Overuse of Cervical Cancer Screening Tests Among Women With Average Risk in the United States From 2013 to 2014

Wright, Jason D.; Chen, Ling; Tergas, Ana I.; Melamed, Alexander; Clair, Caryn M. St.; Hou, June Y.; Khoury‐Collado, Fady; Gockley, Allison; Accordino, Melissa K.; Hershman, Dawn L.

doi:10.1001/jamanetworkopen.2021.8373

Cited by 23 publications

(39 citation statements)

References 34 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This study noted a similar disparity for breast cancer screening with mammography 26 . We found that women who did not undergo cervical cancer screening were unlikely to undergo a routine gynaecological examination, a finding previously reported in women with commercial insurance 10 . Although the value of an annual gynaecological examination has been the subject of debate, the findings further highlight the potential for disengagement from the healthcare system if cervical cancer screening is not routinely performed 27–30 .…”

Section: Discussionsupporting

confidence: 78%

“…10 A previous analysis of women with commercial insurance noted that nearly two-thirds of women were over-screened with repeat testing within 3 years compared with the 33% of Medicaid beneficiaries noted in the current analysis. 10 Several factors probably contribute to the differential in overscreening. Medicaid beneficiaries have a poorer connection | 1109 to the medical system compared with insured women and therefore have potentially fewer interactions with providers in which screening tests may be offered.…”

Section: Discussionmentioning

confidence: 52%

“…26 We found that women who did not undergo cervical cancer screening were unlikely to undergo a routine gynaecological examination, a finding previously reported in women with commercial insurance. 10 Although the value of an annual gynaecological examination has been the subject of debate, the findings further highlight the potential for disengagement from the healthcare system if cervical cancer screening is not routinely performed. [27][28][29][30] Further data on the long-term patterns of follow up and return for screening of Medicaid recipients who elect 3-to 5-year intervals between cervical cancer screening tests are clearly needed.…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Patterns of cervical cancer screening among Medicaid beneficiaries

Dillon

Chen

Melamed

et al. 2021

BJOG

Self Cite

View full text Add to dashboard Cite

Objective: Cervical cancer screening guidelines have evolved over time with the incorporation of human papillomavirus (HPV) testing along with cytology. Current screening guidelines recommend cytological screening every 3 years or HPV testing with or without cytology every 5 years in women age 30-65 years. We examined the use of cervical cancer screening among average-risk Medicaid beneficiaries.Design: Retrospective cohort study.Population: Women age 30-64 years at average risk for cervical cancer who underwent cervical cancer screening with cytology, co-testing or primary HPV testing from 2013 to 2016. Methods:The IBM Watson Health Multi-State Medicaid MarketScan Database was used. Subsequent screening rates within 3 years of the index test were examined. Main outcome measure:The rate of repeat cervical cancer screening was analysed using a cumulative incidence function.Results: A total of 265 083 patients were identified. Overall, 43.1% (n = 114 312) had index co-testing, 55.2% (n = 146 309) had cytology and 1.7% (n = 4462) had primary HPV testing. The cumulative incidence of early, repeat cervical cancer screening was 3.9% at 12 months, 22.7% at 24 months and 33.3% at 36 months. During the period from 12 to 24 months after follow up, 20.9% of women underwent repeat screening while 19.4% underwent repeat screening 24-36 months after the index test. Among women who did not undergo repeat cervical cancer screening, a yearly gynaecological examination was performed in only 16 627 (10.7%) during year 2 and in 11 116 (8.8%) during year 3. Conclusion:Among average-risk Medicaid beneficiaries, cervical cancer screening is frequently overused. Women who do not undergo cervical cancer screening are unlikely to undergo routine gynaecological examination.

show abstract

Section: Discussionsupporting

confidence: 78%

Section: Discussionmentioning

confidence: 52%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Patterns of cervical cancer screening among Medicaid beneficiaries

Dillon

Chen

Melamed

et al. 2021

BJOG

Self Cite

View full text Add to dashboard Cite

show abstract

“… 10 , 35 The American Cancer Society recommends the HPV test as the preferred primary screening method for cervical cancer for women 25 to 65 years of age. 36 Alternatively, individuals can be screened simultaneously with both the HPV and Pap tests (cotesting). Screening using HPV tests can be conducted less frequently than Pap tests ( i.e., every 5 years instead of three), decreasing the number of procedures and potential harm, including vaginal bleeding, pain, infections, and distress, throughout the lifetime of a patient.…”

Section: Early Detection For the Preventive Care Of Hpv-related Cancermentioning

confidence: 99%

“…Screening using HPV tests can be conducted less frequently than Pap tests ( i.e., every 5 years instead of three), decreasing the number of procedures and potential harm, including vaginal bleeding, pain, infections, and distress, throughout the lifetime of a patient. 6 , 32 , 36 …”

Section: Early Detection For the Preventive Care Of Hpv-related Cancermentioning

confidence: 99%

Gaps and Opportunities to Improve Prevention of Human Papillomavirus-Related Cancers

Aninye

Berry-Lawhorn

Blumenthal

et al. 2021

Journal of Women's Health

View full text Add to dashboard Cite

Human papillomavirus (HPV) infections cause more than 35,900 cancers annually in the United States. Although cervical cancer is the most prevalent HPV-related malignancy in women, the virus is also responsible for a significant percentage of anal, vaginal, and vulvar cancers. A comprehensive approach to mitigating cervical cancer includes HPV vaccination (primary prevention), screening and treatment of precancerous lesions (secondary prevention), and diagnosis and treatment of invasive cancer (tertiary prevention). Although a successful strategy, there are opportunities to innovate and increase access that can also be adapted to address the unique clinical care gaps that exist with the other anogenital cancers. The Society for Women's Health Research held a series of interdisciplinary meetings and events, during which expert researchers, clinicians, patient advocates, and health care policy leaders evaluated the current landscape of HPV-related cancers and their effects on women's health. This report summarizes the discussions of this working group and areas it identified in which to address gaps in primary and secondary prevention approaches to improve access and health outcomes for women with HPV-related anogenital cancers.

show abstract

Cervical Cancer Screening Rates Among Rural and Urban Females, From 2019 to 2022

Borders,

Thaxton Wiggins

2024

JAMA Netw Open

View full text Add to dashboard Cite

ImportanceLittle nationally representative research has examined Papanicolaou testing rates from before the pandemic in 2019 through the COVID-19 pandemic in 2022. Papanicolaou testing rates among rural females are a concern as they have historically had lower screening rates than their urban counterparts.ObjectiveTo examine the receipt of a Papanicolaou test in the past year among US females overall and females residing in rural and urban areas in 2019, 2020, and 2022.Design, Setting, and ParticipantsThis repeated cross-sectional study used data from 3 years of the Health Information National Trends Survey (HINTS), a nationally representative survey that asks respondents about cancer screenings, sources of health information, and health and health care technologies. Study participants were females aged 21 to 65 years. Individuals who received a Papanicolaou test more than 1 to 3 years prior to a HINTS interview were excluded as they were likely not due for a Papanicolaou test.ExposuresSurvey year (2019, 2020, and 2022) and rural or urban residence were the main exposure variables.Main Outcomes and MeasuresSelf-reported receipt of a Papanicolaou test within the past year.ResultsAmong the 188 243 531 (weighted; 3706 unweighted) females included in the analysis, 12.5% lived in rural areas and 87.5% in urban areas. Participants had a mean (SE) age of 43.7 (0.27) years and were of Hispanic (18.8%), non-Hispanic Asian (5.2%), non-Hispanic Black (12.2%), non-Hispanic White (59.6%), or non-Hispanic other (4.1%) race and ethnicity. In 2022, unadjusted past-year Papanicolaou testing rates were significantly lower among rural vs urban residents (48.6% [95% CI, 39.2%-58.1%] vs 64.0% [95% CI, 60.0%-68.0%]; P &lt; .001). Adjusted odds of past-year Papanicolaou testing were lower in 2022 than 2019 (odds ratio, 0.70; 95% CI, 0.52-0.95; P = .02).Conclusions and RelevanceThis repeated cross-sectional study found that past-year Papanicolaou testing rates were lower in 2022 than 2019, pointing to a need to increase access to screenings to prevent an uptick in cervical cancer incidence. Rural-vs-urban differences in 2022 indicate a need to specifically target rural females.

show abstract

Overuse of Cervical Cancer Screening Tests Among Women With Average Risk in the United States From 2013 to 2014

Cited by 23 publications

References 34 publications

Patterns of cervical cancer screening among Medicaid beneficiaries

Patterns of cervical cancer screening among Medicaid beneficiaries

Gaps and Opportunities to Improve Prevention of Human Papillomavirus-Related Cancers

Cervical Cancer Screening Rates Among Rural and Urban Females, From 2019 to 2022

Contact Info

Product

Resources

About