Research on Cervical Cancer Screening Rates

Overview of Cervical Cancer

Researchers at the Mayo Clinic have conducted an investigation into the rates of cervical cancer screening among a sample population of women in the United States. Cervical cancer, which occurs at the cervix—the narrow part of the womb connecting the uterus and vagina—is the fourth most prevalent cancer among women globally. The introduction of cervical cancer screening programs in various countries has significantly reduced mortality rates associated with this disease.

Screening Methods: Pap and HPV Tests

The Pap test, introduced in the 1950s, involves gathering cell samples from the cervix during a gynecological examination. These samples are sent to a laboratory for microscopic examination to identify any cancerous changes. The HPV test, a more recent advancement, detects high-risk strains of the human papillomavirus that elevate the risk of cervical cancer. This test can be performed on the same sample as the Pap test or from a separate sample collected simultaneously. Both tests serve distinct purposes for women across different age groups.

In 2012, the US National Cervical Cancer Screening Guidelines recommended that women aged 21 to 65 undergo Pap testing every three years, or Pap-HPV co-testing every five years for those aged 30 to 65. The Mayo Clinic researchers evaluated the trends and current uptake rates of cervical cancer screening among a sample of US women, publishing their findings in the Journal of Women’s Health.

Findings on Screening Rates

The study utilized data from the Rochester Epidemiology Project to assess Pap and Pap-HPV co-testing rates in women aged 16 and older residing in Olmsted County, Minnesota, from 2005 to 2016, involving over 47,000 participants. In 2016, 64.6% of eligible women aged 30 to 65 were current with cervical cancer screening, while 60.8% had undergone Pap-HPV co-testing. Although there was an increase in Pap-HPV co-testing, the overall Pap screening rates declined over time, particularly among younger women aged 21 to 29, where just over half were current with their screenings in 2016. These figures fall short of the 81% self-reported compliance rate noted in the 2015 National Health Interview Survey.

The research also highlighted disparities in screening rates across different racial and ethnic groups. In 2016, African-American women were 50% less likely, and Asian women nearly 30% less likely, to be up-to-date on cervical cancer screening compared to their white counterparts.

Concerns and Recommendations

While the adoption of the 2012 screening recommendations has increased, the researchers expressed concern about the declining screening rates, particularly among younger women and the racial inequalities present. Dr. Kathy Maclaughlin, the lead author, remarked, “These cervical cancer screening rates are unacceptably low. We, as clinicians, must start thinking outside the box on how best to reach these women and ensure they are receiving these effective and potentially life-saving screening tests.”

To address these challenges, suggestions include offering screenings during evenings or weekends, providing tests at urgent care clinics, or considering at-home testing kits.

References

MacLaughlin KL, Jacobson MR, Radecki Breitkopf R, et al. Trends over time in Pap and Pap-HPV Cotesting for cervical cancer screening. Journal of Women’s Health 2018 doi:10.1089/jwh.2018.7380.
Press release: Mayo researchers find “unacceptably low” cervical cancer screening rates. Mayo Clinic https://newsnetwork.mayoclinic.org/discussion/mayo-researchers-find-unacceptable-low-cervical-cancer-screening-rates/