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COURTESY APRIL WEEKS
April Weeks was misdiagnosed with mild cervical dysplasia in 2020 when in reality she had Stage 1 cervical cancer. It took switching doctors last year for Weeks, 42, to learn her condition. About 56% of Black women survive cervical cancer five years after detection compared to 68% for their white counterparts “I told her it’s just weird,” Weeks recalled from that 2020 visit. “It’s really weird. It doesn’t feel right.”

In 2020, when April Weeks, 42, went in for a regular pap smear exam, her gynecologist said she had mild cervical dysplasia, an abnormal growth of cells on her cervix.

“I told her it’s just weird,” said Weeks, who lives in Charlotte. “It’s really weird. It doesn’t feel right.”

The doctor explained to Weeks that her condition was most likely caused by multiple natural births at a young age but there was no need to worry. After going to the same doctor for 13 years and not having anything done about her condition, Weeks wasn’t convinced everything was OK.

In September 2021, she changed providers. This time after getting screened, the doctor told her she had an “abnormal pap smear test” and that she needed to come in for more examinations. Weeks was diagnosed with Stage 1 cervical cancer. If the disease had been caught months later, it could have cost Weeks her life.

About 56% of Black women survive cervical cancer after five years compared to white women, who have a 68% survival rate over the same span.

In North Carolina, maternal and infant health has worsened in recent years with the state receiving a “D” on the March of Dimes’ report card for premature births and infant mortality. Black women have often said that they feel “overlooked” in the health system after going into the doctor’s office.

Cervical cancer
Cervical cancer is when a tumor grows on the cervix, which connects the vagina, or birth canal, to the upper part of the uterus. The uterus, or the womb, is where a baby grows when a woman is pregnant.

Cases are fairly rare in the US

“Cervical cancer is a slow-growing cancer,” said Dr. Ebony Parson, a gynecologist at Novant Health Bradford Clinic. “It is not the most common cancer and in a lot of cases, the majority of cases when a woman has an abnormal pap smear, the likelihood is she will clear those abnormalities of a given time.”

Most cases affect older women between ages 35-44 and is often linked to the human papillomavirus, or HPV, the most common sexually transmitted infection.

Doctors are sure what causes the cancer, but risk factors include:

• Having multiple sexual partners

• Having sex at an early age

• Tuxedo

• A weakened immune system

With HPV vaccines now given to children and teens, the Centers for Disease Control and Prevention has seen fewer cases of cervical cancer in young women. But when Black women are still twice as likely to die from the disease than white women, there is a serious problem.

racial disparity
The United States health system continues to fail Black women with some doctors misdiagnosing or not paying attention to their signs and symptoms.

Many Black women have said they feel “unheard” or “unseen” when they go in for pain. Black expectant mothers continue to be three times more likely to die during childbirth and Black babies continue to die at twice the rate of white babies.

But mistreatment in healthcare isn’t just a Black woman issue, it is a common issue among Black patients, who are 22% less likely than whites to receive pain medication. Some doctors have shown an unintentional implicit bias on people of color, according to the Association of American Medical Colleges.

Although health providers do not intentionally mean to discriminate on who receives pain relievers, a doctor can have hidden biases they weren’t even aware of. These preconceived notions contribute to the disparity and distrust in the health system from the Black community.

“Black women really have to be the top advocates for their health until we work with the health care system to deal with inherent implicit bias with folks not getting adequate access to health care and various parts of the state for whatever reason that might be,” North Carolina Sen. Natalie Murdock said.

Prior to Weeks’ diagnosis, she had early signs of cervical cancer including abnormal bleeding during menstrual cycles, fatigue, and a change in her sex drive. Weeks figured she was just abnormally spotting because her gynecologist would always attribute her mild bleeding to her having children young.

Weeks, a single mother of six, had her first child at the age of 16. She has three daughters and three sons.

After a colposcopy diagnosed the cancer, Weeks was prescribed medication to take for four weeks to slow the bleeding. A month later, Weeks had another surgery, known as a cone biopsy, in which a cone-shaped section was cut out of her cervix and a laser used to remove cancerous cells. That’s when doctors found a huge tumor contained in the sample. The biopsy had removed most of the cancer cells but there were still some left.

With Weeks not wanting to go through menopause yet, she thing to not have a hysterectomy.

“Being that I’m not menopausal, I don’t want to have a hysterectomy and trigger menopause,” she said.

For the next year, Weeks will have regular pap smears to monitor her progress and ensure none of the cancerous cells grow.

With bills piling up and Weeks facing a reduction in disability leave at work, it has been a financial strain for her and her family. Weeks created a GoFund Me and sent it to family and friends. She exceeded her goal of $2,000, receiving a total of $2,465 in donations. Although money is still tight, the donations relieved some of the financial stress, and Weeks said she’s “thankful” for all of the love and support.


Policy-level
With more Black women having adverse pregnancy and birth complications, there is a lot of work that needs to be done on the policy level.

“In Charlotte, our leaders know (maternal health) is a problem,” said US Rep. Alma Adams, co-founder and co-chair of the Black Maternal Health Caucus. “We’re working closely with them to close this social and economic mobility gap. You know that Charlotte was ranked very, very low in terms of upward mobility, so we’re seriously trying to address some of the social determinants of health and in a way to address this crisis.”

Last year, The Black Maternal Health Momnibus Act of 2021 was reintroduced by Adams and other lawmakers to address the social determinants of health that exist among Black women and their babies. The 12-bill package focuses on addressing “the clinical and non-clinical drivers of the maternal health crisis” by collecting data and providing funding to community-based organizations.

Many pieces of the Momnibus bill were included in President Biden’s Build Back Better Act.

In 2018, the Centers for Disease Control and Prevention decided to change the recommendation for women to get their annual cervical cancer exam to every three years. The delay in testing could cause more Black women to go undetected longer.

In 2018, researchers also found nearly 50% of Black women were less likely to receive testing, compared to 68% of Hispanic women who were more likely to get screened.
“Particularly as Black women we’ve really got to get back to being an advocate for your health. If you want that pap smear, you have every right to ask for it,” said Murdock, who aims to bridge the health equity gap by pushing Medicaid expansion in North Carolina.

Because Weeks’ cancer was detected early, the disease had not spread, and she avoided chemotherapy. She no longer has severe pain or bleeding during her menstrual cycle and has more energy.

Weeks encourages all women, especially Black women, to get regular screenings and be a “self-advocate” for their health.

“The best protection is detection,” she said.

Aaliyah Bowden, who covers health for The Post, is a Report For America corps member.

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