Cervical Cancer: Why Awareness Is Critical For Asian American Women

by KAI CURRY.

Cervical cancer is the fourth leading cause of death by cancer among females in the United States. Yet it is fully preventable and treatable if caught in advance. Cervical Cancer Awareness Month, which takes place in January, exists to heighten awareness of cervical cancer and the methods that are available to catch it before it happens, primarily a screening and a vaccine.

The Asian Weekly spoke with Dr. Allen Christensen of the Washington State Department of Health (WaDOH), who gave a succinct definition of cervical cancer as being a growth of cancerous cells in the cervix. Most often, or 90% of the time, cervical cancer is caused by strains of human papillomavirus, or HPV, a common infection which is passed through sexual contact.

Once it reaches an advanced stage, cervical cancer is treated in several ways, like surgery, chemotherapy, and radiation therapy. However, it doesn’t have to go there. The HPV vaccine, which is recommended from as early as age 9, can be the tool that prevents cervical cancer. It is important to note that HPV can affect males and females—and cause cancer in both males and females—however, cervical cancer only applies to those with a cervix.

Christensen reminded that it could be anyone who identifies as female. “The HPV vaccine is cancer prevention,” he said.

The other step, which applies solely to females, is getting regular screenings. A screening is not as mysterious as it might sound—it’s a pap smear, but making sure that the pap smear also screens for cervical cancer, starting by age 21. This constitutes basically another swab “down there” while you’re at your primary care physician’s office. Pap smears can be intimidating, though, and especially among Asian Americans, there seem to be some cultural factors that prevent them from getting theirs.

According to Christensen and WaDOH, “Some Asian American women tend to perceive themselves as being at low risk for cervical cancer.” One can only speculate that some might think it doesn’t apply to them because they are not sexually active (or overactive)—a common misconception in relation to cervical cancer—or that they are simply taking their chances, as many Asians believe that “health” is a matter of “luck.”

There is also a cultural factor of shyness, which healthcare physicians should make themselves aware of. It’s erroneous to tell someone to get screened and just expect them to do it. However, once they understand the importance, Asian American women tend to get the screenings, WaDOH shared.

“Non-HPV-infection related risks [for cervical cancer] are not many,” Dr. Sadia Habib, of Overlake Hospital Medical Center in Redmond, told the Asian Weekly. “Cigarette smoking seems to increase the risk. There could be genetic risk. This needs to be further explored. A lot of it also has to do with fighting the HPV infection. People who are immunocompromised, have HIV, have transplanted organs, they are vulnerable and need to do more and longer screenings [for cervical cancer].”

Any history of cancer or abnormal pap smears also increases the risk, Habib continued. It is true that having multiple sexual partners or being younger (which sometimes equates to being more sexually active) does give HPV and cervical cancer more chances to take hold, yet everyone would be wise to get the vaccine and screenings, as applicable. Thanks to more people getting the HPV vaccine, cervical cancer numbers have decreased in recent years.

Other risk factors can be demographic. “There is a particular group of people who are more at risk globally. Primarily, people in lower income countries…have poor access to cervical cancer screenings, and they will have a higher risk of developing a more severe form of cervical cancer,” Jaycee Wong, an advanced registered nurse practitioner at the Valley Medical Oncology and Hematology Clinic, explained. This applies to anyone with a low income, including in the United States. It’s valuable, then, to pass along, that even if one does not have health insurance, cervical cancer screenings are available through resources such as the WaDOH’s Breast, Cervical, and Colon Health Program, which supports people ages 21 through 64 who are at or below 250% of the federal poverty level and are either uninsured or underinsured.

A recent survey has found that “nationally, Asian women were the least likely to have completed cervical cancer screening, whether it was a pap test or a pap plus HPV testing,” Christensen said.

In Washington, mortality from cervical cancer is the highest among non-Hispanic Pacific Islander women,” Christensen added. Only 64% of non-Hispanic Asian women in Washington have reported having had a pap smear—ever. According to the CDC statistics provided by Wong, Asian American women have consistently reported the lowest cervical screening rates among all ethnic groups in the United States.

In 2013, this rate among Asian women 18 years and older was 66.9%, compared with 73.8% to 77.4% for non-Asian women in the United States. “Our goal is to move forward to over 85%, so I think all of us have some work to do,” said Wong, who would be happy if she never had to see anyone walk into the oncology clinic.

Cervical cancer is one of the only cancers for which a vaccine does exist that can prevent it—so let’s take advantage of that, Wong urged. “We have to encourage people to get those screenings done,” said Habib. “If not screened early enough, people develop cancer that leads to mortality.

There are many stages before the cancer develops that can be identified by this test.” Christensen agreed that “if detected early, cervical cancer is one of the most successfully treatable cancers…It’s important for anyone with a cervix to talk to their doctor about cervical cancer screening.” In 2024, at-home HPV tests were approved by the U.S. Food and Drug Administration—something to bring up to one’s doctor if that is of interest.

“My mother emigrated from Japan. My partner is also Japanese American,” shared Christensen. “When I think about my mother, partner, and daughter, there’s such a value to being able to talk about it. Initially, there might be some discomfort, but normalizing and helping [people] understand,” allowing people to ask questions, letting them know there is treatment, and where, “this is what helps build the social support which is a significant factor for routine pap testing.”

See Original Article at Northwest Asian Weekly

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