Cervical Cancer Screening

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In 2021, 72.4% 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.

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.

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.

It can be challenging to determine by self-report alone which type of cervical cancer screening 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 know if informed by her healthcare provider. People may also not always accurately recall the specific time they received a particular test. Additionally, 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, guidelines for cervical cancer screening have increased in complexity over time, which results in a greater likelihood for missing or incomplete self-reported information about the screening tests women received. Different approaches by researchers for handling this missing information can result in somewhat varied estimates presented for up-to-date cervical cancer screening status, depending on publication.

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. It 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 U.S.

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, 1987–2021.

In 2019 the NHIS questionnaire was redesigned to increase relevance, enhance data quality, and minimize respondent burden. In addition, the COVID-19 pandemic created challenges conducting in-person interviews for the 2020 NHIS, requiring changes to field procedures to conduct most surveys by telephone, which impacted survey response rates. For details related to the potential impacts of these issues, please refer to Potential Impact of NHIS Redesign and COVID-19 on the Cancer Trends Progress Report.

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, 1987-2021
Overview Graph Detailed Trend Graphs Most Recent Estimates (2021)
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, 1987-2021 All Races/EthnicitiesClick to see the detailed trend graph for All Races/Ethnicities 72.4 71.2 - 73.5
Non-Hispanic WhiteClick to see the detailed trend graph for Non-Hispanic White 75.7 74.2 - 77.1
Non-Hispanic BlackClick to see the detailed trend graph for Non-Hispanic Black 71.6 68.1 - 74.9
HispanicClick to see the detailed trend graph for Hispanic 67.9 65.1 - 70.5

By Poverty Income Level

Percentage of females aged 21-65 years who were up-to-date with cervical cancer screening by poverty income level, 1998-2021
Overview Graph Detailed Trend Graphs Most Recent Estimates (2021)
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, 1998-2021 <200% of federal poverty levelClick to see the detailed trend graph for <200% of federal poverty level 63.3 61.0 - 65.5
>=200% of federal poverty levelClick to see the detailed trend graph for >=200% of federal poverty level 76.0 74.6 - 77.2

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, 1987-2021
Overview Graph Detailed Trend Graphs Most Recent Estimates (2021)
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, 1987-2021 Less than High SchoolClick to see the detailed trend graph for Less than High School 58.4 53.5 - 63.2
High SchoolClick to see the detailed trend graph for High School 63.9 61.3 - 66.5
Greater than High SchoolClick to see the detailed trend graph for Greater than High School 77.2 76.0 - 78.3

Additional Information on Cervical Cancer Screening

Year Range

1987-2021

Recent Summary Trend Year Range

2019-2021

Summary Tables

Breast and Cervical Cancers

Recent Summary Trend

Falling

Desired Direction

Rising