Disparities in HPV and Cervical Cancer Among Black and Hispanic/Latina Women: A Critical Review

Introduction

Human papillomavirus (HPV) is widely established as the etiologic agent for nearly all cases of cervical cancer (Sokale et al., 2025). Despite advances in prevention, screening, and treatment, Black and Hispanic/Latina women continue to bear a disproportionate burden of disease. This article reviews key epidemiologic trends, structural and biological contributors, and potential strategies to narrow these disparities.

Epidemiologic Patterns & Disparities
HPV Burden & Oncogenic Risk

There are more than a dozen “high-risk” HPV types that confer elevated cancer risk (e.g., HPV-16, HPV-18) (Sokale et al., 2025). While HPV infects individuals from all demographic groups, non-Hispanic Black and Hispanic populations are disproportionately affected by HPV-related cancers (Sokale et al., 2025).

Incidence, Stage at Diagnosis, and Mortality

Black women often receive diagnoses at older ages (e.g., median age 50–54) compared to White (45–49) (de Melo et al., 2024).

Black women exhibit the highest mortality rates and lowest five-year relative survival across cervical cancer subtypes and stages (de Melo et al., 2024).

Hispanic women have the second highest cervical cancer mortality rate, only behind non-Hispanic Black women (CDC, 2025).

Black women’s mortality is estimated to be ~65% higher than that of White women; Hispanic women’s mortality is ~30% higher (Cancer Today, 2022).

Black and Hispanic women are more likely than White women to present with regional or distant disease rather than localized disease (Yu et al., 2019).

These patterns imply delays in detection, access, or effective follow-up once abnormal results are found.

Screening & Follow-up Disparities

Although screening (e.g., Pap tests, HPV testing) has reduced cervical cancer incidence overall, underutilization of follow-up care after abnormal screening disproportionately affects Black and Hispanic women (Boitano et al., 2022).

In a study of 284 women referred for colposcopy, 45.9% of Black women failed to present for follow-up after abnormal screening, compared to lower rates in non-Hispanic White counterparts (Boitano et al., 2022).

About 25% of Black and Hispanic women experience delayed follow-up (≥ 3 months), compounding the risk of progression (Boitano et al., 2022).

Rural–urban disparities further exacerbate inequities: Black and Hispanic women in rural areas have higher incidence of regional and distant-stage disease compared to their White counterparts (Yu et al., 2019).

Contributing Factors & Mechanisms
Structural & Social Determinants of Health

Insurance & medical access: Black and Hispanic women are more likely to be uninsured or rely on Medicaid, limiting access to preventive services (Cancer Today, 2022; CDC, 2025).

Health care access & geography: Many live in medically underserved or rural areas where screening, referral networks, or specialist availability are limited (Yu et al., 2019).

Socioeconomic constraints (transportation, childcare, work inflexibility) and health literacy disparities create barriers to attending screening or follow-up (Perez, 2023).

Cultural & language barriers: Language discordance and cultural stigma around sexual health further discourage screening or follow-up (Perez, 2023).

Systemic bias & mistrust: Historical and ongoing discrimination in healthcare settings can decrease engagement and trust in medical recommendations (Agénor et al., 2024).

Biological & Viral Factors

Some studies propose that viral clearance rates differ by race, with Black women potentially taking longer to clear HPV infection (Cancer Today, 2022).

There is emerging evidence that non-16/18 high-risk HPV strains may be more prevalent in Black and Hispanic women, possibly leading to lesions that are less targeted by standard screening or vaccine strategies (Cancer Today, 2022).

Chronic stress and its immunologic sequelae (driven by social adversity) may impair viral clearance or cellular repair, contributing to oncogenesis (Cancer Today, 2022).

Strategies & Recommendations
Strengthen Prevention & Vaccination

Increase culturally tailored HPV vaccination outreach in minority communities, with clear messaging about safety, effectiveness, and cancer prevention (Sokale et al., 2025).

Partner with community organizations, faith-based institutions, and trusted community leaders to improve uptake.

Improve Screening & Follow-up Infrastructure

Expand low-cost or free screening clinics in underserved areas.

Develop patient navigation systems that aid scheduling, reminders, transportation, and follow-up support.

Use mobile health units or telehealth where feasible to reach remote communities.

Implement automated recall systems and provider feedback loops to reduce loss to follow-up.

Culturally Competent Care & Provider Awareness

Train health care providers in cultural humility, implicit bias, and trauma-informed communication to build trust with Black and Hispanic patients (Agénor et al., 2024).

Encourage providers to proactively recommend HPV vaccination and screening, particularly in underrepresented populations.

Research & Policy Interventions

Support research into racial and ethnic differences in HPV strain prevalence, immune response, and tumor biology.

Advocate for policy changes to increase insurance coverage, fund safety-net clinics, and reduce cost barriers to screening and treatment.

Allocate resources toward community-based participatory research involving Black and Hispanic women to shape interventions.

Conclusion

HPV-driven cervical cancer is largely preventable, yet Black and Hispanic/Latina women continue to suffer disproportionately from later-stage diagnoses, lower survival, and inadequate follow-up care. These disparities arise from a complex interplay of structural inequities, social determinants, healthcare access, and possibly biological differences. To eliminate this health injustice, multi-level strategies must be deployed—centered in equity, community engagement, and sustained systemic change.