Three months after Patti Murillo-Casa retired from the New York Police Department, she was diagnosed with stage 2B cervical cancer. She was 45-years-old and had been happily married for 11 years. .
Because her gynecologist moved back to his home country, Murillo-Casa says didn’t have a pap smear for three years. “I was lazy to find another person and I was in a monogamous relationship,” she says.
When she kept spotting in between menstrual cycles, she realized something was wrong. “I thought it was because of stress,” she says. But the bleeding progressed until she couldn’t ignore it any longer.
“I was ashamed and scared,” she says. “I was afraid of what my husband thought. That’s the myth and stigma the disease has,” she says. At first Murillo-Casa says she withdrew and became depressed, but her husband motivated her by researching the disease and educating her about it.
Murillo-Casa first received her diagnosis in November of 2008, and after 35 treatments of radiation, seven rounds of chemotherapy and other treatments, she was cancer free in May of 2009.
High-risk HPVs (human papillomaviruses) cause virtually all cervical cancers as well as other types of cancers. Though cervical cancer is almost 100 percent preventable, Latinas continue to suffer and die of the disease. They have the highest incidence of cervical cancer among all ethnic/racial groups and the second highest mortality rate after black women.
The situation is even worse for Latinas in Texas whose rates are 19 percent higher than the national average and 11 percent higher than the national average for Latinas. Women living in counties on the U.S. Mexico border are 31 percent more likely to die of cervical cancer compared to women in non-border counties.
“It’s not that the sexual behavior is any different. They’re just not getting the care they need in a timely manner,” says Jessica González–Rojas, executive director at the National Latina Institute for Reproductive Health. “It’s not anything different about Latina’s bodies, but it’s about barriers.”
According to the National Latina Institute for Reproductive Health, Latinas are less likely than other groups to have access to employer sponsored health coverage or private plans. Sixty-six percent of immigrant women don’t have access to employer sponsored coverage. González–Rojas says that immigrant women often don’t know how to navigate the patchwork of healthcare services, which vary from state to state.
In addition to lacking access to healthcare, Latinas also face cultural and linguistic barriers. González–Rojas points out that many patients have a hard time communicating with their health care providers and sometimes require their child to translate for them, which can create an awkward situation when discussing sexual health.
“I see women who have had two or three children in their countries and have never had a pap smear,” says Dr. Nilda Moreno, director of Family Planning Section and Fellowship at MedStar Health. “If you come from a country that didn’t have access to healthcare, you don’t know where to get care.”
Moreno also points out that though the HPV vaccine is now widely available, many parents assume that in giving their teenagers the vaccine, they will become sexually active. A 2012 study found that fewer than half of low-income and minority adolescents receiving health maintenance services initiated HPV vaccination, and only 20 percent completed the series. Provider failure to discuss vaccination with their patients appears to be an important contributor to a lack of vaccination.
“Everything comes down to education,” says Moreno. “There is a lot of focus on breast cancer and heart disease and not enough on cervical cancer.” Moreno believes that because prevention has decreased the actual incidence of the disease, it’s lost visibility though it continues to be a problem among certain populations.
The American College of Obstetricians and Gynecologists recommends that women begin getting pap tests when they turn 21. Under revised recommendations released in 2012, women should have a pap every 3-5 years, depending on their age.
Murillo-Casa, who is president of New York Chapter of the cancer organization Tamika and Friends, now raises awareness in Latino communities. “This disease isn’t because you’re promiscuous,” she says. “If you’re sexually active, you’re going to get the virus. You have to go to the doctor. I tell women they don’t have to go through what I went through.”