Dive Brief:

• The rate of U.S. women with up-to-date cervical cancer screenings is likely lower than the average found by the 2015 National Health Interview Survey, alarming Mayo Clinic researchers who reported the findings Monday in the Journal of Women's Health.
• Based on a sample study conducted in Olmsted County, Minnesota, home to Mayo, researchers found less than two-thirds of women ages 30 to 65 had current cervical cancer screenings in 2016. For women ages 21 to 29, just over 50% were up-to-date with screenings. Both figures paint a different picture than the 81% national screening rate self-reported by women in 2015.
• While cervical cancer rates have dropped by at least 50% since the widespread adoption of Pap smears, researchers say that prevention opportunities have significant room for growth.

Dive Insight:

Cervical cancer was likely the cause of death for 4,170 women in the U.S. last year, as estimated by the American Cancer Society. The organization notes that cervical pre-cancers are more often diagnosed than invasive cervical cancer, largely thanks to Pap tests, or the collection of cells from a woman's cervix to check for precancerous or cancerous cells.

In 2012, the U.S. Preventive Services Taskforce recommended Pap testing every three years for women ages 21 to 65, or a combination of Pap and human papillomavirus (HPV) testing every five years, the latter of which screens for the virus that can cause cervical cancer. Vaccines for HPV are another proactive measure available to both women and men.

Even with these improved prevention technologies, researchers found the medical community's understanding of screening rates significantly inflated, which lead author and Mayo Clinic family medicine specialist Kathy MacLaughlin called "unacceptable."

The Minnesota study used the Rochester Epidemiology Project database to review medical records of 47,000 women living in Olmsted County from 2005 to 2016. The study found high rates of adoption of the 2012 guidelines by health providers in regards to appropriate use of co-testing and in not screening women under 21 or over 65, but the rates of screening within the appropriate age groups were lower than expected.

Researchers also found racial inequities within the screening rates, with Asian women being 30% less likely than white women to be screened, and African-American women 50% less likely. Researchers noted that the study was limited by Olmsted County's less ethnically and racially diverse profile than the U.S. population as a whole, but said the county’s demographic makeup is reflective of the Upper Midwest and that the numbers are consistent with several other studies from across the U.S.

McLaughlin said the findings should remind clinicians to think "outside the box" on how to better reach women, potentially through expanding access to pap clinics with expanded hours, at-home HPV testing kits, or offering screenings at urgent care clinics.