Cervical Cancer Screening Rates Within a Large National Network of Community-Based Health Care Organizations: A Cross-Sectional Study

Abstract

Introduction:

Insufficient cervical cancer screening contributes to increased cervical cancer rates, particularly among disadvantaged groups, yet research on screening practices by race and ethnicity is underreported. Our objectives were to find the rates of up-to-date (UTD) cervical cancer screening within a nationwide network.

Methods:

A cross-sectional study was conducted using data from OCHIN, a diverse, national database consisting of over 6 million publicly or underinsured patients in rural and medically underserved communities that provides electronic health records to over 34,500 U.S. providers. We included all females between the ages of 21 and 65 with a cervix and at least one encounter at an OCHIN clinic from January 2015 to December 2023. UTD cervical cancer screening was the primary outcome.

Results:

Of the 2,464,565 patients with OCHIN, 2,279,808 met the inclusion criteria. The 2015–2023 rates of UTD cervical cancer screening for all races and ethnic groups were below the Healthy People 2030 goal of 84.3% and below the 2021 national screening average of 75.2%. Screening varied by race/ethnicity, with Hispanic individuals having the highest rates of UTD screening. Geographic location (urban, large rural, or isolated rural) did not show statistically significant differences in screening rates.

Conclusions:

In our analysis, we noted lower rates of participation in cervical cancer screening than national goals and the national average among all ages and racial/ethnic groups. Efforts to increase access and participation in cervical cancer screening programs are critical to eliminating preventable cervical cancer health inequities.