Millions of US women are not getting screened for cervical cancer

Despite evidence that cervical cancer screening saves lives, about eight million women ages 21 to 65 years have not been screened for cervical cancer in the past five years, according to a new Vital Signs (www.cdc.gov/vitalsigns) report from the Centers for Disease Control and Prevention. More than half of new cervical cancer cases occur among women who have never or rarely been screened.

“Every visit to a provider can be an opportunity to prevent cervical cancer by making sure women are referred for screening appropriately,” said CDC Principal Deputy Director Ileana Arias, Ph.D. “We must increase our efforts to make sure that all women understand the importance of getting screened for cervical cancer. No woman should die from cervical cancer.”

Researchers reviewed data from the 2012 Behavioral Risk Factor Surveillance System to determine women who had not been screened for cervical cancer in the past five years. They analyzed the number of cervical cancer cases that occurred during 2007 to 2011 from CDC’s National Program of Cancer Registries and the National Cancer Institute’s Surveillance, Epidemiology and End Results Program. Cervical cancer deaths were based on death certificates submitted to the National Vital Statistics System.

Key findings:

• In 2012, 11.4 percent of women reported they had not been screened for cervical cancer in the past five years; the percentage was larger for women without health insurance (23.1 percent) and for those without a regular health care provider (25.5 percent).
• The percentage of women not screened as recommended (www.cdc.gov/cancer/cervical/basic_info/screening.htm) was higher among older women (12.6 percent), Asians/Pacific Islanders (19.7 percent), and American Indians/Alaska Natives (16.5 percent).
• From 2007 to 2011, the cervical cancer incidence rate decreased by 1.9 percent per year while the death rate remained stable.
• The Southern region 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 five years (12.3 percent).

Using the human papillomavirus (HPV) vaccine as a primary prevention measure could also help reduce cervical cancer and deaths from cervical cancer. Another recent CDC study showed that the vaccine is underused; only 1 in 3 girls and 1 in 7 boys had received the 3-dose series in 2013. The HPV vaccine is recommended as a routine vaccine for children 11 – 12 years old. Modeling studies have shown that HPV vaccination and cervical cancer screening combined can prevent as many as 93 percent of new cervical cancer cases.

Even with improvements in prevention and early detection methods, most cervical cancers occur in women who are not up-to-date with screening. Addressing financial and non-financial barriers can help increase screening rates and, in turn, reduce new cases of and deaths from this disease.

Efforts to prevent cervical cancer

CDC’s National Breast and Cervical Cancer Early Detection Program (www.cdc.gov/cancer/nbccedp/) provides low-income, uninsured, and underinsured women access to breast and cervical cancer screening and diagnostic services in all 50 states, the District of Columbia, 5 U.S. territories, and 11 American Indian/Alaska Native tribes or tribal organizations.

Through the Affordable Care Act, more Americans can find and choose health care coverage that fits their needs and budget, including important preventive services such as cervical cancer screening and HPV vaccines that can be covered with no additional costs. Visit Healthcare.gov or call 1-800-318-2596 (TTY/TDD 1-855-889-4325) to learn more.

To learn more about recommended ages and tests for cervical cancer screening, visit: www.cdc.gov/cancer/cervical.

To learn more about HPV vaccine recommendations, visit: www.cdc.gov/vaccines/teens.

Vital Signs (www.cdc.gov/vitalsigns) is a report that appears on the first Tuesday of the month as part of the CDC journal, Morbidity and Mortality Weekly Report (www.cdc.gov/mmwr). The report provides the latest data and information on key health indicators.  These are cancer prevention, obesity, tobacco use, motor vehicle passenger safety, prescription drug overdose, HIV/AIDS, alcohol use, health care-associated infections, cardiovascular health, teen pregnancy, food safety, and viral hepatitis.

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U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES