Knowing Your Numbers: Cervical Cancer Stages and What We Need to Know

Cervical cancer is one of the most preventable types of cancer, yet for African American women, it remains a serious threat. The story of cervical cancer in our community isn’t just about biology; it’s about access, follow-up, and ensuring our concerns are heard.

Here is the reality we need to face together:

• Higher Mortality: Black women die from cervical cancer at a rate 65% higher than white women.
• The Follow-Up Gap: While Black women get screened (Pap smears) at similar rates to other groups, we are less likely to receive timely follow-up care after an “abnormal” result.
• Late-Stage Risk: We are more likely to be diagnosed at a later stage, when treatment is more difficult, and survival rates are lower.
• Age Matters: While many think this is a young woman’s disease, Black women over the age of 65 have significantly higher odds of being diagnosed with late-stage cancer compared to younger women.

Understanding the stages of this disease is the first step to protecting yourself. When you know what is happening in your body, you can push for the treatment you deserve.

Understanding the Stages of Cervical Cancer

Stage I: Localized Cancer

The cancer has formed but is found only in the cervix or uterus.

Treatment Options: Surgery (removing the cervix or uterus) is often the gold standard here.

The Disparity: Research shows that Black women at this stage are less likely to receive surgery than white women, often receiving radiation instead, which may not be the optimal choice for early disease.

Stage II: Locally Advanced

The cancer has spread beyond the cervix and uterus to the upper part of the vagina or the tissue around the uterus.

Treatment Options: Usually a combination of radiation and chemotherapy.

Stage III: Advanced Spread

The cancer has spread to the lower part of the vagina, the pelvic wall, or is blocking the kidneys.

Treatment Options: Radiation plus chemotherapy is standard.

Stage IV: Metastatic Cancer

The cancer has spread to nearby organs like the bladder or rectum (Stage IVA) or distant parts of the body like the lungs or bones (Stage IVB).

Treatment Options: Treatment focuses on controlling the disease and relieving symptoms. This may include chemotherapy, radiation, and newer options like immunotherapy.

More About Those Treatment Options: What is Most Effective?

For early-stage cervical cancer (Stage I), surgery (hysterectomy or procedures to remove the cervix) is often the most effective treatment. However, studies in Alabama and nationally have shown that Black women are sometimes steered toward radiation even when surgery is an option. Immunotherapy is a newer treatment that helps your immune system fight cancer. It can be a powerful tool for advanced stages, but Black women are often underrepresented in the clinical trials that test these drugs.

Using the ROOT Framework for Self-Advocacy

Navigating a cancer diagnosis—or even a scary Pap smear result—can be overwhelming. Use the ROOT Framework to avoid getting lost in the “follow-up gap.”

R = Reveal What’s Going On

Pay attention to your body’s warning signs.

• Signs to Watch: Abnormal bleeding (between periods or after sex), unusual discharge, or pelvic pain.
• Action: Log these symptoms with dates. If you are over 65, do not assume bleeding is just “part of aging.”

O = Offer Your Observations

When you see your provider, use clear language.

• Script: “I have noticed spotting after intercourse for the last two months. I know this can be a symptom of cervical issues, and I would like to be screened.”

O = Outline What You Need

This is the most critical step for Black women. If you have an abnormal Pap smear, do not leave the office without a plan.

• The Problem: Sometimes providers use vague language, such as “you have some dirty cells” or “a little virus,” without explaining the urgency.
• Script: “Can you explain exactly what ‘abnormal’ means in my case? Do I need a colposcopy (a closer look at the cervix)? When exactly should I schedule it?”
• Advanced Advocacy: If you are diagnosed with Stage I cancer, ask: “Am I a candidate for surgery? If not, can you explain why radiation is being recommended instead?”

T = Take Note & Follow-Up

Missed appointments are a significant reason for the survival gap.

• Action: Schedule your follow-up appointment while you are still at the front desk.
• Accountability: If you don’t get your results within two weeks, call them to follow up. Do not assume “no news is good news.”

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References

Human Rights Watch. (2025). No Excuse: Inadequate Cervical Cancer Prevention and Care for Black Women in the United States, Mississippi Delta.

National Institutes of Health (NIH). (2024). Survival disparities in non-Hispanic Black and White cervical cancer patients.

PubMed Central. (2022). Increased disparities associated with black women and abnormal cervical cancer screening follow-up.

National Institutes of Health (NIH). (2025). Association Between Age and Race and Cervical Cancer Stage.

Resilient Sisterhood Project. (n.d.). Black Women and Cervical Cancer.

Cervivor. (2025). Black Communities and Cervical Cancer: Breaking the Silence.

PubMed Central. (2022). Disparities in Cervical Cancer Treatment Options between African American (Black) and White Women.