She contracted cervical cancer later in life. As a Black woman, she’s more at risk

Ernestine Turner noticed something peculiar was happening to her body.

“I had vaginal bleeding and it got worse,” said Turner, who lives in Fort Lauderdale. “You want to say, ‘No, this isn’t it.’ So finally, after three months I got up enough nerve to admit it to my primary care physician.”

In December 2018, Turner, 72, was diagnosed with cervical cancer, which is generally due to the human papillomavirus (HPV). If caught early, cervical cancer has a five-year survival rate of more than 90 percent.

Higher mortality rates for Black women

Although most cases of cervical cancer can be prevented with Gardasil 9, the FDA-approved vaccine for the human papillomavirus, Black women die of the disease at a disproportionately high rate, according to a joint report issued in January from the Southern Rural Black Women’s Initiative for Economic and Social Justice (SRBWI) and Human Rights Watch (HRW).

About 4,280 women will die from cervical cancer in 2022, the American Cancer Society estimates.

The study’s researchers interviewed 148 people, mostly Black women between the ages of 18 and 82 who lived in three rural Georgia counties: Baker, Coffee and Wilcox.

In Georgia, the study found, Black women were almost 1 1/2 times as likely to die of cervical cancer as white women. Black women in Georgia were also more likely to never have been screened for cervical cancer, leading to late-stage diagnoses.

Several factors play a role in these findings, including a mistrust of the medical community and lack of access to doctors and healthcare facilities.

In South Florida, the story is more nuanced.

“Our Black population isn’t homogenous in South Florida,” said Dr. Scott Jordan, a gynecological oncologist at Broward Health Medical Center. “Afro Caribbeans and African Americans all have different ideas and varying levels of trust in the healthcare system. It boils down to a lack of preventative care for whatever reason.

“Access is a bigger issue with some of our international patients in South Florida,” Jordan added. “I have a lot of Bahamian and Haitian women show up and they’ve never seen a gynecologist. They’ve never had a pelvic exam or a pap smear and all of a sudden show up with advanced stage cervical cancer. Maybe if they were here in the United States and had access to even rudimentary preventative care, then they wouldn’t have developed such an advanced disease.”

Vaccine cuts risk of cervical cancer

Getting the HPV vaccine — Gardasil 9 — will greatly reduce the chances of contracting cervical cancer, Jordan said.

“The reason HPV is so common is because it is asymptomatic. Unless you have warts, you would never know you had it,” Jordan said. “Eighty to 90 percent of the population has had an HPV infection at one time.

“We’ve got a way to prevent a terribly deadly cancer almost 100 percent with the vaccine,” Jordan added. “My biggest encouragement to women is to get vaccinated and vaccinate your sons and daughters if they are not vaccinated.”

Last month, the Food and Drug Administration issued guidance for enrolling more participants from underrepresented racial and ethnic populations in the U.S. into clinical trials, which should help in detecting cancer at earlier stages.

Enrolling more Blacks in clinical trials

Black women also have lower survival rates in uterine and endometrial cancer, noted Dr. Brian Slomovitz, a gynecologic oncologist at Mount Sinai Medical Center in Miami Beach.

Some in the medical community attribute this to lack of access to care, such as having insurance that won’t reimburse its members for participating in clinical trials.

“This isn’t the case,” Slomovitz said. “It is due to a worse prognosis and response to therapy. We need to account for this as we look at new therapies. There is a biological difference in tumors between Black and white women.”

To combat the issue, Slomovitz suggests clinical trials should represent a diverse population to help overcome the mistrust by some of the medical community. To do this, the trials should cover transportation and meal costs for patients who may not have the money, and federal health agencies and others need to create funding for public hospitals to conduct research studies.

“The solution to these problems is research sponsored by the federal government, pharmaceutical companies and by the health community,” Slomovitz said. “We have to stop talking about minority accrual in clinical trials and do something about it.”

Turner’s cancer journey

After undergoing chemo and radiation, Turner was diagnosed free of cervical cancer in May 2019.

But during a follow-up visit after her treatment, doctors discovered in April 2020 that she had lung cancer. Turner said she began treatment for lung cancer and started having complications from where the chemo port was inserted. She also contracted deep vein thrombosis, lymphedema and neuropathy.

A retired security officer, Turner remained in high spirits throughout her treatment and even began working as a school crossing guard in March 2020 after her friend told her of the job opening.

“I wasn’t doing anything but staying home and going to the doctor,” Turner said. “My friend said, ‘I know you like to work and keep busy.’ I did the job all the way through my treatment. I had no problem with it.”

Turner celebrated her 72nd birthday on May 1 with her family. She is the mother of three children, and has 16 grandchildren and 13 great grandchildren. She regularly drives other elderly relatives and friends to their doctor appointments, grocery shopping and bill payment centers.

“I’m always there and I have a hard time saying no because we are all elderly,” Turner said. “Even with everything I’ve been through, I still think I’m the luckiest one of them. I’m the healthiest one.”

This story was originally published May 12, 2022 at 6:00 AM.