Definition
The proportion of women 18 years or older who reported having a Pap test in the last three years.Numerator
The proportion of women 18 years or older who reported having a Pap test in the last three years.Denominator
The total number of female survey respondents aged 18 or older excluding those who responded "don't know" or "refused" to the numerator question.Data Interpretation Issues
To reduce bias and more accurately represent population data, the BRFSS has changed survey methodology. In 2010, it began conducting surveys by cellular phone in addition to landline phones. It also adopted "iterative proportional fitting" (raking) as its weighting method. More details about these changes can be found at: [https://ibis.health.utah.gov/pdf/opha/resource/brfss/RakingImpact2011.pdf].Why Is This Important?
Cervical cancer is one of the most curable cancers if detected early through routine screening.
Almost all cases of cervical cancer are caused by infection of high-risk types of the human papillomavirus (HPV). The HPV vaccine protects against the HPV types that most often cause cervical cancer. Women who have had an HPV vaccine still need to have routine Pap smears because the vaccine does not fully protect against all the strains of the virus and other risk factors that can cause cervical cancer.
HPV is transmitted through sexual contact. Any woman who is sexually active is at risk for developing cervical cancer. Other risk factors include giving birth to many children, having sexual relations at an early age, having multiple sex partners or partners with many other partners, cigarette smoking, and use of oral contraceptives.
The U.S. Preventive Services Task Force recommends cervical cancer screening (Pap smear) every 3 years for women 21 to 65 years old. For women 30 to 65 years old, Pap smears may be conducted every 5 years in conjunction with human papillomavirus (HPV) testing.How Are We Doing?
Cervical cancer screening rates have continually fallen since 2010 at both the state and national level. Between 2012 and 2020, the percentage of Utah women aged 18 or older who reported receiving a Pap test within the last three years decreased from 70.7% to 62.9% (age-adjusted rates), compared to a national rate of 68.8%.
Cervical cancer screening rates in Utah vary by geography, ethnicity, race, socio-economic status, and age.
For combined years 2019 and 2020, Central Utah (54.8%), Southwest (55.0%), and Utah County (56.8%) local health districts reported statistically significantly lower cervical cancer screening rates when compared to the state rate (60.9%). Salt Lake County (63.6%) reported a statistically significantly higher rate. See additional data views for screening rates by Utah Small Areas.
In 2020, women who identified as Hispanic reported receiving a screening for cervical cancer within the past 3 years at a higher rate (65.3%) than women who identified as non-Hispanic (62.4%), although this was not significantly different. Those who identified racially as Pacific Islander reported the lowest rates (44.9%), while those who identified as Asian (69.8%) and American Indian/Native Alaskan (69.1%) reported the highest rates in 2019-2020. However, none of these were statistically significantly different than the overall state rate.
In 2020, and when looking at the highest level of education completed, college graduates (69.7%) and those with some post high school education (68.5%) were more likely to have received a Pap test than those with a high school diploma (63.9%) or those with no high school degree (59.7%). Women in households with annual incomes less than $25,000 (51.6%) were significantly less likely to have had a Pap test in 2020 than women in households with higher incomes (total 67.6%).
Women age 18-34 years old (56.1%) were significantly less likely to have had a Pap test in 2020 than women age 50-64 (69.4%) and women age 35-49 (78.5%). The U.S. Preventive Services Task Force does not recommend screening for cervical cancer in women older than 65 years who have had adequate prior screening and are not otherwise high risk for cervical cancer.How Do We Compare With the U.S.?
Cervical cancer screening rates have continually fallen since 2010 at both the state and national level. Screening rates in Utah have also consistently been lower than national rates.
Nationally, the percentage of women aged 18 or older who reported receiving a Pap test in the past three years decreased from 80.7% in 2010 to 68.8% in 2020. In Utah, the percentage of women who received a pap test decreased from 74.3% in 2010 to 62.9% in 2020. The latest state rates from 2020 indicate that only 62.9% have received a cervical cancer screening test within the past 3 years.What Is Being Done?
The Utah Breast & Cervical Cancer Program (Utah B&C) partners with local health departments, community clinics, hospitals and healthcare professionals to help those with low incomes who do not have adequate insurance gain access to timely breast and cervical cancer screening, diagnostic and treatment services. Eligible women can apply to Utah B&C by calling 800-717-1811 or by submitting an online enrollment form available at: [https://cancerutah.org/do-i-qualify/].
In addition, the Utah Immunization Vaccines for Children (VFC) program provides low cost HPV vaccines to females ages 9 to 18 who meet income guidelines. Visit [https://immunize.utah.gov/vaccines-for-children-program/] for more information.Health Program Information
The 2000 Utah Legislature approved a resolution encouraging private health insurance companies and employers to include insurance coverage for the screening and detection of cervical cancer. As of July 2001, the Utah Breast and Cervical Cancer Program is able to refer Utah women in need of treatment for cervical cancers for full Medicaid benefits. The women must meet all requirements as outlined in the National Breast and Cervical Cancer Treatment Act.