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The death rate from cervical cancer in the United States is significantly higher than previously thought, according to a study published today in the journal Cancer. In it, researchers detail how they re-examined existing numbers and found that not only are death rates higher than previously thought, the disparity in death rates between black women and white women is also bigger.

Researchers reported the mortality rate for black women was 10.1 per 100,000, whereas for white women it is 4.7 per 100,000. The previous rates were estimated to be 5.7 and 3.2 per 100,000, respectively.

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Death rates for cervical cancer are calculated by comparing the number of women who die from the disease to the number of people in the general population who could get the disease. The new analysis examined health data from 2000 to 2012, but did so with a twist—researchers excluded women who had had hysterectomies when calculating the risk for the larger population.

In many cases, a hysterectomy also removes the cervix and thus the possibility of developing cervical cancer. Since men are excluded from calculations because they’re not at risk for cervical cancer, then it makes sense to also exclude women who do not have a cervix.

Researchers find the death rate from cervical cancer is higher than previously believed—especially among black women.

The study did not explore delve into why black women have higher rates of the disease, but it has been noted in earlier studies. Recently, the gap was thought to have narrowed because of declining death rates among black women due to cervical cancer. However, the results from this study indicate that the rate at which black women are dying from the disease is comparable to that of women living in some poor developing countries in Latin America, Asia, and Africa, particularly sub-Saharan Africa.

Here’s Jan Hoffman, reporting for The New York Times:

“This shows that our disparities are even worse than we feared,” said Dr. Kathleen M. Schmeler, an associate professor of gynecologic oncology at the University of Texas M. D. Anderson Cancer Center. “We have screenings that are great, but many women in America are not getting them. And now I have even more concerns going forward, with the” — expected — “repeal of the Affordable Care Act, which covers screening, and the closing of family planning clinics, which do much of that screening.”

What makes the disparity disturbing is that cervical cancer is largely preventable when women adhere to screening guidelines and follow-up monitoring.

Guidelines suggest that screening end at age 65 for women who have had two or three consecutive negative results in the previous decade. Yet the current study says the greatest mortality was among black women 85 and older.

But experts say the new findings do not necessarily indicate the need to revisit the upper end of the guidelines. Cervical cancer progresses slowly and has many early-warning stages, so it is unlikely that a 65-year-old woman who has met guidelines’ requirements develops the disease.