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Doctors say minority women are not accessing cervical cancer screening services as much as they should, putting them at higher risk of developing the disease. Although incidence of cervical cancer continues to drop in the United States, rates for minority women remain higher than in the rest of the population.
There is "an ongoing problem of failure to access screening services by women, especially minority women," says Dr. Tri A. Dinh, a gynecologic oncologist at the Methodist Hospital in Houston. The problem is compounded by minority women's "reluctance to be examined 'down there'," because they "don't have this culture of yearly preventive medicine routine that American women or women acclimated to the U.S. health system have."
"There's still no thought about preventive medicine in a lot of cultures," Dinh added, "that's a problem."
Dr. Adnan R Munkarah, MD, a specialist in gynecologic cancer including ovarian and uterine cancer at the Henry Ford Hospital in Detroit, agrees.
"He says the main issue facing health care professionals today regarding cervical health in minorities is "noncompliance with cervical cancer screening program." He attributes the "inadequate follow-up and management of abnormal Pap smears," to a combination of factors including less access, cultural norms and lack of information.
Robert A. Burger, MD, of the Ovarian Cancer Research Program of the Fox Chase Cancer Center in Philadelphia, says "more effective utilization of yearly screening examinations for women at higher risk for developing the disease and primary public education," is needed regarding the issue of HPV infection.
Dinh says another problem regarding screening for cervical cancer involves older women. Calling it a "physicians' problem," Dinh says some doctors don't read the fine print when it comes to screening women over 70.
"There is the thought that if one is past the age of 70 one does not need Pap smears anymore, and that is a true statement if one meets the criteria," Dinh said. Women over 70 don't need to be screened for cervical cancer if they have not had an abnormal Pap smear in the last 10 years and if they've had three consecutive normal Pap smears. But, many physicians just look at the age, Dinh said. "They don't read past the first line of the recommendation."
"Any screening test has its limitations," said Dr. Munkarah. "However, if one abides by the screening guidelines for Pap smear, the incidence of invasive cervical cancer and disease related mortality will be significantly reduced."
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