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Introduction
Screening methods used to find cervical changes that may lead to cervical cancer include the Pap test and human papillomavirus (HPV) testing. 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.
Screening can reduce deaths due to cervical cancer;, although the percentage of women aged 18 years and older who reported they had a screening test within the past 3 years is relatively high, certain groups of women in the United States are less likely than others to be screened. A number of factors have been associated with lower rates of cervical cancer screening, including low income, less education, and a lack of health insurance. Studies have also shown that women who have had a medical visit in the last year are more likely to have received cervical cancer screening.
Measure
The percentage of women aged 21 to 65 years who were up-to-date with cervical cancer screening. 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 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 in 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.
Healthy People 2020 Target
- Increase to 93 percent the proportion of women aged 21 to 65 years who received cervical cancer screening based on the most recent guidelines.
Healthy People 2020 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, 1987–2018.
Trends and Most Recent Estimates
By Race/Ethnicity
Overview Graph | Detailed Trend Graphs | Most Recent Estimates (2018) | |
---|---|---|---|
Percent of women | 95% Confidence Interval | ||
![]() ![]() |
All Races![]() |
81.1 | 80.0 - 82.2 |
Non-Hispanic White![]() |
81.5 | 80.2 - 82.8 | |
Non-Hispanic Black![]() |
85.3 | 82.6 - 87.7 | |
Hispanic![]() |
80.9 | 77.8 - 83.6 |
By Poverty Income Level
Overview Graph | Detailed Trend Graphs | Most Recent Estimates (2018) | |
---|---|---|---|
Percent of women | 95% Confidence Interval | ||
![]() ![]() |
<200% of federal poverty level![]() |
73.7 | 71.4 - 75.8 |
>=200% of federal poverty level![]() |
84.0 | 82.8 - 85.2 |
By Education Level
Overview Graph | Detailed Trend Graphs | Most Recent Estimates (2018) | |
---|---|---|---|
Percent of women | 95% Confidence Interval | ||
![]() ![]() |
Less than High School![]() |
71.2 | 67.0 - 75.1 |
High School![]() |
77.3 | 74.6 - 79.8 | |
Greater than High School![]() |
83.6 | 82.5 - 84.7 |
Evidence-based Resources
Resources are available on cervical cancer screening to allow for the prioritization of cancer control efforts and the development, implementation and evaluation of cancer control plans. State and local level cervical cancer data, research-tested interventions, state plans for comprehensive cancer control, discussions and more are available on Cancer Control P.L.A.N.E.T. – cervical cancer.
Additional Information on Cervical Cancer Screening
For the public
- Cervical Cancer (PDQ®)–Patient Version. National Cancer Institute.
- HPV and Pap Testing. National Cancer Institute.
- Medicare Coverage for Cancer Prevention and Early Detection. American Cancer Society.
- Gynecological Cancers – What Should I Know About Screening? Centers for Disease Control and Prevention.
- National Breast and Cervical Cancer Early Detection Program. Centers for Disease Control and Prevention.
For health professionals
- Cervical Cancer Screening (PDQ®)-Health Professional Version. National Cancer Institute.
- Cervical Cancer Prevention (PDQ®)-Health Professional Version. National Cancer Institute.
- The Community Guide: Cancer. Centers for Disease Control and Prevention, Community Preventive Services Task Force.
- Cervical Cancer: Screening (August 2018). U.S. Preventive Services Task Force.
- Cervical Cancer Screening: What’s New? Updates for the Busy Clinician.. Zhang S, McNamara M, Batur P. Am J Med 2018 Jun; 131(6): 702.e1-705e.5
Scientific reports
- Cervical cancer screening research in the PROSPR I consortium: Rationale, methods and baseline findings from a US cohort. Kamineni A, Tiro J, Beaber EF, et al. Int J Cancer 2019; 144(6): 1460-73.
- Cervical cancer risk for women undergoing concurrent testing for human papillomavirus and cervical cytology: a population-based study in routine clinical practice. Katki HA, Kinney WK, Fetterman B, et al. Lancet Oncol 12(7): 663-72, 2011.
- Cytology versus HPV testing for cervical cancer screening in the general population. Koliopoulos G, Nyaga VN, Santesso N, et al. Cochrane Database of Systematic Reviews 2017; Issue 8. Art. No.: CD008587: DOI: 10.1002/14651858.CD008587.pub2.
- Screening for cervical cancer with high-risk human papillomavirus testing: Updated evidence report and systematic review for the U.S. Preventive Services Task Force. Melnikow J, Henderson JT, Burda BU, et al. JAMA 2018; 320(7): 687-705.
- Effect of Screening With Primary Cervical HPV Testing vs Cytology Testing on High-grade Cervical Intraepithelial Neoplasia at 48 Months: The HPV FOCAL Randomized Clinical Trial. Ogilvie GS, van Niekerk D, Krajden M, et al. JAMA 320 (1): 43-52, 2018.
- Performance of human papillomavirus testing on self-collected versus clinician-collected samples for the detection of cervical intraepithelial neoplasia of grade 2 or worse: a randomised, paired screen-positive, non-inferiority trial. Polman NJ, Ebisch RMF, Heideman DAM, et al. Lancet Oncol 20 (2): 229-238, 2019.
- National, regional, state, and selected local area vaccination coverage among adolescents aged 13–17 years — United States, 2017. Walker TY, Elam-Evans LD, Yankey D, et al. MMWR 2018; 67(33): 909-17.
Statistics
- Health Information National Trends Survey. National Cancer Institute.
- SEER Cancer Stat Facts: Cervical Cancer. National Cancer Institute.
- Behavioral Risk Factor Surveillance System: Prevalence Data & Data Analysis Tools. Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion.