Two Thirds of Women Do Not Meet Cervical Cancer Screening Exit Criteria
The majority of women aged 64 to 66 years do not meet the criteria to discontinue cervical cancer screening, despite current guidelines recommending cervical cancer screening exit at age 65. In addition, women aged 55 to 65 years are often screened inadequately.
The researchers compared data from women with employer-sponsored insurance who were enrolled in a national database, and those with a primary care provider at a safety net health center. A total of 590,901 women aged 64 years were included from the national database from 2016 to 2018, and 1544 women aged 64 to 66 years were included from the health center in 2019.
Current guidelines were utilized to determine eligibility to discontinuing screening. Patients needed to have no evidence of cervical cancer or HIV-positive status, no evidence of cervical precancer in the past 25 years and had either a hysterectomy with removal of the cervix or 2 HPV screening tests, HPV plus Pap co-tests, or 3 Pap tests within the past 10 years without any abnormal results.
The results indicated that 22.2% (n = 131,059) of women in the national claims database were eligible to discontinue screening due to hysterectomy (1.6%) or negative screening (20.6%). In comparison, 34.2% (n = 528) of women from the safety net health center were eligible due to hysterectomy (9.3%) or negative screening (24.9%).
In both groups, the majority of women (64.7% and 56.7%, respectively) did not have sufficient data available to meet the exit criteria. Further, 41.5% of women with 10 years of insurance claims data did not meet the criteria.
“Examining insurance claims in a national database and electronic medical records at a safety net institution led to remarkably similar findings: two thirds of women fail to qualify for screening exit,” the researchers concluded. “Additional steps to ensure eligibility prior to screening exit may be necessary to decrease preventable cervical cancers among women aged >65.”
Mills JM, Morgan JR, Dhaliwal A, Perkins RB. Eligibility for cervical cancer screening exit: comparison of a national and safety net cohort. Gynecol Oncol. Published online June 3, 2021. https://doi.org/10.1016/j.ygyno.2021.05.035