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EPV044/#201 Understanding the never-screened population for cervical cancer in the United States – a descriptive and trend analysis
  1. A Francoeur1,
  2. C-I Liao2,
  3. D Wong1,
  4. E Thayer3,
  5. A Milki4,
  6. A Moon5,
  7. A Mann6,
  8. MA Caesar7,
  9. A Chan8,
  10. D Kapp9,
  11. B Monk10 and
  12. J Chan11
  1. 1University of California Los Angeles, Obstetrics and Gynecology, Los Angeles, USA
  2. 2Kaohsiung Veterans General Hospital, Obstetrics and Gynecology, Kaohsiung City, Taiwan
  3. 3University of Massachusetts Medical School, Obstetrics and Gynecology, Worcester, USA
  4. 4George Washington University School of Medicine and Health Sciences, Obstetrics and Gynecology, Washington DC, USA
  5. 5Stanford University School of Medicine, Obstetrics and Gynecology, Division of Gynecologic Oncology, Stanford, USA
  6. 6Palo Alto Medical Foundation, Research Institute, Palo Alto, USA
  7. 7California Pacific Medical Center, Research Institute, San Francisco, USA
  8. 8Palo Alto Medical Foundation Research Intitute, Obstetrics and Gynecology, Palo Alto, USA
  9. 9Stanford University School of Medicine, Department of Radiation Oncology, Stanford, USA
  10. 10Arizona Oncology, Gynecologic Oncology, Obstetrics and Gynecology, Phoenix, USA
  11. 11California Pacific Medical Center, Obstetrics and Gynecology, San Francisco, USA


Objectives It is estimated that 50% of patients diagnosed with cervical cancer never had any screening. We aimed to determine the changes in cervical cancer screening in the United States.

Methods Pap smear rates were evaluated using the Behavioral Risk Factor Surveillance System (BRFSS). SEER*Stat 8.3.8 and Joinpoint regression program were used to calculate incidence trends.

Results In 2016, 6.28% women in the U.S were never screened for cervical cancer. Based on race, 21.3% of Asian, 11.63% Hispanic, 8.09% Black and 5.1% of White women have never undergone screening. The age groups with higher never screened rates were the 80 and older age cohort at 11.14% followed by the 25–29 group at 8.87%. Over the last 6 years of our study, there has been an increase of 7.4% annually of never screened rates (p=0.008). In regards to age, there has been an increase in never pap was the 25–29 age group (AAPC +7.31%, p<0.001). White and Black women have increasing never pap smear rates at 1.49% (p=0.008) and 4.05% (p<0.001), respectively, while Hispanic women have no change. The intersectionality of age and race shows that Black women ages 25–29 have the highest increased rate of no screening, 9.84% annually (p<0.001).

Conclusions Based on this large survey, nearly one fourth of Asian women were never screened for cervical cancer in the U.S. There is also an increasing proportion of never-screened particularly in younger Black women. Further research is warranted to understand the change in screening practices in relation to vaccination and access to care.

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