Adherence to National Guidelines on Cervical Screening: A Population-Based Evaluation From a Statewide Registry. (31st August 2021) - Castle, Philip E
Abstract: In 2012, national recommendations for cervical cancer screening of women aged 30-64 years were quinquennial human papillomavirus and cytology cotesting or triennial cytology. Data from a statewide surveillance program in New Mexico demonstrated 65.2% (95% confidence interval [95% CI] = 64.6% to 65.7%) of women screened in 2019 had a negative cotest within the last 3 years. Percentages of women screened in 2013, 2016, and 2019 with a prior negative cotest more than 5 years 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 years 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 cotesting and 27.7% (95% CI = 27.1% to 28.3%) of the 18 733 underwent cytology at the recommended interval. The observed under- and overscreening could result in increases in cervical cancer incidence and harms and costs, respectively.