Cervical Cancer: Preventable, but Not Under Capitalism

February 27, 2017 | Revolution Newspaper | revcom.us

 

Every year, more than 500,000 women in the world are diagnosed with cervical cancer and half of them die of the disease. In the U.S. about 13,000 women a year learn they have cervical cancer and about 4,000 die of this illness.

According to 2012 statistics about 84 per cent of cervical cancer cases occurred in less developed countries. The highest incidence of cervical cancer was in Africa, Latin America and the Caribbean, while the lowest incidence was in Northern America. The country with the highest rate of cervical cancer was Malawi, followed by Mozambique. Cervical cancer is the fourth-leading cause of cancer-related death across the globe, and the number one cause of cancer-related death in Africa. (International Agency for Research on Cancer) The dimensions of this huge international health problem reflect the lopsidedness of the world, only exacerbated by a world where rich, imperialist countries dominate and exploit the Third World.

This situation is not only horrible, but totally unnecessary. Cervical cancer is the second most common cancer worldwide, but it’s highly preventable. It could and should be easily preventable. But in this world, as it is now, including in the U.S., it is not.

Most cervical cancer is caused by sexually transmitted infections with human papillomavirus (HPV), for which there is a vaccine, Gardasil. Tests, including the cervical Pap smear, can detect precancerous cervical abnormalities early, when they can be more easily treated. And they can determine the need for more rigorous monitoring. This is why screening is the frontline in preventing cervical cancer. But the disease persists because many women do not get regular screenings, largely because of the dominant social and economic relations in the world today.

To see how this is the case, look at the situation in the United States where many things prevent women, especially poor and minority women, from getting regular Pap smears like: Lack of health insurance; little or no access to low-cost health care, poor health education; inability to take time off work to go to the doctor; and living in communities with inadequate health facilities. And things are about to get worse if Trump is allowed to stay in office. He has vowed to take away federal funds from Planned Parenthood—which provides 270,000 Pap smears a year. He is moving to get rid of Obamacare, which will mean more people without health insurance, especially Black people, Latinos, and other minorities.

Then there is the poisonous ideological opposition to screening and treating cervical cancer coming  from the Christian fascists—who are now ruling from deep in the White House. When it was announced in 2005 that the Gardasil vaccine was 100 percent effective in preventing the main strains that cause cervical cancer, Tony Perkins, the president of the Family Research Council, a Christian fascist lobby group, said, “Our concern is that this vaccine will be marketed to a segment of the population that should be getting a message about abstinence. It sends the wrong message.” These are the anti-science, patriarchal Christian fascists who have been working for decades to take away abortion rights and birth control; to get rid of sex education; to spread the LIE that fetuses are babies and that women are incubators; who preach that sex is only about procreation and that it’s a sin to have sex outside of marriage. These are the dark-ages proponents who want to shut down Planned Parenthood. These enemies of women are guilty of contributing to the conditions in which females don’t get Pap smears and don’t get the life-saving vaccine.

All this means fewer women with access to early screening, leading to more women dying from cervical cancer. According to the Agency for Healthcare Research and Quality, nearly half of the women with newly diagnosed cervical cancer have not received a Pap test in the previous five years. (Washington Post, May 2, 2011)

Dr. John Farley, a practicing gynecologic oncologist and professor at Creighton University School of Medicine at St. Joseph’s Hospital and Medical Center in Arizona, says, “We have a vaccine which can eliminate cervical cancer, like polio, that is currently available, and only 40% of girls age 13 to 17 have been vaccinated. This is an epic failure of our health care system in taking care of women in general and minorities specifically.” (CNN.com, January 25, 2017)

New Study: Higher Death Rates, Bigger Gap Between White and Black Women

A new study published in the journal Cancer underscores the life and death nature of this situation. It reveals that the death rate from cervical cancer in the U.S. is much higher than previously estimated and that the gap in a higher death rate for Black women compared to white women is significantly wider. (New York Times, January 23, 2017)

Black women are dying from the disease at rates comparable to women in many poor, Third World countries and the racial disparity in cervical cancer rates had been observed in earlier studies. But it was thought this gap in the U.S. was narrowing because cancer death rates for Black women were declining. However the way the rate has been assessed in the past has compared the number of women who died from the disease to the general population at risk—including women who had had hysterectomies (who had had their cervix removed and would therefore not be at risk for cervical cancer). This is a significant difference: about 20 percent of women in the U.S. get hysterectomies, with higher rates for Black women than white women.

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This new analysis, which excluded women with hysterectomies, now puts the mortality rate for Black women at a little over 10 per 100,000—up from 5.7 per 100,000. And for white women, it found the rate 4.7 per 100,000—up from a little over 3 per 100,000 (77 percent more deadly for black women and 44 percent more deadly for white women than previously thought).

Cervical Cancer Preventable, but Not Under Capitalism

So we have to ask what is it about the economic and political system of capitalism that creates a situation where so many women are dying of cervical cancer when it is a highly preventable disease?

Health care—one of the most basic things that allow human beings to stay alive and live a decent life—is NOT a right in this country. Providing the people with health care should be the responsibility of any government, or any society. But today some 28 million people still do not have any health insurance. And if Trump gets rid of Obamacare, it is predicted that more than 20 million people will be added to those without health insurance. A 2009 American Journal of Public Health study found that close to 45,000 deaths annually in the U.S. were associated with lack of health insurance.

Health care for people with care and compassion should be a priority in any society. And there are many dedicated doctors, nurses and others who are trying to save lives and give patients the best medical treatment they can. There are people, like those in Doctors Without Borders, who go where the U.S. is waging imperialist wars, and risk their own lives to try and save people. But what these people are trying to do actually has to go up against the U.S. health care system itself—which is all bound up with private ownership, control over the means of production, and the overall organization of the economy. Political economist Raymond Lotta tells the story of hearing someone ask CNN health expert Sanjay Gupta, “Wouldn’t it make sense to focus on preventive care, on the actual health of people as the first priority?” and Gupta said, “From a medical and ethical standpoint, yes it would make sense to put more emphasis on preventive health care. But from the bottom line, it doesn’t.” In every aspect of medical care—from insurance, to hospitals, to pharmacies, to doctors, etc.—profit determines everything, before the health and needs of the people.

So, imagine if the hospital networks in the U.S.—a large number of which are are owned by huge corporations—actually tried to address the high rate of cervical cancer, especially among Black women and other women of color.

Let’s say one of these hospital networks hired enough doctors, nurses, and other staff so that patients got the kind of care they need. It set up free screening for cervical cancer, went into the community making it very accessible so that people did not have to travel to the hospital. It did lots of outreach—especially in poor, Black and Latino communities, giving people health education about cervical cancer prevention and the importance of early screening and prevention. It provided services either free or low cost so that even people without health insurance could get screened and treated. It provided subsidies and tried to negotiate with the pharmacies. And efforts were made to actively counter the white supremacy, patriarchy, and religious obscurantist, anti-scientific thought that so often gets inserted in all kinds of decisions made in terms of patient care and medical research. These are the kind of beginning steps needed to counter the things that prevent so many women from getting screened, diagnosed and treated for cervical cancer—that lead to so many women dying from cervical cancer.

Well, in a very short time this hospital network would be forced to close down. Why? Because while all of these things are what is needed to help solve this problem—they take a lot of money, they don’t make a profit. This would mean this hospital would not be able to compete with other hospital networks. Also, this would be going up against the dominant political and ideological thinking in society and would come under attack—especially from Christian fascists, including powerful forces in the government who would demand that funding be withdrawn.

These hospitals would still be subject to the laws of capitalism, of profit in command; it would still be operating in a world where white supremacy, patriarchy run through every vein of society. It would still be operating in a capitalist system that considers all this not “health care” but a “health care industry” and like any other sector in the economy it is for investment, it is a business—not social need, not social responsibility.

In fact, there are doctors, nurses and others who are trying to do some of what’s described above. But the problem is bigger than any one hospital, greedy pharmaceutical company, or avaricious medical research lab. It will take a revolution to put an end to the capitalist system, which produces the economic laws that mandate the profit-before-everything way things operate now.

Indeed, things don’t have to be this way. Things would be radically different in the state made possible by revolution and envisioned in the Constitution for the New Socialist Republic in North America written by Bob Avakian. To read how this is possible, click here.

People are dying in so many ways because of the very nature of capitalism.
We need a whole new world.
We need revolution.

 

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