Rates of cervical cancer screening have dropped recently in the United States, with screening rates lowest among Asian and Hispanic women, as well as women who live in rural areas, are uninsured, or are sexual minorities, according to findings published by Ryan Suk, PhD, and colleagues in JAMA Network Open.
The nationally representative, cross-sectional study of 20,557 women revealed a major uptick in the proportion in women without an up-to-date cervical cancer screening among all sociodemographic groups—from 14.4% in 2005 to 23.0% in 2019. The study pulled data from the National Health Information Survey (NHIS) from the Centers for Disease Control and Prevention. Major disparities were found across different sociodemographic groups. Still, the most commonly reported reason for not receiving a timely screening across all groups was lack of knowledge, ranging from 47.2% of women identifying as LGBQ+ (defined as lesbian, gay, bisexual, other, or unsure) to 64.4% of women with Hispanic ethnicity.
Ryan Suk, PhD
“What this means is that more campaigns about cervical cancer screenings are needed,” said Dr. Suk, Assistant Professor of Management, Policy, and Community Health at UTHealth School of Public Health. “There would need to be targeted, culturally adapted campaigns for each of these sociodemographic groups.”
Significantly higher rates of overdue screening were found among women of Asian descent compared with those of non-Hispanic White race and ethnicity (31.4% vs 20.1%). There were also higher rates of overdue screening among women living in rural vs urban areas (26.2% vs 22.6%), those without insurance vs those with private insurance (41.7% vs 18.1%), and women who identified as LGBQ+ vs heterosexual (32.0% vs 22.2%). Transgender individuals could not be identified because the NHIS data does not have information on transgender people and only includes a binary sex variable of male and female.
Other key findings include:
Dr. Suk said that these findings underscore the importance of recommendations from health-care professionals in promoting cervical cancer screenings, which may play an even larger role as access to care continues to improve.
“Timely cervical cancer screening is a crucial prevention measure of cervical cancer, especially for those who could not benefit from the introduction of HPV vaccine,” she said. “Most cervical cancer cases are preventable, and we need to spend more efforts on improving overall timely screening rate, but also on reducing disparities across diverse populations. This study emphasizes and reminds us that we need a more inclusive and sustainable approach in the implementation of this evidence-based screening strategy.”
Disclosure: For full disclosures of the study authors, visit jamanetwork.com.The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.