Adherence to National Guidelines on Cervical Screening: A Population-Based Evaluation from a Statewide Registry

Authors

Philip E. Castle, Albert Einstein College of Medicine, Bronx, NY, USA,National Institutes of Health, National Cancer Institute, Division of Cancer Prevention and Division of Cancer Epidemiology and Genetics, Rockville, MD, USA
Walter K. Kinney, Sacramento, CA, USA
Lu Chen, University of New Mexico Comprehensive Cancer Center, Biostatistics Shared Resource, Albuquerque, NM, USA
Jane J. Kim, Harvard T.H. Chan, School of Public Health, Boston, MA, USA
Steven Jenison, University of New Mexico, School of Medicine, Albuquerque, NM, USA
Giovanna Rossi, Collective Action Strategies, Albuquerque, NM, USA
Huining Kang, University of New Mexico Comprehensive Cancer Center, Biostatistics Shared Resource, Albuquerque, NM, USA
Jack Cuzick, Queen Mary University of London, Wolfson Institute of Preventive Medicine, London, UK
Cosette M. Wheeler, University of New Mexico Comprehensive Cancer Center, Center for HPV Prevention, Albuquerque, USA
New Mexico HPV Pap Registry Steering Committee

Document Type

Article

Publication Date

8-31-2021

Abstract

In 2012, national recommendations for cervical-cancer screening of women aged 30-64 years were quinquennial human papillomavirus and cytology co-testing or triennial cytology. Data from a state-wide surveillance program in New Mexico demonstrated 65.2% (95% confidence interval [95%CI]= 64.6%% to 65.7%) of women screened in 2019 had negative co-test within the last 3 years. Percentages of women screened in 2013, 2016, and 2019 with a prior negative co-test more than 5 and up to 7 years ago were 2.6% (95% CI = 2.2% to 2.9%), 2.1% (95% CI = 1.9% to 2.2%), and 6.5% (95% CI = 6.2% to 6.8%), respectively (2-sided P trend<.001). Percentages of women screened in 2013, 2016, and 2019 with a prior negative cytology more than 5 and up to 7 years ago were 3.8% (95% CI = 3.7% to 3.9%), 9.0% (95% CI = 8.7% to 9.3%), and 14.9% (95% CI = 14.4% to 15.4%), respectively (2-sided P trend<.001). Thus, in 2019, only 12.7% (95% CI = 12.4% to 13.1%) of the 30,215 women aged 30-64 years underwent co-testing and 27.7% (95% CI = 27.1% to 28.3%) of the 18,733 underwent cytology at the recommended interval. The observed under- and over-screening could result in increases in cervical-cancer incidence and harms and costs, respectively.

Recommended Citation

Castle PE, Kinney WK, Chen L, Kim JJ, Jenison S, Rossi G, Kang H, Cuzick J, Wheeler CM; New Mexico HPV Pap Registry Steering Committee. Adherence to National Guidelines on Cervical Screening: A Population-Based Evaluation from a Statewide Registry. J Natl Cancer Inst. 2021 Aug 31;114(4):626–30. doi: 10.1093/jnci/djab173. Epub ahead of print. PMID: 34463763; PMCID: PMC9002271.