Cervical Cancer Screening

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In 2019, 73.5% of women aged 21-65 years were up-to-date with cervical cancer screening.

Summary graph for Cervical Cancer Screening, Click to see detailed view of graph

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Background

Screening methods used to find cervical changes that may lead to cervical cancer include the Pap test (cytology-based screening, where a sample of cervical cells are collected and examined under a microscope) and human papillomavirus (HPV) testing (which tests cervical cells for the presence of high-risk types of HPV, a viral infection causing nearly all cervical cancer). Such screening tests may find cancers earlier, when they are more easily treated. Women who have never been screened face the greatest risk of developing invasive cervical cancer.

The U.S. Preventive Services Task Force (USPSTF) recommends screening for cervical cancer with the Pap test alone every 3 years in women aged 21 to 29 years. In women aged 30 to 65 years, the USPSTF recommends the Pap test alone every 3 years or HPV testing, with or without Pap co-testing, every 5 years.

Measure

The percentage of women aged 21 to 65 years who were up-to-date with cervical cancer screening, by race/ethnicity, income, and education level. For 2013 and before, up-to-date was defined as having a Pap test within the past 3 years. For 2014-2018, up-to date is defined as having a Pap test within the past 3 years for all women aged 21 to 65 years, or having a Pap test, with or without an HPV test, in the past 5 years for women aged 30 to 65 years.

Note: Starting in 2018, up-to-date on cervical screening was additionally defined as having an HPV test alone in the past 5 years for women aged 30 to 65 years. The data source used for this measure only asks about HPV tests administered at the time of a Pap test; therefore, the HPV test alone criteria cannot be measured.

Measurement challenges

We track cervical cancer screening rates in U.S. women using a large, national, in-person survey in which people are asked about their health behaviors and the medical care they receive (see Data Source, below). There are important limitations to this method that impact what information we can accurately collect and how confident we can be in the findings. Studies have found that certain types of healthcare survey questions can be difficult for people to clearly understand and answer, and it is easy for some questions to be misinterpreted.

In the case of cervical cancer screening, it can be challenging to determine by self-report alone which type of test a woman received (i.e., a Pap smear, HPV test, or both). Both tests appear identical to the woman experiencing them; a person may only be aware which test she received if informed by her healthcare provider. Cancer screening is looking for cancer before a person has symptoms, when they are not known to have had that specific cancer type before. Looking for new or recurrent asymptomatic cancer in a person previously diagnosed and treated for that cancer type represents a different type of testing known as surveillance testing. Finally, people may not always accurately recall the specific time they received a particular test. As people do not always accurately recall what medical tests they have received, the purpose of that testing, or its exact timing, our measure captures any type of cervical cancer screening received by a woman, and the population may include those with a prior diagnosis of cervical cancer. Our measure is a reasonable approximation of the true U.S. cervical cancer screening rate, but it is not perfectly comparing the actual frequency of women’s use of specific cervical cancer screening tests to national recommendations.

Even though the National Health Interview Survey cervical cancer screening measures have limitations, it is the best nationally representative data we have available to assess cervical cancer screening rates. It is frequently used by governmental and other organizations to track screening use over time in the US.

Healthy People 2030 Target

  • Increase to 84.3 percent the proportion of women aged 21 to 65 years who received cervical cancer screening based on the most recent guidelines.

Healthy People 2030 is a set of goals set forth by the Department of Health and Human Services.
Note: Goals are indicated as blue line on Detailed Trend Graphs.

Data Source

Centers for Disease Control and Prevention, National Center for Health Statistics, National Health Interview Survey, 1987–2019.

Trends and Most Recent EstimatesHelp with navigating the graphs and data tables

By Race/Ethnicity

Percentage of females aged 21-65 years who were up-to-date with cervical cancer screening by race/ethnicity, 1987-2019
Overview Graph Detailed Trend Graphs Most Recent Estimates (2019)
Percent of women 95% Confidence Interval
Thumbnail of graph for Percentage of females aged 21-65 years who were up-to-date with cervical cancer screening by race/ethnicity, 1987-2019 All RacesClick to see the detailed trend graph for All Races 73.5 72.4 - 74.6
Non-Hispanic WhiteClick to see the detailed trend graph for Non-Hispanic White 75.4 74.0 - 76.7
Non-Hispanic BlackClick to see the detailed trend graph for Non-Hispanic Black 74.8 71.9 - 77.5
HispanicClick to see the detailed trend graph for Hispanic 70.3 67.6 - 72.8

By Poverty Income Level

Percentage of females aged 21-65 years who were up-to-date with cervical cancer screening by poverty income level, 1998-2019
Overview Graph Detailed Trend Graphs Most Recent Estimates (2019)
Percent of women 95% Confidence Interval
Thumbnail of graph for Percentage of females aged 21-65 years who were up-to-date with cervical cancer screening by poverty income level, 1998-2019 <200% of federal poverty levelClick to see the detailed trend graph for <200% of federal poverty level 64.2 62.1 - 66.2
>=200% of federal poverty levelClick to see the detailed trend graph for >=200% of federal poverty level 77.8 76.5 - 79.0

By Education Level

Percentage of females aged 21-65 years who were up-to-date with cervical cancer screening by highest level of education obtained, 1987-2019
Overview Graph Detailed Trend Graphs Most Recent Estimates (2019)
Percent of women 95% Confidence Interval
Thumbnail of graph for Percentage of females aged 21-65 years who were up-to-date with cervical cancer screening by highest level of education obtained, 1987-2019 Less than High SchoolClick to see the detailed trend graph for Less than High School 59.1 54.6 - 63.4
High SchoolClick to see the detailed trend graph for High School 67.1 64.6 - 69.4
Greater than High SchoolClick to see the detailed trend graph for Greater than High School 78.1 76.9 - 79.3

Additional Information on Cervical Cancer Screening

Year Range

1987-2019

Recent Summary Trend Year Range

2015-2019

Summary Tables

Breast and Cervical Cancers

Recent Summary Trend

Falling

Desired Direction

Rising