Cervical cancer screening among women by hysterectomy status and among women aged ≥65 years - United States, 2000-2010

Abstract

Since 2003, major U.S. organizations consistently have recommended against screening most women for cervical cancer after a total hysterectomy for benign disease. Starting in 2003 and becoming consistent across organizations in 2012, guidelines also state that women with a history of adequate screening no longer should be screened after age 65 years. Reports have shown that many of those women continue to receive Papanicolaou (Pap) testing, contrary to recommendations. To measure recent screening behaviors and trends in accordance with evidence-based recommendations, biennial cross-sectional data from the Behavioral Risk Factor Surveillance System (BRFSS) on women aged ≥30 years were analyzed and stratified by hysterectomy status and by age (30-64 years and ≥65 years). The proportion of women reporting having had a hysterectomy who reported a recent (within 3 years) Pap test declined from 73.3% in 2000 to 58.7% in 2010. Declines among women having had a hysterectomy were significant among those aged 30-64 years, from 81.0% in 2000 to 68.5% in 2010, and among those aged ≥65 years, from 62.0% to 45.0%. Among women aged ≥65 years with no history of hysterectomy, recent Pap testing also declined significantly, from 73.5% to 64.5%. Although recommendations have resulted in reductions in screening posthysterectomy and of those aged ≥65 years, many women still are being screened who will not benefit from it.