Most women aged 64 to 66 years may not meet requirements that would allow them to forgo cervical cancer screening, according to a study published in Gynecologic Oncology.
The study included 2 cohorts of women. One consisted of 590,901 women from a national claims database who were 64 years of age during 2016 to 2018 and had employer-sponsored health insurance. The other cohort included 1544 women, aged 64 to 66 years, who were seen at a safety net health center in 2019.
The patients were considered eligible to stop cervical cancer screening if they had undergone a hysterectomy with removal of the cervix and had no indication of cervical precancer or cancer. They were also eligible if they had two consecutive negative HPV tests, three consecutive negative Pap tests, or two consecutive negative co-tests.
A minority of women in both cohorts met the criteria to forgo cervical cancer screening — 22.2% from the national claims database and 34.2% from the safety net health center.
Of the 77.8% of women in the database cohort who were ineligible for screening exit, 64.7% did not have sufficient data, and 13.1% had a medical or screening history that required them to continue screening.
Of the 65.8% of women in the safety net cohort who were ineligible for screening exit, 56.7% did not have sufficient data, and 9.1% had a medical or screening history that required them to continue screening.
Among women who had continuous health insurance coverage for 10 years, 58.5% did not meet the criteria to stop screening. This included 37% of women who did not have sufficient data and 21.5% who had a history that required them to continue screening.
The study authors said these data raise “several issues,” including the lack of adequate cervical cancer screening among women younger than 65 years of age, the need to assess medical and screening histories before stopping screening, and the challenge of applying screening guidelines in clinical practice.
Disclosures: The study authors declared no competing interests.
Mills JM, Morgan JR, Dhaliwal A, and Perkins RB. Eligibility for cervical cancer screening exit: comparison of a national and safety net cohort. Gynecol Oncol. Published online June 3, 2021. doi:10.1016/j.ygyno.2021.05.035