Trends in the use of cervical cancer screening tests in a large medical claims database, United States, 2013–2019

Details

• Alternative Title:
  Gynecol Oncol
• Personal Author:
  Qin, Jin ; Shahangian, Shahram ; Saraiya, Mona ; Holt, Hunter ; Gagnon, Maribeth ; Sawaya, George F.
• Description:
  Objective.
  
  To examine trends in the use of cervical cancer screening tests during 2013–2019 among commercially insured women.
  
  Methods.
  
  The study population included women of all ages with continuous enrollment each year in the IBM MarketScan commercial or Medicare supplemental databases and without known history of cervical cancer or precancer (range = 6.9–9.8 million women per year). Annual cervical cancer screening test use was examined by three modalities: cytology alone, cytology plus HPV testing (cotesting), and HPV testing alone. Trends were assessed using 2-sided Poisson regression.
  
  Results.
  
  Use of cytology alone decreased from 34.2% in 2013 to 26.4% in 2019 among women aged 21–29 years (P<.0001). Among women aged 30–64 years, use of cytology alone decreased from 18.9% in 2013 to 8.6% in 2019 (P<.0001), whereas cotesting use increased from 14.9% in 2013 to 19.3% in 2019 (P<.0001). Annual test use for HPV testing alone was below 0.5% in all age groups throughout the study period. Annually, 8.7%–13.6% of women aged 18–20 years received cervical cancer screening. There were persistent differences in screening test use by metropolitan residence and census regions despite similar temporal trends.
  
  Conclusions.
  
  Temporal changes in the use of cervical cancer screening tests among commercially insured women track changes in clinical guidelines. Screening test use among individuals younger than 21 years shows that many young women are inappropriately screened for cervical cancer.
  
  
• Subjects:
  Administrative Claims, Healthcare Adult Aged Age Factors Alphapapillomavirus Cervix Uteri Databases, Factual Early Detection Of Cancer Female Humans Medicare Middle Aged Papanicolaou Test Papillomavirus Infections Patient Acceptance Of Health Care Practice Guidelines As Topic Uterine Cervical Neoplasms Vaginal Smears Young Adult

  More +
• Keywords:
  Cervical Cancer Screening Cytology HPV Test Screening Guidelines Trends
• Source:
  Gynecol Oncol. 163(2):378-384
• Pubmed ID:
  34507826
• Pubmed Central ID:
  PMC8585712
• Document Type:
  Journal Article
• Funding:
  CC999999/ImCDC/Intramural CDC HHSUnited States/
• Place as Subject:
  United States
• Volume:
  163
• Issue:
  2
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:9d0e2dae5c41694aa470b53ea407997c8731bd03260077a127726842dde5920f
• Download URL:
  https://stacks.cdc.gov/view/cdc/111704/cdc_111704_DS1.pdf
• File Type:
  [PDF - 670.51 KB ]