Rates of cervical cancer screening have dropped in the U.S., with screening rates lowest among Asian and Hispanic women, as well as women who live in rural areas, don’t have insurance, or identify as LGBQ+, according to researchers with The University of Texas Health Science Center at Houston ( UTHealth Houston ).
A nationally representative cross-sectional study of 20,557 women led by Ryan Suk, PhD, an assistant professor of management, policy and community health at UTHealth School of Public Health, 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, which pulled data from the National Health Information Survey (NHIS) from the Centers for Disease Control and Prevention (CDC), was published today in JAMA Network Open.
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+ to 64.4% of women with Hispanic ethnicity.
“What this means is that more campaigns about cervical cancer screenings are needed,” Suk said. “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 among women living in rural versus urban areas (26.2% vs. 22.6%); those without insurance versus those with private insurance (41.7% vs. 18.1%); and women identifying as LGBQ+ versus heterosexual (32.0% vs. 22.2%). Transgender individuals could not be identified because the NHIS data does not have information on transgender and only includes a binary sex variable of male and female.
Other key findings include:
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,” Suk 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.”
UTHealth Houston co-authors on the report include Suja S. Rajan, PhD, associate professor in the Department of Management, Policy, and Community Health at UTHealth School of Public Health, and Yenan Zhu, MS, research assistant at the school. Other co-authors include Young-Rock Hong, PhD, and Zhigang Xie, MPA, with the University of Florida and Jennifer C. Spencer, PhD, with the University of Texas at Austin.
JAMA Network Open
10.1001/jamanetworkopen.2021.43582
18-Jan-2022