Cervical cancer kills over 4,000 women annually in the United States. Nearly all of these deaths could be prevented by early detection and treatment, according to authors from the National Cancer Institute and Harvard University. Many of us get Pap smear tests every year to screen for cervical cancer. With appropriate treatment, cancers detected in this way are highly curable, with a 5-year survival rate of over 90 percent. However, significant numbers of women have fallen behind in their tests.
In a national sample of 2,070 women, 84 percent were found to be adherent to screening guidelines. These women reported two consecutive Pap tests within the last three years, with another Pap test planned within the next three years. The 84 percent figure is considered an overestimate, since numerous studies have shown that women tend to underestimate the time since their last screening. Thus we may have as many as one in five women who are at risk for undetected cervical cancer.
The study identified factors that are associated with low rates of Pap test screening:
1. Obesity. Women with excess weight are significantly more likely to die of cervical cancer than those in the ideal weight range. Thus, screening efforts are especially important to this group. Unfortunately, obese women have lower rates of Pap tests. They may have frequent contact with health care providers for issues related to weight, but these providers may not pay enough attention to screening tests.
2. Smoking. Similar to obesity, smoking is a risk factor for both death from cervical cancer and neglecting Pap smear tests. The authors suggested that poor health behaviors occur in clusters.
3. Low income and lack of health insurance. These are economic factors that clearly make it more difficult to obtain screening.
4. Lack of a usual source of health care. Screening tests fall to low priority when the patient does not have a regular doctor or clinic.
5. Ethnicity. Asian, Hispanic, and foreign-born women are less likely to be screened.
6. Low educational attainment. Women who are better informed about preventive care are more likely to be tested.
7. Psychological distress. The authors used a broad definition of self-reported psychological distress, which was associated with low rates of cancer screening.
The authors encourage health care providers to devote more efforts to screening tests for women in these high risk groups.
1. Nelson W et al, “Adherence to cervical cancer screening guidelines for U.S. women aged 25 – 64: Data from the 2005 Health Information National Trends Survey (HINTS)”, Journal of Women's Health 2009; 18(11): 1759-68.
2. Cancer statistics:
Linda Fugate is a scientist and writer in Austin, Texas. She has a Ph.D. in Physics and an M.S. in Macromolecular Science and Engineering. Her background includes academic and industrial research in materials science. She currently writes song lyrics and health articles.