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CDC Studies Find More Women Getting Pap Tests as Recommended

Some women are tested without need (Jan. 3)

Younger women (aged 30 years and younger) are getting screened consistent with newer national recommendations, according to a report from the Centers for Disease Control and Prevention (CDC). In a second study, the agency found that 60% of women continue to get Pap tests even after having a total hysterectomy. The two studies were published in Morbidity and Mortality Weekly Report.

In 2012, the U.S. Preventive Services Task Force, the American College of Obstetricians and Gynecologists, and the American Cancer Society recommended that women, beginning at age 21, should start Pap test screening every 3 years, and that women should not be screened annually. The same groups agreed that screening is unnecessary for most women who have had a total hysterectomy for noncancerous reasons, or for women aged 65 years and older with several years of normal test results.

“As we monitor Pap test use among U.S. women, we can make sure that women are being screened in accordance with guidelines, to best maximize the benefits of screening and minimize the harms,” said Meg Watson, MPH, an epidemiologist with the CDC’s Division of Cancer Prevention and Control.

The researchers for both studies analyzed Pap-test survey data from the CDC’s Behavior Risk Factor Surveillance System during 2000 through 2010.

They found that screening has become more consistent with current cervical cancer screening recommendations:

  • The percentage of women aged 18 to 21 years who reported never being screened increased from 23.6% in 2000 to 47.5% in 2010. Screening is not recommended for women under the age of 21.
  • In 2010, recent Pap testing (within 3 years) declined among women aged 30 years and older without a hysterectomy (from 73.5% in 2000 to 64.5%), primarily because of declines among women aged 65 years and older.
  • For women aged 30 years and older who had a hysterectomy, Pap testing declined from 73.3% in 2000 to 58.7% in 2010.

The researchers also found that contrary to recommendations:

  • The percentage of women aged 22 to 30 years who had not been screened increased from 6.5% in 2000 to 9.0% in 2010.
  • Women aged 30 to 64 years who did not have health insurance and had not had a hysterectomy were less likely to have received a Pap test within the previous 3 years, declining from 74.4% in 2000 to 68.7% in 2010.

“The good news is we are focusing our public health efforts on women at highest risk, while decreasing screening for women under age 21, when cervical cancer is rare and screening is not recommended,” said Keisha Houston, DrPh, Epidemic Intelligence Service officer with the CDC’s Division of Cancer Prevention Control. “We need to remain vigilant and increase screening among women who would benefit most from this preventive service.”

Because of the Affordable Care Act, many private health plans and Medicare now cover certain preventive services, including cervical cancer screening, with no copays or other out-of-pocket costs.

Source: CDC; January 3, 2013.

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