Another January has come to a close, as the Republican legislature looks to continue its unprecedented attack on the cervixes of Texas. We need to restore funding to family planning and women’s healthcare so that all women can receive the care that they need.
In honor of the 100,000 Texas women who lost access to healthcare last session, I'm reposting this diary. It is sadly still too relevant. — kh
Why should you care? Because the cervix is yet another battlefield in the Republican Party's war on women. Positioned between the vagina and the uterus — two body parts that aging white male Republicans always seem most eager to want to legislate control of — the cervix is literally in the middle of the debate over women's health.
Thanks to the Republican Party and their draconian cuts to women's health and family planning services, next year's Cervical Awareness Month will celebrate a lot fewer healthy Texas cervixes.
And as the Republican Legislature's efforts continue to close Planned Parenthood clinics and curtail funding to health centers that perform pap smears, we should see the incidence of and death from cervical cancers rise, and watch our overall healthcare costs increase as well. So let's talk about cervical cancer, and why the Republican legislature's policies will increase the number of women who die from this thoroughly preventable, treatable disease.
Here in America, cervical cancer is the 8th most common cancer of women. Approximately 11,000 new cases are diagnosed each year, and an estimated 3,800 women are expected to die of the disease. Thankfully, here in the US our mortality rate is much less than the rest of the world, due in part to widespread Pap smear testing.
Pap smear screening every 3-5 years with appropriate follow-up can reduce the rate of cervical cancer by up to 80%. Pap smears are recommended for women beginning at age 21, or three years after a woman becomes sexually active, whichever is earlier. In 2010, Planned Parenthood performed 769,769 pap smears nationwide. (They also provided 747,607 breast exams but hey, it's not breast cancer awareness month yet, now is it?!) They also provided over 44,000 treatment procedures for women with abnormal pap smear results. It's all part of the 14.5% of Planned Parenthood's national work that consists of cancer screening and cancer prevention. Here in Texas, PP screened 104,000 women for cervical cancer in 2010. Over 13,000 pap tests were abnormal.
Between 2 and 3 million women have an abnormal pap smear every year. It's very common, as is the human papilloma virus that causes it. Yes, HPV. More on that later. Ask around at your next ladies night and you should find a few women who admit to an abnormal pap smear. For 90% of women, the abnormalities clear up within a year, especially in younger (under 30) women. Meanwhile, if you want to read more about abnormal pap smears, The Hairpin has a really helpful guide with a very cute cartoon.
70% of cervical cancer is caused by HPV. HPV vaccines reduce the risk of cancerous or precancerous changes of the cervix by about 93%. The fact is, the HPV vaccine that's so often bandied about as a political football would go a long way to reduce this disease. While Rick Perry is routinely excoriated for his failed mandate that all girls in sixth grade and above be vaccinated against HPV, the policy would have gone a long way to lower the incidence of cervical cancer. Of course, a whiff of cronyism surrounds the decision since Perry's former Chief of Staff Mike Toomey was a lobbyist for Merck at the time Perry signed the executive order. The mandated vaccine would have generated millions in revenue for the pharmaceutical giant. The policy had flaws, but with some adjustments, such as parents having the choice to opt out, and male children being vaccinated as well, it could have been a great public policy initiative.
Hispanic women have a cervical cancer incidence that is 50% higher than that of the general population. African-American women also have a higher rate. Poor White people also have a higher incidence than non-poor White people. According to the National Cancer Institute, this statistical disproportionality is due to lack of access to health care and low socio-economic status. So here in Texas, where we have a majority-minority population and some of the highest rates of poverty in the country, we're facing a greater risk of exploding cervical cancer rates if we slash family planning funds. Planned Parenthood and other clinics that the state has put on the chopping block serve an overwhelmingly low-income population.
In their attempts to slash funding from Planned Parenthood and women's health centers, Republicans are making sure that less women can access pap smears and get the early detection they need to avoid cervical cancer. Early diagnosis and treatment are vital to short- and long-term survival. The longer the cancer goes undetected and untreated, the worse the survival rates are. 80-90% of women with Stage I cancer survive five years after diagnosis; only 15% of those diagnosed with Stage IV cancer make it that long. It's worth repeating: the majority of cervical cancers in the US occur in women who haven't been screened in the last five years. That's why making sure these services are prevalent and affordable — such that more women can get pap smears more frequently — is so key to keeping the diagnosis and mortality rate down.
It's not just Planned Parenthood that is suffering — Republicans slashed funding to most family planning clinics, including the federally qualified health centers they so love to prop up as an alternative to PP. Those FQHC's are already overburdened with patients, and in a state as big — and as rapidly-growing — as Texas, we need more outlets for low-cost women's healthcare, not less. Last biennium, 71 clinics received state funding. Now, that number is down to 41. Family planning funds used to serve 220,000 women a year. Now, that number is down to 60,000. The cuts in funding represent a drastic decrease in care, which in turn will mean more missed pap smears and more advanced diagnoses of cervical cancer.
In developing nations, cervical cancer is a leading killer of women, because these populations lack the early detection necessary to stop the disease in its tracks. Texas Republicans are enacting policies that threaten to bring our own women back to that same low level of detection, treatment, and survival. It's shameful!
For a political party that routinely abuses the phrase “pro-life,” Republicans are doing everything in their power to systematically increase the number of women that die from or have their lives greatly shortened by cervical cancer.
But hey, on the upside, maybe during the next session Republicans can re-name January as “Systematic-Denial-of-Pap-Smears-to-Women,-Especially-Poor-Women,-Thus-Increasing-the-Odds-That-They-Die Awareness Month.” It'd be more honest, right?