Cervical Cancer Screening Overused in Some Groups

National organizations recommended against Papanicolaou testing, a method of cervical screening that is used to detect potentially precancerous and cancerous processes in the endocervical canal, for women without a cervix following a hysterectomy.

The organizations also suggest the test be not performed on those who do not have a history of high-grade precancerous lesion or cervical cancer and for women older than 65 years because the risk of developing this slow-growing cancer is very small at such a late stage in life, as well as on those who had adequate prior screening and who are not at high risk.

Scientists at the University of Utah (Salt Lake City, UT, USA) examined data from the 2010 US National Health Interview Survey, an annual health survey of representative samples of the entire USA population since 1957. The 2010 survey included the most recent cancer control supplement, which is included every three to five years. They investigated the timing of most recent Papanicolaou test, within the past year, one to three years ago, or more than three years ago by sociodemographic characteristics and by hysterectomy status.

Among women reporting a hysterectomy, 34.1% reported a Papanicolaou test in the past year. A total of 64.8% of women reporting a hysterectomy also reported a recent Papanicolaou test since their hysterectomy, and among women 65 years and older without a hysterectomy, 58.4% reported receipt of a Papanicolaou test in the past three years, together representing approximately 14 million women.

Deanna Kepka, PhD, MPH, the lead author from the Huntsman Cancer Institute (Salt Lake City, UT, USA) said, “We knew there would be overuse of Pap tests, because the few studies of cervical cancer screening showed overuse ten years ago, but we were shocked to see so little change over the past ten years. We're hoping to see better use of the tests over the next decade as changes in the health care infrastructure take place. Electronic medical records, health care provider reminder systems, decision support, and new strategies to improve the quality of care may promote guideline-consistent practices among clinicians.” The study was published on November 25, 2013, in the Journal of the American Medical Association Internal Medicine.

Related Links:
University of Utah
Huntsman Cancer Institute