‘Unacceptably’ low cervical cancer screening rates

The rate of women in the Upper Midwest who underwent cervical cancer screening in 2016 was lower than nationally reported rates, and researchers said this is “unacceptable,” according to a study recently published in the Journal of Women’s Health.

“Although Pap screening has reduced incidence of cervical cancer and death by more than 60% since being introduced in the 1950s, underscreened and especially never-screened women continue to be at particularly high risk,” Kathy L. MacLaughlin, MD, of the department of family medicine at the Mayo Clinic in Minnesota and colleagues wrote.

Cervical cancer screening guidelines adopted in 2012 by most major medical societies recommend Pap testing every 3 years for women aged 21 to 65 or Pap-HPV cotesting every 5 years for women aged 30 to 65, according to a press release.

Researchers calculated 3-year Pap and 5-year Pap-HPV moving prevalence rates of screening as proportion of eligible population in a cohort of approximately 50,000 women living in Minnesota that were older than 16 years.

MacLaughlin and colleagues found that in 2016:

64.6% of screening-eligible women aged 30 to 65 years were current with cervical cancer screening, and of those, 60.8% had received Pap-HPV cotest screening and 3.9% were screened via Pap test.

53.8% of screening-eligible women aged 21 to 29 years were current with cervical cancer screening. Of those, 47.3% had received Pap test and 6.5% had received Pap-HPV cotests.

2.1% of screening-eligible women aged 16 to 21 years had either a Pap and Pap-HPV cotest

8.8% of screening-eligible women older than 65 years had either a Pap and Pap-HPV cotest

Data from the 2015 National Health Interview Survey showed that 81.1% of women age 21 to 65 years said they had a Pap test within the past 3 years, according to researchers.

"These cervical cancer rates are unacceptably low," MacLaughlin said in a press release.

"We, as clinicians, must start thinking outside the box on how best to reach these women and ensure they are receiving these effective and potentially life-saving screening tests," she added.

January is Cervical Cancer Awareness Month, according to the CDC. As a courtesy to its readers, Healio Family Medicine compiled a list of some of the latest research and news involving cervical cancer. – by Janel Miller

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The use of an intrauterine device appeared associated with a significant decrease in invasive cervical cancer incidence, according to study findings. Read more.

Women with HPV without cellular abnormalities at increased risk for cervical cancer

Women positive for HPV16 or HPV18 but who do not have any cellular abnormalities remain at an increased risk for cervical cancer and its precursor lesions, according to results of a nested case-control study published in Cancer. Read more.

Epigenetic cervical cancer test may represent 'enormous development'

A new epigenetic test for cervical cancer demonstrated 100% accuracy, predicting development of the disease as many as 5 years in advance, according to a blinded case-control study published in International Journal of Cancer. Read more.

Minimally invasive surgery associated with worse survival among women with cervical cancer

Women with early-stage cervical cancer who underwent minimally invasive radical hysterectomy had higher rates of recurrence and worse survival outcomes than women who had open surgery, according to results of two studies published in The New England Journal of Medicine. Read more.

FDA approves Keytruda for cervical cancer

The FDA expanded the approval of pembrolizumab to include the treatment of women with recurrent or metastatic cervical cancer who have PD-L1-expressing tumors that progressed on or after chemotherapy. Read more.

Reference: CDC.gov. Announcement: Cervical Cancer Awareness Month — January 2013.

https://www.cdc.gov/mmwr/preview/mmwrhtml/mm6151a5.htm. Accessed Jan. 4, 2019.

Disclosure s : MacLaughlin reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.