National Trends and Disparities in Cervical Cancer Screening among Commercially Insured Women, 2001-2010

J. F. Wharam, F. Zhang, X. Xu, B. E. Landon, D. Ross-Degnan
2014 Cancer Epidemiology, Biomarkers and Prevention  
Previous surveys reported declining cervical cancer screening rates from 2000 to 2010, but trends by key demographic and age groups are less clear. Methods: We examined 3-year Papanicolaou (Pap) test rates among 4.2 million women enrolled in a large national health plan during 2001 to 2010. We calculated and plotted adjusted 3-year rates stratified by age and key neighborhood-level socioeconomic characteristics including poverty level and race/ethnicity (white, black, Hispanic, and mixed
more » ... ty neighborhood). We fitted trends in 2001-2010 screening rates and socioeconomic disparities as annual percentage changes (APC) using joinpoint analysis. Results: Women ages 21 to 29 years had estimated 3-year Pap testing rates of 81.3% to 81.4% over the decade. Estimated disparities by low-high poverty level were 3.1% and 2.0% in 2001-2003 and 2008-2010, respectively, a nonsignificant decline. Initial white-black disparities were 4.0% and declined significantly from 2005-2007 to 2008-2010 to 2.8% at an APC of À0.65% (P ¼ 0.021). White-Hispanic disparities declined from 4.3% to 0.8% over the decade, a À0.50% APC (P ¼ 0.024). Among women ages 30 to 64 years, estimated 3-year Pap testing rates trended down from 76.1% to 71.8% over the decade [À0.94% APC (P < 0.001) until [2005][2006][2007]. This pattern was similar among women from most categories of poverty and race/ethnicity. Conclusions: Among commercially insured women ages 21 to 29 years, 3-year Pap testing rates remained stable at 81% over the decade; disparities were small and improved for Hispanic women to a greater degree than for black women. Among women ages 30 to 64 years, 3-year Pap testing rates declined from 2001 to 2010.
doi:10.1158/1055-9965.epi-13-1202 pmid:25128400 fatcat:vsmeeqqx3jckllhuga5rr26vry