Confronting Cervical Cancer Disparities in AANHPI Communities by Bridging Cultural Barriers

In this second blog post for AANHPI Heritage Month, we explore the health disparities affecting Asian American, Native Hawaiian, and Pacific Islander cervical cancer survivors.

Previously, Cervivor community members Arlene Simpson (Filipina), Joslyn Chaiprasert-Paguio (Chinese-Thai), Anna Ogo (Japanese), and Anh Le (Vietnamese) shared their diverse experiences, revealing a shared truth: While stigma and cultural silence around cervical and other “below-the-belt” cancers are common, their impact varies across AANHPI communities.

Despite these differences, many face similar systemic barriers to prevention, screening, and timely care—barriers that continue to cost lives. Case in point:

  • According to the American Cancer Society, Pap test screening is significantly lower among Chinese (69%) and Asian Indian (74%) women compared to white women (84%). This gap in screening may contribute to later-stage diagnoses and worse outcomes. 
  • HPV vaccination rates also lag behind national averages. A 2023 Centers for Disease Control and Prevention (CDC) report found that only 58% of Asian American adolescents had initiated the HPV vaccine series—lower than their Hispanic (73%) and White (61%) counterparts.
  • A 2024 ACS article also noted that while cervical cancer rates are higher in some parts of Asia, many AANHPI individuals are unaware of risks based on their country of origin. 

Experts and survivors highlight the following key challenges to reversing these trends as well as some promising progress: 

Language Barriers

Dr. Ha Ngan “Milkie” Vu

Asian Americans come from over 30 countries and speak more than 100 languages and dialects, explains Dr. Ha Ngan “Milkie” Vu, Assistant Professor at Northwestern University’s Feinberg School of Medicine. These linguistic and cultural differences often make accessing health information difficult.

As Arlene shares, “Medical terms don’t always translate clearly, and jargon makes it harder. Even basic words like ‘cervix’ don’t translate well in some cultures.” Joslyn, featured in Everyday Health, says, “In Thai, there’s no direct word for cervix—it’s described as a ‘plug’ that keeps the baby in. Without a proper term, how do you talk about your body?”

These communication challenges are often compounded by a lack of in-language medical materials. Dr. Jennifer Tsui, Associate Professor of Population and Public Health Sciences at USC’s Keck School of Medicine, recalls translating for her Asian immigrant grandparents at medical visits—an experience common to many second-generation individuals. Through her current work on the National Cancer Institute-funded ACHIEVE Study, which examines barriers to cervical cancer treatment and survivorship care, she has found that many patients want materials in their native language to understand whether the vaccine has been tested in their communities and if it’s effective for different Asian American groups.

Dr. Jennifer Tsui

Bridging these language gaps often requires more than translation—it takes cultural nuance. Dr. Zhengchun Lu, a cancer pathologist and resident physician at Oregon Health & Science University, originally from Zhenjiang, China, actively works to meet patients where they are. She communicates with Chinese-speaking patients and adapts CDC and World Health Organization (WHO) materials into formats that resonate culturally. For other language needs, she collaborates with hospital interpreters. “Removing language barriers also removes fear—people feel empowered to get screened,” she says.

Dr. Zhengchun Lu

To support these efforts, organizations like the American Cancer Society offer multilingual resources through their “Cancer Information in Other Languages” initiative, which provides materials in 13 languages, including Chinese, Korean, Tagalog, and Vietnamese. Making vital information more accessible is a crucial step toward equity in prevention and care.

Limited Awareness, Not Hesitancy

In the first post, Dr. Lu emphasized that many AANHPI patients simply lack awareness about HPV and the need for regular cervical cancer screenings. The same goes for the HPV vaccine.

Dr. Tsui’s research confirms this: “Many people hadn’t heard of the HPV vaccine or didn’t know it helps prevent multiple cancers.”

Adolescents often help bridge the gap. “Teens are more acculturated and read the materials—they’re the ones bringing this information home and influencing family decisions,” she says.

Trusted community messengers also matter. “In many Asian communities, people rely on their aunts, grandmothers, and community leaders,” says Dr. Tsui. “That’s why strong local partnerships are key.”

Navigating a Complicated Health System

Confusion about the U.S. healthcare system can delay screenings and treatment. While many AANHPI communities hold physicians in high regard and prefer care from well-known institutions, accessing these systems—or even getting a second opinion—can be complicated, explains Dr. Tsui.

For patients with abnormal Pap results, referrals to specialists often mean traveling to unfamiliar facilities without language support, creating additional barriers. Demanding work schedules further complicate making and keeping appointments.

To address this, Dr. Lu’s team partners with local groups to host screening events staffed by bilingual volunteers. “Bringing services directly to the community has built trust and boosted participation,” she says.

She also sees promise in HPV self-collection. “It’s not a home test, but it can be offered at outreach events under medical supervision. It’s more private, more flexible, and less intimidating—especially for those wary of pelvic exams.”

Dr. Lu works with Rabeka Ali, the research coordinator at OHSU Pathology, during an HPV testing event at a Chinese church in Portland, OR.

Lack of Gender Concordance

“In our Filipino culture, especially among older generations, there’s a belief that you don’t question the doctor—or that traditional remedies are better,” says Arlene. “But many women also feel uncomfortable discussing reproductive health with male doctors and may avoid care because of it.”

Dr. Tsui agrees. “Women are less likely to follow up if they don’t feel comfortable with their provider. In local Asian American communities like our Chinatown, having female doctors can make all the difference.”

Anti-Asian and Anti-Immigrant Sentiment

Lingering fear from the pandemic and rising anti-immigrant rhetoric have also impacted care-seeking behaviors. A 2024 Axios/Harris poll found that 50% of Americans support mass deportations of undocumented immigrants, fueling anxiety in immigrant communities.

“There was definitely a delay in seeking care—not just because of COVID, but because of fear,” says Dr. Tsui. Many in the AANHPI community avoided medical visits due to rising anti-Asian sentiment and concerns about overusing medical resources—or fears that if they left the country, they might not be allowed to return.

This fear compounded the silence around health issues like cervical cancer, which only deepened stigma, Arlene adds. “It’s more important than ever to speak up, share our stories, and help Asian women feel safe and supported.”

Dr. Tsui’s team regularly works in Asian American communities around USC.

Dr. Tsui sees hope in community-driven efforts: “It’s not all doom and gloom. In cities like San Francisco, LA, New York, Chicago, and Atlanta, AANHPI organizations are stepping up. Local clinics and advocates are helping people understand their rights and access life-saving care—just as they did during the pandemic.”

Cultural Beliefs and Cancer Fatalism

Dr. Tingting Zhang

In a 2024 American Cancer Society article, Dr. Tingting Zhang, a thyroid cancer survivor, patient advocate, and CEO of ONEiHEALTH, noted: “Some AANHPI individuals may avoid discussing cancer risk, viewing it as a bad omen or personal failure. But cancer is not retribution—it’s biology. And early detection saves lives.”

Cancer fatalism is a well-documented barrier. As Dr. Vu adds, “In my research, Filipino and Vietnamese respondents reported especially high levels of fatalistic beliefs. That mindset can lead to inaction—people believe they can’t change their outcomes, so they don’t engage in prevention. That’s why education is key: the HPV vaccine prevents cancer. We need to make that message loud and clear.”

Let’s Keep Breaking the Silence

At Cervivor, Inc. we believe that every story matters—and every voice can spark change. If you are an AANHPI cervical cancer survivor, caregiver, or advocate, we invite you to join our community. Better yet, share your unique Cervivor Story. (Submit your story here.) Together, we can dismantle stigma, increase awareness, and save lives.

From Awareness to Action: Empowering Voices to End HPV-Related Cancers

Every year, over 600,000 people worldwide are diagnosed with HPV-related cancers, including cervical, anal, oropharyngeal, penile, vulvar, and vaginal cancers. In the United States alone, more than 14,000 women are diagnosed with cervical cancer annually. These statistics highlight the urgent need for awareness, education, and collective action—especially on HPV Awareness Day (March 4). The good news? Many of these cases and deaths are preventable.

The Facts About HPV

Human papillomavirus (HPV) is extremely common, with 80% of people contracting it at some point in their lives. Despite its prevalence, many people mistakenly believe that HPV only affects women. However, HPV can affect anyone, regardless of gender. One of the challenges with HPV is that it often has no visible symptoms, making it difficult to know if you have it.

While cervical cancer accounts for most HPV-related cancer diagnoses, cases of head and neck and anal cancers in both men and women are increasing. In fact, HPV is responsible for 60,000 cancer diagnoses in men each year. 

Although there is no approved screening test for other HPV-related cancers, for individuals with a cervix, cervical cancer screening can detect abnormal cells in the cervix that could develop into cervical cancer, while an HPV test indicates that the virus is present in the cervix. If you notice genital warts or have concerns about HPV, it’s essential to speak with your healthcare provider to detect and treat HPV early.

Expert Insights with Dr. Shobha S. Krishnan

Dr. Shobha S Krishnan is a renowned board-certified family physician and gynecologist with over 30 years of experience in primary care and women’s health. As the Founder and President of the Global Initiative Against HPV and Cervical Cancer (GIAHC), she has dedicated her career to combating cervical cancer and HPV-related diseases globally. Her work has taken her to various parts of the world, including rural India, where she has implemented innovative screening and treatment methods, such as visual inspection with acetic acid (VIA) and cryotherapy.

“Cervical cancer is something that we can almost completely eliminate by vaccination and screening. However, we should not even have one death, because we have the tools to prevent it.”

– Dr. Shobha S Krishnan, Future Science OA

Through GIAHC, Dr. Krishnan aims to educate providers, parents, and the public about the importance of HPV vaccination, screening, and early treatment. Despite the challenges faced in both developed and developing countries, Dr. Krishnan remains committed to making the HPV vaccine affordable, accessible, and acceptable to all. Her organization has partnered with various groups, including the American Medical Women’s Association, to raise awareness and promote education about HPV and cervical cancer. Her book, “The HPV Vaccine Controversy,” is a valuable resource for anyone seeking to understand the disease and the importance of vaccination.

Meet Morgan Newman: A Young Adult’s Journey with Cervical Cancer

At just 24 years old, Morgan Newman received the devastating news that she had stage III cervical cancer. Despite undergoing intense treatments, including chemotherapy, radiation, and a metastatic recurrence to her lungs. “I’ll admit, when I was a teenager, I was very hesitant to get the HPV vaccine. My mom begged me to get it, but I told her no because I was skeptical, and I told her it would never happen to me.”

Soon after Morgan entered the survivorship phase, she found her voice through the Cervivor community by attending a patient advocacy training. Now, 10 years later, she’s on a mission to raise awareness and empower others. Morgan proudly serves as Cervivor’s Community Engagement Liaison. “I’m lucky because I went in for a routine screening, and that’s how my cancer was detected. I’m lucky because my body responded to two journeys with cervical cancer.”

HPV-Related Cancer Survivors Share Their Stories

Quinn Billie Jo was diagnosed with stage III anal cancer, which severely impacted her quality of life. The tumor destroyed her sphincter muscle, causing severe issues like incontinence, and she is now scheduled for surgery, which will result in two colostomy bags, one for urine and one for fecal matter. Despite their resilience, Quinn faces the added burden of stigma surrounding anal cancer, often receiving uncomfortable reactions when sharing their diagnosis. Quinn would like to change that narrative.

Patrick, a penile cancer survivor, is advocating for increased awareness and conversation about human papillomavirus (HPV) and its link to male cancers. After being diagnosed with penile cancer in 2020, Patrick underwent life-altering surgery and treatment. He is now urging young people to get vaccinated against HPV and encouraging older men to speak openly about male cancers, emphasizing that conversations about penile cancer should be as normalized as those about breast cancer.

Ada, a 62-year-old single mother of two, was diagnosed with HPV-positive squamous cell carcinoma after discovering a lump on her neck, which she initially thought was a reaction to a bee sting. Following a series of medical appointments, biopsies, and surgeries, Ada underwent 33 radiation sessions and six rounds of chemotherapy. She credits the bee sting with saving her life, as it led her to discover the cancer. With the support of her loved ones, Ada successfully completed her treatment and rang the bell, symbolizing her triumph over cancer.

Teresa, a 40-year-old Black woman, was diagnosed with vulvar cancer after visiting her doctor about a persistent bump on her vulva. Despite her initial calm demeanor, Teresa’s world was turned upside down when her doctor revealed that the cancer was more aggressive than anticipated. After undergoing two surgeries, including a node dissection, Teresa was relieved to learn that the cancer had not spread to her lymph nodes. Now cancer-free, Teresa advocates for HPV vaccination, particularly among young Black women, who she believes are more vulnerable to the virus. She emphasizes the importance of early detection and encourages open conversations about vulvar cancer to combat shame and stigma.

A Call to Action: Eliminating HPV-Related Cancers

So, what can you do to help eliminate HPV-related cancers? The answer is simple: Every action counts, every voice matters, and every choice can make a difference. By taking control of our own health, sharing our stories, and supporting others, we can create a ripple effect that spreads far and wide. Here are some ways you can join the movement:

  1. Get Informed: Learn about HPV, its risks, and the importance of vaccination and screening. Share this knowledge with others to help spread awareness.
  2. Get vaccinated: The HPV vaccine is available for both males and females and can protect against certain types of HPV that can cause cancer.
  3. Get screened: Regular cervical cancer screening can help detect abnormal cell changes early, when they’re easier to treat.
  4. Share your story: If you or someone you know has been affected by HPV-related cancer, share your story to help raise awareness and support others.

The statistics are staggering, the stories are heart-wrenching, but the message is clear: We have the power to eliminate HPV-related cancers. By sharing our stories, educating ourselves and others, getting vaccinated, and getting screened, we can create a world where no one has to suffer from these preventable diseases.

“Our stories are powerful, but they’re so much more impactful as a collective voice.” – Morgan Newman

Let’s continue to break the silence, let’s shatter the stigma, and let’s unite in our quest for an HPV cancer-free future. Join the movement, share your voice, and together, we can make a difference.