Affordable Care Act Requires Plans to Offer Annual, No-cost Well-woman Exams, Screenings
Kimberly N. Alleyne
For all the forms of cancer whose causes are a mystery, cervical cancer is one for which there is a known cause — human papillomavirus (HPV). Cervical cancer is most often caused by a high-risk type of HPV, the most common of all sexually transmitted infections (STIs). In fact, HPV is so common, the Centers for Disease Control and Prevention (CDC) estimate approximately 80 percent of sexually-active women (and 90 percent of sexually-active men) will be infected with at least one type of HPV in their lifetime.
In the United States an estimated 14 million new HPV infections are diagnosed annually. The virus, which is spread by skin-to-skin contact, normally presents without symptoms and clears on it own within two years. However, for reasons not yet identified, Black women have higher rates of HPV, and also have a more difficult time clearing the virus. And although Latina women, according to the CDC, have the highest rates of cervical cancer among racial and ethnic groups, Black women have lower five-year survival rates and higher mortality rates from the disease says the Black Women’s Health Imperative (BWHI).
An estimated 11,967 women are diagnosed with cervical cancer every year. According to the BWHI, an estimated 2,000 Black women are diagnosed with cervical cancer each year, and approximately 40 percent of them die from the disease.
Black women who are diagnosed with cervical cancer are twice as likely to die than Caucasian women. If not for a boil under her arm, Tamika Felder would have been among the statistics.
“After I graduated from college, I got a freelance gig with no benefits. I went without health insurance for several years, and didn’t have access to annual testing. I eventually landed a job with insurance benefits. Soon after I started the job, I went to the emergency room because of a boil, and the doctor happened to ask me when I had my last Pap smear,” says Felder, who was diagnosed in 2001 at age 25. “Since I had not had a Pap smear in a while, the doctor ordered one and that is how I was diagnosed, otherwise I would not be here,” Felder says.
Following the diagnosis Felder had a full or radical hysterectomy, chemotherapy and radiation. She founded Cervivor.org in 2005 to drive awareness about HPV and cervical cancer.
Prevention and early detection are critical
Dr. Peter Grossman, an Augusta, Ga.-based OB-GYN highlights the advances in cervical cancer research. “Well, there are four great things we know about cervical cancer: We have a precursor in cervical dysplasia (abnormal changes in the cells on the cervix surface); We know the cause, which is HPV; We have a great screening test with the Pap smear; and it takes a long time to develop, about 10 to 20 years from the initial exposure to HPV to the development of cervical cancer,” Grossman explains.
Prior to the 2010 passage of the Affordable Care Act (ACA), lack of access to Pap smear testing was thought to be a primary reason for higher rates of cervical cancer deaths among Black women. However, lack of access is no longer a barrier. The ACA requires that all marketplace health plans include preventive services such as a yearly Well-woman exam, a Pap smear, and HPV screening. To curtail spread of HPV, the CDC recommends girls starting at age 11 get the three-dose series of HPV vaccine; women can be vaccinated through age 26.
For women past the vaccination age, it is critical to get regular Pap smears and HPV screenings. Incidences of and deaths from cervical cancer can be prevented and reduced with these measures.
- When the Pap smear was introduced in the 1940s, cervical cancer was the leading cause death among women.
- In 2006, a vaccine to prevent HPV was released in the United States.
- HPVs comprise a group of 200 viruses. Of those, 40 are spread by sexual contact, and 12 of those are high-risk. HPV viruses of these type, when they do not clear, cause cervical cancer.
- Cervical cancer can take several years to develop, and in its early stages, may not cause symptoms. Advanced cases of cervical cancer may cause abnormal vaginal bleeding or discharge. Click here to view the CDC’s cervical cancer screening guidelines.
- Preventive services such as Well Woman exams do not require a co-payment or co-insurance. Learn more here healthcare.gov.