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CDC: Too Many Women Go Unscreened for Cervical Cancer

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November 20, 2014

Cervical cancer can be a deadly disease if not detected early and treated. The best way to find cervical cancer at an early stage or even prevent it is to have regular screening. Yet, more than 10% of women in the U.S. who are recommended to receive screening don't get tested, according to the November 5 Morbidity and Mortality Weekly Report from the Centers for Disease Control and Prevention (CDC).

In the report, the CDC presented some worrisome statistics on cervical cancer screening for 2012, the latest year for which it has data. Overall, the percentage of women who had not been screened for cervical cancer in the past five years was about 11%. The percentage was even higher for women without health insurance, at about 23%, and higher still for women without a regular healthcare provider, at over 25%. Compared to the rest of the U.S., the South had the highest percentage of women who had not been screened in the past five years, at roughly 12%, and it had the highest incidence and death rate for cervical cancer.

More than 12,000 women get cervical cancer and more than 4,000 women die of the disease in the U.S. each year, but regular screening can save lives. Cervical cancer often goes unnoticed because symptoms may be non-specific or easy to overlook, especially in the early stages. A Pap test can detect cancerous cells in the cervix as well as changes in those cells that may eventually turn into cancer. Another type of test can detect the presence of human papilloma virus (HPV), the major cause of cervical cancer. If a screening test is positive, a woman can undergo an examination called colposcopy. During this examination, a physician uses a device to get a closer look at the cervix and collect a sample of cells for further testing for cancer. If pre-cancerous or cancerous areas are found on the cervix, they can be treated before cancer develops or has a chance to spread.

Major health organizations, including the American College of Obstetricians and Gynecologists, the American Cancer Society, and the U.S. Preventive Services Task Force, agree that women benefit from regular cervical cancer screening. These groups have published recommendations on testing options and timing:

  • Women between the ages of 21 and 29 should have a Pap smear every three years. A Pap smear for women younger than 21 is not recommended because the incidence of cancer in this age group is very low. False-positive results may occur due to normal cell changes.
  • For women aged 30 to 65, screening with a Pap smear and an HPV test every five years is preferred, although a Pap test alone every three years is also acceptable.
  • The groups advise against screening women over the age of 65 who have had negative results on prior screening tests (three consecutive negative Pap smears or two consecutive negative HPV tests in the prior 10 years, with the most recent within five years).

The CDC report also pointed out that cervical cancer can be prevented with HPV vaccination, but many people who could benefit are not getting immunized. According to the National Immunization Survey-Teen from 2013, only about 37% of teen girls and 14% of teen boys received all three recommended doses of the HPV vaccine.

Although cervical cancer incidence decreased by about 2% per year and the death rate remained stable from 2007 to 2011, more can be done with better screening and vaccination rates. Some studies have shown that 93% of new cases of cervical cancer could be prevented with a combination of screening and vaccinations. The CDC encourages health practitioners, clinics, and health systems to help more people get the recommended tests and immunizations.

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NOTE: This article is based on research that utilizes the sources cited here as well as the collective experience of the Lab Tests Online Editorial Review Board. This article is periodically reviewed by the Editorial Board and may be updated as a result of the review. Any new sources cited will be added to the list and distinguished from the original sources used. To access online sources, copy and paste the URL into your browser.

(November 2014) Centers for Disease Control and Prevention. Cervical Cancer is Preventable. Vital Signs. Available online at http://www.cdc.gov/vitalsigns/cervical-cancer/ through http://www.cdc.gov. Accessed November 14, 2014.

(November 5, 2014) Bernard V, et.al. Centers for Disease Control and Prevention. Vital Signs: Cervical Cancer Incidence, Mortality, and Screening — United States, 2007–2012. Morbidity and Mortality Weekly Report (MMWR), 63(Early Release);1-6. Available online at http://www.cdc.gov/mmwr/preview/mmwrhtml/mm63e1105a1.htm through http://www.cdc.gov. Accessed November 14, 2014.

(November 7, 2014) Herman, Amy Orciari. Over 10% of U.S. Women Not Screened for Cervical Cancer. JournalWatch. Available online at http://www.jwatch.org/na36216/2014/11/07/over-10-us-women-not-screened-cervical-cancer?query=etoc_jwwomen through http://www.jwatch.org. Accessed November 14, 2014.