US Not Making the Grade on Cervical Cancer Screening

Megan Brooks

November 05, 2014

Cervical cancer screening saves lives, yet about 8 million women aged 21 to 65 years in the United States have not been screened in the past 5 years, federal health officials with the US Centers for Disease Control and Prevention (CDC) said today.

"There continue to be women who are not screened as recommended, and women who die from this preventable cancer," write Vicki B. Bernard, PhD, of the CDC's Division of Cancer Prevention and Control, and colleagues in a report published today in CDC Vital Signs.

"No woman should ever die from cervical cancer," Ileana Arias, PhD, CDC principal deputy director, said during a media briefing about the new data.

"Screening has been proven to work, but not enough women are getting these recommended preventive services. We need to take action now to increase cervical cancer screening by educating women, eliminating barriers to care, and seizing on existing opportunities to provide this preventive care," Dr Arias said.

According to data from the 2012 Behavioral Risk Factor Surveillance System survey, an estimated 11.4% of women were not screened for cervical cancer in the past 5 years. The figure was larger for women lacking health insurance (23.1%) and for those without a regular healthcare provider (25.5%).

The percentage of women not screened as recommended was also higher among older women (12.6%), Asians/Pacific Islanders (19.7%), and American Indians/Alaska Natives (16.5%).

"We already know that over half of cervical cancers occur in women who have never been screened or who have not been screened in the past 5 years; increasing screening among these women will make the greatest impact on the cervical cancer burden in the US," Dr Arias told reporters.

From 2007 to 2011, women living in the southern United States had the highest rate of cervical cancer (8.5 per 100,000), the highest death rate (2.7 per 100,000), and the largest percentage of women who had not been screened in the past 5 years (12.3%), the report notes.

"We have seen incredible reductions in cervical cancer incidence and deaths since the Pap test was first introduced in 1950. We know that screening works," Dr Arias said.

Yet each year, more than 12,000 women get cervical cancer, and more than 4000 women die of the disease. As many as 93% of all cervical cancer cases could be prevented by cervical cancer screening and human papillomavirus (HPV) vaccination, Dr Arias said.

Unfortunately, the HPV vaccine continues to be underutilized, Dr Arias said.

A recent CDC study found that only one in three eligible girls and one in seven eligible boys received the three-dose series in 2013. The HPV vaccine is recommended as a routine vaccine for children aged 11 to 12 years. "Girls and boys have the best protection when they receive all doses as recommended before they are exposed to HPV. Girls ages 13-26 and boys ages 13-21 should get the vaccine if they have not received it already," the Vital Signs report notes.

The CDC recommends that women aged 21 to 29 years have a Pap test every 3 years. Women aged 30 to 65 should have a Pap test every 3 years or a Pap test plus HPV test every 5 years.

"Every visit to a provider is an opportunity to screen or make sure that women are getting screened and that preteens and teens are getting vaccinated," Dr Arias said.

CDC Vital Signs. Published online Nov 2014. Full Text

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