Improving access to regular cervical cancer screenings, especially for women in underserved communities, is key to reducing mortality rates.
The American Cancer Society estimates that there will be 13,960 new cases of invasive cervical cancer diagnosed this year and of those cases, 31% will be fatal. More than nine of every 10 cases of cervical cancer are caused by the human papillomavirus (HPV). Yet up to 93% of cervical cancers are preventable. If more women had access to regular screenings and proactive health care, including the HPV vaccine, fewer women would face this devastating disease.
Cervical cancer screenings are in decline
Prior to the pandemic, screening rates were declining. In 2005, only 14% of women were behind on their tests and that number jumped to 23% in 2019.
Recent analysis from the Evernorth Research Institute1 confirms that the downward trend has continued. Research findings indicate that the number of cervical cancer screenings fell 13.5% from 2019 to 2020. With the onset of the COVID-19 pandemic and stay-at-home orders, access to screenings was limited, and many women deferred outpatient medical visits. Although the rate for cervical cancer screening grew 11.4% from 2020 to 2021, overall numbers have not rebounded to pre-pandemic levels.
Percentage of Women Receiving Annual Cervical Cancer Screenings by Year (%)
Preventive cervical cancer screenings are less likely among women in under-resourced communities
Our research also shows that social and economic conditions can affect whether women are receiving cervical cancer screenings and preventive care. Factors that may limit screening include lack of knowledge of the importance of screenings, lack of access and limited provider availability.
Women who live in areas that rank high or very high for the most social needs on the Evernorth Social Determinants Index (ESDI) have the lowest screening rates.
Cervical Screening Rates by Year and Evernorth Social Determinants Index (%)
The Evernorth Social Determinants Index identifies areas where underlying social determinants are present that may impact a person’s health. High or very high classification represents those living in an under-resourced area where many social determinants are present.
Research also shows that those living in areas of high social need have higher cervical cancer incidence and mortality rates than those that live in highly resourced communities. Black and Hispanic women in the US are more likely to die from cervical cancer than any other demographics.
Residents living in these areas also have higher mortality and incidence rates for other cancers, including colorectal, liver, stomach and lung. Additional research shows that individuals living in areas of greater social need have lower rates of all recommended cancer screenings, leading to higher incidence rates. Black people have the highest mortality rates for all cancers at 166.7 deaths per 100,000 compared to 144.1 overall.
Screening levels haven’t bounced back in a post-pandemic world
When 2021 cervical cancer screening rates are broken down geographically, there are significant differences among the regions.
Most Likely to Be Screened (%)
For most regions, screening rates have not returned to or exceeded the pre-pandemic levels of 2018-2019 and rates in all regions are generally lower among those living in under-resourced communities.
Screening and education can save lives.
Improving access to screenings is essential to reducing the number of women diagnosed with cervical cancer. Cancer screening is covered at no cost to the individual under the Affordable Care Act. Equally important is expanding education about preventing cancer with proactive care. In a recent study, participants stated “lack of knowledge” was a common reason for not receiving timely screenings for cervical cancer.
Continuing to work with providers to recommend screenings and ensure women understand the recommended guidelines is key. Even if they have received an HPV vaccine, women should still be screened for cervical cancer because the vaccines do not protect against all HPV types that cause cancer.
Awareness of cervical cancer can help women recognize the benefits of regular cancer screenings to prevent it.
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Evernorth Social Determinants of Health Index
The Evernorth Social Determinants Index (ESDI) is designed to better understand the potential health challenges an individual may experience in the area where they live. It incorporates census data with 22 social determinant measures across six categories (economic, education, food access, health coverage, infrastructure, and language) to determine a geographic-based score that quantifies the potential impact of social determinants of a particular area. Higher ESDI scores indicate areas with greater likelihood of being underserved.
Evernorth Research Institute
Evernorth Research Institute is a catalyst for change: generating the industry-leading thinking that will redefine health care as we know it. Combining Evernorth’s unmatched data and analytics with the expertise of our partners, we unlock pivotal insights that incite action and guide meaningful progress in health care.
1 The Evernorth Research Institute analysis included nearly 3 million lives, obtained from an Evernorth integrated data peer group with a subset of Commercial clients with medical claims available. Cervical cancer screening rates were determined from the percentage of women 21 to 64 years of age who received one or more PAP tests during the year.