clinic that can provide screening or diagnosis without insurance, which can be really challenging to find, and it’s a difficult system to navigate.
When patients are ultimately diagnosed with cervical cancer, the most common treatment is a combination of both chemotherapy and radiation. Unfortunately, this treatment is really time-intensive. It’s every day and must be completed within a certain number of weeks. And so it can be really hard on patients to access this treatment, whether it’s for transportation difficulties, because they live far from their clinic, or sometimes transportation difficulties even if they only live five minutes from the clinic.
It’s also really hard on patients who have, who provide child or elder care, who work, who speak languages other than English, who have other responsibilities. And so I do encourage both provider teams and patients to speak up about any barriers that they might foresee and in order to best address them in order to make the diagnosis and then the treatment as seamless as possible.
My [ACT]IVATION tip for this question is to speak up about barriers and this applies to both providers and to patients. I really encourage patients to think about what their provider is recommending and to think about the different things that they’re going to need in order to meet all of those goals. I encourage patients to lean on their support groups in their family and their caregivers, because they’re probably going to need a little bit of help through this process.
I also encourage providers to think about what their patients might need, think about where their patients live, what resources they have, think about what support groups they have at home and for providers to also pay attention to their caregivers. The caregivers of patients are so important for patients to complete their therapy. And a lot of times we don’t ask the caregivers how they’re doing and what they’re going to need to help their patients. And so including the patient and the caregiver in the discussion is really important.
Lisa Hafield:
Okay, thank you, that’s great. And I do have one follow-up question in talking about barriers, particularly with access. So you have a clinic in Houston that does screenings in the Hispanic community. So if a patient comes in and is screened and the results come back abnormal on the screening, what is the next step for that patient? Will these clinics that could be around the country or throughout, in different states, will they provide continued care, or will they provide referrals for these patients who are already maybe having difficulty with access? What is the next step for those patients who may receive those abnormal results?
Dr. Abigail Zamorano:
An abnormal cervical cancer screen doesn’t always mean a cervical cancer. Most of the time it means a cervical pre-cancer. And that can be very low grade or very mild, which sometimes those go away on their own. Our bodies are really good at managing our own illnesses. And even with early pre-cancers, sometimes our immune systems help manage those. The higher grade pre-cancers that are closer to cancer typically do require a treatment. Our clinic does provide both the diagnosis of pre-cancer and the management. These are procedures that we perform in the clinic.
They don’t need someone to be in the hospital or in the operating room, necessarily. So we’re able to provide all of these services in our clinic. Most clinics that provide cervical cancer screening, typically just provide the screening and then have other specialty clinics that they would refer out to for the management of abnormal results. Ours is a little unique because we do it all together, and we really aim to be a referral center for all of those clinics that do a great job at screening the population and reaching as many patients as possible. But we want to be the specialty center that then manages the cervical pre-cancer to prevent it from ever becoming cancer. For the patients that are ultimately diagnosed with cancer, we have referral patterns, and we have ways of navigating them to cancer-based therapy.