Trends in Cervical Cancer Screening Versus National Guidelines [23J

Abstract

INTRODUCTION: Guidelines for cervical cancer screening via pap smear changed in 2012. Previous studies suggest mixed opinions about extended screening intervals. This descriptive study relates trends in pap smear use with the new recommendations. METHODS: Self-reported pap smear information from 2012-2014 Behavioral Risk Factor Surveillance System (BRFSS) surveys were weighted for the US population and subsequently analyzed using SPSS per The BRFSS Data User Guide. Age groups were determined by the 2012 cervical cancer screening guidelines. RESULTS: American women who reported “ever having a pap” declined 1.3% from 2012-2014. Specifically, Paps performed in 18-20 year olds decreased from 38.6% (n=2,580,856) to 27% (n=1,703,912). During this time period, the estimated percentage of women who “had a pap within the last year” declined from 53.6% (n=57,395,954) to 48.4% (n=49,965,054). In 2014 alone, approximately 70% (n=1,184,449) of 18-20 year olds and 23.6% (n=4,832,250) of women over 65 had their most recent pap within the previous year. Conversely, the number of women with a 3-year interval between Paps increased from 7.8% (n=8,327,940) to 9.5% (n=9,831,709) from 2012-2014. CONCLUSION: National Pap smear use is slowly aligning with 2012 guidelines, yet screening trends remain problematic. From 2012-2014, many women aged 18-20 or over 65 underwent a pap while no longer indicated, and few women utilized the extended interval. This can increase use of invasive follow-up procedures, anxiety, and cost, therefore contributing to excessive healthcare spending. Continued analysis of national pap testing will guide future studies that may unveil causes of excessive cervical cancer screening from the physician and patient perspective.