PIH11 EXAMINING CERVICAL CANCER SCREENING INTERVALS AMONG WOMEN WITH NEWLY DIAGNOSED CERVICAL CANCER

Abstract

To describe cervical cancer screening rates among women with newly diagnosed cervical cancer and evaluate the screening patterns against established guidelines. Women aged 21-64 years with incident cervical cancer diagnosed between 2010 and 2017 were identified in the IBM® MarketScan® Explorys® Claims-EMR Data Set, which includes detailed administrative medical and pharmacy claims data and clinical and laboratory information. The interval between cervical screening tests (cytology or cytology and HPV), rates of colposcopy and cervical intraepithelial neoplasia (CIN) were described. Women with a prior diagnosis of cervical cancer or CIN were excluded. There were 3,291 newly diagnosed cervical cancer cases. The look-back period ranged from 1 to 15 years, during which 75% of women had evidence of cervical cancer screening while 25% did not have evidence of a cervical cancer screening exam in the linked claims-EMR database. Among women with no record of a screening exam, many demonstrated a history of other medical encounters; 82% had at least one physician visit in the year prior to their cervical cancer diagnosis. Of the 3,921 women with cancer, 1,279 had at least 3 years of continuous data during the 10 years prior to the diagnosis of cervical cancer. Of these, a subgroup of 811 (84%) did not have documentation of prior CIN. Among this subgroup of women, 3.4 unique screening exams were observed with an average interval of 3.8 years. The occurrence of cervical cancer among screened women adds information regarding how to optimize a screening program to prevent the occurrence of advanced disease. The observation that most unscreened women had concurrent medical encounters underscores the opportunity for health care providers to discuss a patient’s risk, confirm the date of her last cervical screening exam and reinforce the importance of routine cervical cancer screening.