
Cervical cancer is more deadly than previously thought - Tomte
http://arstechnica.com/science/2017/01/cervical-cancer-just-got-much-deadlier-because-scientists-fixed-a-math-error/
======
jph
Cervical cancer is highly preventable. For more information and testing
options see Planned Parenthood
[https://www.plannedparenthood.org/learn/womens-health/pap-
te...](https://www.plannedparenthood.org/learn/womens-health/pap-tests-hpv-
tests)

~~~
feld
Planned Parenthood is being eradicated in this country.

~~~
elastic_church
On that subject I wanted to ask:

Are the services that Planned Parenthood provide so economically unviable that
they require the life support and political will of the US Government?

Why can't a competitor or even a Bill Gates philanthropic initiative be a
private sector version of the same thing?

~~~
rabboRubble
Here's a case that proves Planned Parenthood's unique function. PP offers
rapid HIV testing. I get a test every year because you catch that shit early,
the available treatments give you a nearly normal life.

Now this last year, I didn't go to PP for my annual lady check up for reasons
that are long and boring.

So I asked my primary care physician during the annual everything else check
up for a rapid test. She didn't have it and was surprised PP did. So instead
of a finger prick I got a blood draw and waited. Weeks later I got a test
report for everything else tested for (liver / diabetes / etc.) _except_ the
HIV and other STD tests. I ended up having to call to get the results.

So compare the 10 minute HIV test with immediate results versus the 8 week
odyssey for finding out my sexual health status.

Planned Parenthood is brilliant at what they do. They do it well. Primary care
physicians are _shiat_ at reproductive health.

~~~
elastic_church
Okay, that sounds like a user experience problem, of which federal funding has
nothing to do with?

A private organization could offer the same thing without needing to be "in
network" like your PCP? I'm guessing

~~~
rabboRubble
Normally, out of network means not covered by my insurance. Or covered at a
greatly reduced rate.

If there were a private organization that was as earnest and competent at
providing full service reproductive care up to and including abortive
treatments, I would definitely consider them as an option. Such an
organization does not exist as of today. I can't postpone medical care until
such time an organization like that exists.

Ah! I have another story that demonstrates how awesome Planned Parenthood is.
So I came back from overseas and needed a non-emergency but urgent visit. I
had insurance. Overseas insurance. I called around to OBGYNs around town
without having a local PCP. Obviously having just come from overseas, I didnt'
have a local doctor. Nobody would take me. I told them I would pay 100% cash.
Still no takers. Planned Parenthood did. They took my appointment, gave me a
price, I paid 100% of the charge, and they filled out my foreign insurance
paperwork in a foreign language.

Why is Planned Parenthood so much better at providing reproductive care and so
much more accessible than OBGYNs?

~~~
elastic_church
Typically companies that can depend on the state to keep the lights on offer
worse service.

Conceptually.

This sounds like a user experience situation, a commitment to customer
service, that has nothing to do with their federal funding. Yes they would
have to adjust or find a real revenue stream, but I think it is mutually
exclusive, unless it just simply is economically unviable.

I would totally hope there is no disruption in service. I'm just trying to
understand what advantages Planned Parenthood actually has in the marketplace
- outside of being a political football - that prevents alternatives from
being available.

~~~
rabboRubble
They have presence in every state. Granted in North Dakota, they may have only
1 office. Anywhere in the country, I'm traveling in and out of network, or
find myself as an edge case with a weird situation, raped on a business trip
in an unfamiliar city, I know they are there for me with unbiased medical
service & care.

[https://www.plannedparenthood.org/about-us/local-state-
offic...](https://www.plannedparenthood.org/about-us/local-state-
offices/planned-parenthood-health-centers-by-state)

I can't think of any other reproductive service public or private that has
such nationwide coverage.

(Edit: sort of an afterthought... Planned Parenthood isn't the political
football, it's the women in this country. I never hear about special
restrictive legislation affecting the men who rely upon Planned Parenthood.)

~~~
elastic_church
I'm still scratching my head a little, so lets reframe it another way:

Why isn't it news that Planned Parenthood has a monopoly on this health
service contract? (Perhaps their extended operational history made them the
most qualified)

Why is the only part of that contract in question related to one of the
services they provide?

I'll skim wikipedia, I suppose. I understand the convenience they offer and I
don't expect to get the answers here. I think it will be non-news after they
get defunded and continue operating on a fraction of the budget, I mean, or
not.

~~~
rabboRubble
I found this for you...

[https://www.plannedparenthoodaction.org/blog/how-federal-
fun...](https://www.plannedparenthoodaction.org/blog/how-federal-funding-
works-at-planned-parenthood)

PP doesn't have a monopoly on federal funding. In Oregon, at least, one
provider for Medicaid services is Providence Hospital. Providence is a
Catholic hospital which means they don't provide surgical or medicinal
abortions. I can get a routine OBGYN check through Providence but if I'm
pregnant and don't want to be, then Providence will refuse care.

On a personal note, I have a medical condition called endometrial hyperplasia
which can be treated with an progesterone infused IUD or difficult-to-manage
progesterone pill treatment taking only _some_ days of the 28 day cycle. Due
to the need for routine biopsies, I ultimately decided to go with the pill
(although I'm 2nd guessing the choice because it's so easy to screw up the
pill dosing). I could tell the Providence doctor was really uncomfortable with
the idea of providing an IUD. Many Catholics believe the IUD is an abortive
type birth control and refuse to provide it. I may be going back to PP if I
decide that an IUD is the better way to handle my condition. If I were more
stupid or less able to deal with remembering odd calendar based dosing
regimes, the IUD would be the only solution.

(Edit: I'd also recommend reading this article about the oversized impact of
Catholic hospitals in Washington State.

[https://www.propublica.org/article/catholic-hospitals-
grow-a...](https://www.propublica.org/article/catholic-hospitals-grow-and-
with-them-questions-of-care).

Apparently PP was paid $2million to open a branch across from a hospital being
taken over by Providence! Also note lack of emergency contraception for rape
victims and mismanagement of miscarriages in Catholic hospitals.)

~~~
elastic_church
thanks! that was very insightful

------
dmurray
>"The researchers found that black women have a mortality rate of 10.1 per
100,000. For white women, the rate is 4.7 per 100,000. Past estimates had
those rates at 5.7 and 3.2, respectively."

Let's check the numbers here.

5.7 per 100,000 is 10.1 per 177,000. The rate of cervical cancer among black
women with intact cervices is given as 10.1 per 100,000, and the change in
estimate is ascribed solely to changing the methodology to consider only women
with cervices, so 77,000 of that 177,000 had hysterectomies, or 43%. The
corresponding number for white women is 30%.

This number seems far too high. I can't find a reliable source for the US, but
[0] says "up to a fifth of women have had their womb removed by the age of 55"
in the UK. Is the rate of hysterectomies really 43% for black women, or is
someone lying about the statistics?

[0][https://www.womens-health-concern.org/help-and-
advice/factsh...](https://www.womens-health-concern.org/help-and-
advice/factsheets/hysterectomy/)

~~~
coredog64
At one point, it was so common for an African-American woman to get an
involuntary hysterectomy that it got its own euphemism: The Mississippi
Appendectomy [0]

[0]
[https://mississippiappendectomy.wordpress.com/about/](https://mississippiappendectomy.wordpress.com/about/)
(That's the first result from big G, but you should be able to find more were
you so inclined).

~~~
08-15
Come on! All people who got their womb removed in the 1920s and 30s are dead
now. They don't affect any statistics anymore, especially not those concerning
women who had their womb removed by the age of 55.

I agree with GP, a rate of >40% hysterectomies sounds unbelievable.

~~~
rabboRubble
You would like to think that forced sterilization is an old timey problem.
It's not.

The state of California forcibly sterilized ~150 female inmates as late as
2010 [0].

More to read up on... [1]

[0]
[https://en.wikipedia.org/wiki/Compulsory_sterilization#Unite...](https://en.wikipedia.org/wiki/Compulsory_sterilization#United_States)

[1] [http://www.ourbodiesourselves.org/health-info/forced-
sterili...](http://www.ourbodiesourselves.org/health-info/forced-
sterilization/)

Edit: would love to know why this post was down voted. Is there a wellspring
of support for sterilization without consent? Completely mystified at this
point.

------
shmageggy
What a bad title. It's not a math error, it's a methodological choice.
Furthermore this is basically the linked NYT article cut in half.

[https://www.nytimes.com/2017/01/23/health/cervical-cancer-
un...](https://www.nytimes.com/2017/01/23/health/cervical-cancer-united-
states-death-toll.html)

~~~
choward
I agree. Hideous title. How did cervical cancer become more dangerous? Oh. It
didn't.

------
xutopia
What are the chances of getting cervical cancer if you do have a cervix?

~~~
nonbel
>"The researchers found that black women have a mortality rate of 10.1 per
100,000. For white women, the rate is 4.7 per 100,000. Past estimates had
those rates at 5.7 and 3.2, respectively."

Mortality rate isn't really the chances of dying from the cancer though. It
looks like a variation on the old frequencies vs probabilities confusion.

~~~
goodJobWalrus
Methodological choice aside, I am primarily shocked by the size of the racial
disparity (I mean, I have expected it, but not this big).

~~~
godmodus
Black are generally more prone to the claws of sociological economic Literacy
disparities.

Lesser education or of poorer quality, + poverty = bad/no sex ed.

This is true to most minorities that suffer(ed) from discrimination.

It's am uphill battle to Remedy this. I wonder where Hispanics would land. I
assuse in-between.

Shocking numbers. Really.

~~~
loafa
Why wouldn't it just be genetically related like so many other diseases whose
prevalence vary by race?

~~~
godmodus
Because unlike regionally based illnesses we didn't discover a genetic
disposition. And these things are well researched due to the need to control
for variables. Hpv is prevalent globally, not at all a regional issue. Our
genes treat it equally, because its prevalence normalised its effects.

Regional differences might actually cause a nasty strain of hpv to arise, and
it would again effect us equally if infected.

