Study: More young women skip cervical cancer screenings

Cervical cancer screening rates are dropping precipitously, especially among young women, according to a new report from the Medical University of South Carolina.

These findings are troubling, the researchers wrote in JAMA Network Open, as cervical cancer rates continue to climb.

They're also concerning because young women aged 21-29 represent a key demographic for targeted preventive care outreach. Completing required cancer screenings early in life helps set individuals up for stronger patient engagement later, the team said.

Conversely, people who skip preventive care, like cancer screenings and vaccinations, might maintain this habit later in life when they are at higher risk for late-stage and hard-to-treat cancers.

Startlingly, the number of women skipping out on preventive cervical cancer screenings has grown nearly every year over the past two decades.

Using data from the National Health Interview Survey between 2005 and 2023, the researchers flagged a 5% increase in the number of young women aged 21-29 who had never had a cervical cancer screening. By 2023, about a third of women in that age group had never had a cervical cancer screening.

For women aged 30-65, that increase was far smaller. In 2005, 5.3% of women aged 30-65 had never gotten a cervical cancer screening. By 2023, that figure was 14.8%.

These findings, especially regarding younger women, are troubling, the researchers said. The proportion of women never completing a cervical cancer screening nearly doubled during the study period. At the same time, a 2019 NHIS survey showed that 45.5% of women aged 21-29 had not received the HPV vaccine, which is key to preventing cervical cancer.

Population health experts also have to worry about the general uptick in cervical cancer rates, especially regional-stage (meaning the cancer has spread beyond the cervical and uterus) and distant-stage (meaning the cancer has spread to distant organs or lymph nodes) cancers. Regional-stage and distant-stage cervical cancer incidence increased by 2% per year between 2017 and 2023 among women aged 30 to 65.

Additionally, the researchers identified differences by demographic, with racial minorities, those without health insurance and those living in Southern states being the most likely to never have gotten a cervical cancer screening. This comes as late-stage cervical cancer is more common among these groups.

The researchers did not examine the reasons why young women are skipping their cervical cancer screenings. However, separate reports have identified the usual barriers: high costs, logistical barriers like taking time off from work and the fear of being seen by a doctor.

Indeed, April data in JAMA Network Open showed that those behind on their cervical cancer screenings were among the most likely to face at least one barrier to care, with as many as 50% of them reporting an issue. Specifically, 21% of those behind on cervical cancer screening reported that cost was a barrier.

There's also the question of patient education.

A 2023 survey from the Harris Poll showed that 81% of women don't know how often they should get a Pap test. Another 51% said they were unaware of how often they should get an HPV test.

There's also some confusion about what Pap and HPV tests actually detect, the survey showed. The former tests cancerous lesions on the cervix, while HPV tests detect the human papillomavirus, one of the leading causes of cervical cancer.

Healthcare organizations need to think beyond appointment scheduling to fill these care gaps. Ensuring patients are aware of and understand cancer screening and do not experience social determinants of health barring screening will be essential to getting women in for care.

Sara Heath is an executive editor at Xtelligent Healthcare Media, where she covers patient engagement, healthcare policy and health IT.