Adherence to Cervical Cancer Screening Guidelines Is Low

TUESDAY, Dec. 16, 2025 (HealthDay News) — Adherence to cervical cancer screening guidelines is low, with more than 60 percent undergoing overscreening, according to a research letter published online Dec. 10 in JAMA Network Open.

Michelle B. Shin, Ph.D., M.P.H., R.N., from the University of Washington in Seattle, and colleagues examined cervical cancer screening guideline adherence among a nationally representative commercially insured cohort to assess factors and modalities associated with nonadherence. Data were analyzed from the 2013 to 2021 Optum Clinformatics anonymized longitudinal claims database covering about 13 million individuals annually.

The researchers found that among 670,003 eligible individuals, 47.1 and 52.9 percent received cytology alone and cotesting, respectively. Overall, only 7.3 percent were guideline-adherent, while 61.6 and 31.1 percent were overscreened and underscreened, respectively. The overall adjusted predicted probability (PP) of overscreening and underscreening was 89.4 and 81.0 percent, respectively, and was mainly similar across racial and ethnic groups. Those screening with cotesting had higher overscreening PP than those screened with cytology alone (96.2 versus 82.4 percent). The highest overscreening was seen for non-Hispanic Black, younger age, high Charlson Comorbidity Index (CCI), and high socioeconomic status (SES). Underscreening PP was also higher with cotesting than cytology alone (93.1 versus 68.7 percent) and was highest among non-Hispanic Asian, older age, high CCI, and low SES groups.

“Consistent with prior work, we observed low adherence (7.3 percent) to cervical cancer screening guidelines among the commercially insured U.S. population despite stable coverage, likely reflecting guideline confusion among patients, clinicians, and health systems,” the authors write.

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