Guideline Concordant Cervical Cancer Screening Among Active-Duty Servicewomen in the U.S. Military from 2017 to 2022

Abstract

Background:

Cervical cancer remains a significant health concern for women, with the U.S. Preventive Services Task Force (USPSTF) recommending routine screenings for women ages 21–65 years. This study aims to evaluate cervical cancer screening rates among active-duty servicewomen (ADSW) in the U.S. military and assess the proportion meeting USPSTF guidelines during fiscal year (FY) 2017–2022.

Methods:

We conducted a retrospective cohort study of ADSW ages 21–60 years screened for cervical cancer in FY 2017, who were then followed through FY 2022. Excluded from the study were reservists, National Guard, and Coast Guard personnel. Screening compliance was determined based on the USPSTF age-based guidelines. We performed descriptive statistics and logistic regression to examine screening rates and compliance likelihood.

Results:

We identified 212,081 ADSW during FY 2017 (62% were ages 21–29 years and 38% were ages 30–60 years). Overall, 76.5% of eligible ADSW received cervical cancer screenings. ADSW in the 30–60 years age group were less likely to undergo screening (odds ratio [OR]: 0.73, 95% confidence intervals [CI]: 0.71–0.74) compared with those aged 21–29 years. Similarly, senior officers showed lower screening rates compared with junior-enlisted personnel (OR: 0.78, 95% CI: 0.74–0.82). Compliance with USPSTF guidelines varied by age group, race, and military branch, with Black (OR: 0.88, 95% CI: 0.83–0.93), Asian American, and Pacific Islanders (OR: 0.85, 95% CI: 0.77–0.93), and those in the Air Force (OR: 0.64, 95% CI: 0.61–0.68) and Navy (OR: 0.84, 95% CI: 0.79–0.90) showing lower compliance rates compared with White and Army ADSW, respectively. Compliance rates were higher among ADSW opting for 5-year screening intervals (98%) compared with 3-year intervals (85%).

Conclusions:

Our results show that about three-fourths of the ADSW had a cervical cancer screening, and more than 90% of those screened were USPSTF compliant. Despite overall progress, disparities persist across military branches, rank, and racial groups, highlighting the need for targeted interventions to enhance screening rates among specific groups.