Changes to cervical cancer prevention guidelines: effects on screening among U.S. women ages 15-29

Prev Med. 2013 Jan;56(1):25-9. doi: 10.1016/j.ypmed.2012.10.025. Epub 2012 Nov 5.

Abstract

Objective: A shift toward later initiation of cervical cancer screening for women began in 2002. We generated national estimates of screening prevalence rates and guideline-consistent screening among U.S. women ages 15-29 before and after the first evidence-based recommendations for reduced cervical cancer screening.

Method: We used National Survey of Family Growth data to compare self-reported cervical cancer screening in 2002 and 2006-2008, stratified by age (15-17, 18-20, 21-29) and sexual activity. We also assessed receipt of guideline-consistent screening by selected demographic variables.

Results: Among females ages 15-17, the proportion screened decreased from 23% to 12%, and screening was significantly more likely to be guideline-consistent. Among females ages 18-20, 24% were screened too early in 2006-2008, but among those not yet sexually active, screening declined to 8%, appropriately reflecting new guidelines. In multivariable analysis, private health insurance, pregnancy, and hormonal contraceptive use were associated with guideline-consistent screening among sexually-active women.

Conclusion: Fewer adolescents were being screened before sexual initiation, representing newer guidelines. However, sexually-active young adult women also should have later screening initiation. Factors related to health care access contribute to receipt of screening. Monitoring and provider education are needed to improve guideline-consistent screening, as newer guidelines call for less screening.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Female
  • Health Care Surveys
  • Human papillomavirus 16 / isolation & purification
  • Humans
  • Mass Screening / standards*
  • Mass Screening / statistics & numerical data
  • Multivariate Analysis
  • Practice Guidelines as Topic*
  • United States
  • Uterine Cervical Neoplasms / prevention & control*
  • Vaginal Smears / statistics & numerical data
  • Young Adult