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State of Alaska

Health Indicator Report of Cancer Screening - Cervical (Pap test) - Women (Ages 21-65)

If detected early, cervical cancer is one of the most successfully treatable cancers. The Papanicolaou ("Pap") test is the screening tool used to detect cancerous and precancerous changes in a woman's cervix. The American College of Obstetrics and Gynecologists (ACOG) recommends that women should have their first Pap test at age 21. Women aged 21 - 30 may then be screened every other year, women 30 and older may be screened once every three years. Women with certain risk factors may need more frequent screening and should discuss their medical history with their clinician ^1^. [[br]][[br]] ---- {{class .SmallerFont 1. Cervical Cancer Screening. American Congress of Obstetricians and Gynecologists website. [http://www.acog.org/Patients/FAQs/Cervical-Cancer-Screening]. Accessed April 4, 2016. }}

Data Sources

  • Alaska Data: [http://dhss.alaska.gov/dph/Chronic/Pages/brfss/default.aspx Behavioral Risk Factor Surveillance System], Alaska Department of Health and Social Services, DPH, Section of Chronic Disease Prevention and Health Promotion
  • U.S. Data: National Center for Chronic Disease Prevention and Health Promotion, Behavioral Risk Factor Surveillance System (BRFSS)

Data Interpretation Issues

Note: Prevalence of cervical cancer screening excludes women who report having had a hysterectomy. Questions on cervical cancer screening were asked from 1991-2000 and subsequently in even-numbered years.

Definition

Percentage of women aged 21-65 years who have had a Pap test within the past 3 years as assessed by answering the [http://dhss.alaska.gov/dph/Chronic/Pages/brfss/default.aspx Behavioral Risk Factor Surveillance System (BRFSS)] questions: "Yes" to the following question: "A Pap test is a test for cancer of the cervix. Have you ever had a Pap test?", and "Within the past year", "Within the past 2 years", or "Within the past 3 years" to the following question: "How long has it been since you last had your last Pap test?" Note: this excludes women who report having had a hysterectomy.

Numerator

Weighted number of women aged 21-65 years who reported having a Pap test in the last three years of the BRFSS based upon the following questions: "Yes" to the following question: "A Pap test is a test for cancer of the cervix. Have you ever had a Pap test?", and "Within the past year", "Within the past 2 years", or "Within the past 3 years" to the following question: "How long has it been since you last had your last Pap test?"

Denominator

Weighted number of female respondents aged 21-65 years with complete and valid responses on the BRFSS to the questions on having a Pap test and time of last test, excluding those who responded "don't know" or "refused" to either question.

Healthy People Objective: Increase the proportion of women who receive a cervical cancer screening based on the most recent guidelines

U.S. Target: 93.0 percent

How Are We Doing?

The percentage of Alaska women (ages 21-65) who have had a pap test to screen for cervical cancer in the prior 3 years has decreased over the past two decades from 95.1% in 1991 to 77.3% in 2016. Similar declines have occurred among Alaska Native women, from 94.1% in 1991 to 84.3 in 2016. There were significant declines in 2014 from the previous reporting in 2012 but rates were steady or rose again in 2016. Since the development of the Healthy Alaskans 2010 targets, the US Preventive Services Task Force released its recommendations for screening for cervical cancer.^2^ This updated recommendation is that women ages 21 and older be screened every 3 years. The Healthy Alaskans 2010 target of 95% has not been met. There are no significant differences in cervical cancer screening rates by race or ethnicity or between most regions. There are differences in screening rates between women who are college graduates versus those who were high school graduates; those employed versus those unable to work; and those with middle/high income versus those who are poor or near poor. Crosstabulations by BMI, current smoking, sexual orientation, disability, and Adverse Childhood Experiences (ACEs) score were conducted for the 3-year average of 2012-2016. Only the significant differences related to current smoking are presented but the other comparisons are available upon request. [[br]][[br]] ---- {{class .SmallerFont 2. Screening for Cervical Cancer. Recommendations and Rationale. U.S. Preventive Services Task Force website. [http://www.uspreventiveservicestaskforce.org/3rduspstf/cervcan/cervcanrr.htm]. Accessed May 13, 2011. }}

How Do We Compare With the U.S.?

The Alaska cervical cancer screening rate is consistently has been slightly higher than or equal to the US rate.

What Is Being Done?

In collaboration with four Alaskan Tribal National Breast and Cervical Cancer Early Detection Program grantees, DHSS's Breast and Cervical Health Check Program is working to increase both public and provider awareness about current breast and cervical cancer screening recommendations as well as access to services throughout the state. "Cervical Cancer Screening in Alaska Guidelines" are developed utilizing American College of Gynecology and American Society for Colposcopy and Cervical Pathology recommendations and distributed to establish a standard throughout the state.^3^ [[br]][[br]] ---- {{class .SmallerFont 3. Final Update Summary: Cervical Cancer: Screening - US Preventive Task Force. [http://www.uspreventiveservicestaskforce.org/Page/Document/UpdateSummaryFinal/cervical-cancer-screening http://www.uspreventiveservicestaskforce.org/Page/Document/UpdateSummaryFinal/cervical-cancer-screening]. Accessed April 4, 2016. }}

Evidence-based Practices

WHAT WORKS Cancer Prevention and Control: Cancer Screening.^4^ Reducing out of pocket costs is one of the ways to increase cervical cancer screening along with group education and client reminders. Clinical Advisor. Cancer screening rates are short of the goal.^5^ Screening rates are declining for all three screenable cancers. Women with a higher education and income exceed the Healthy People 2020 goals and adults without insurance have the lowest screening rates.[[br]] [[br]] ---- {{class .SmallerFont 4. WHAT WORKS Cancer Prevention and Control: Cancer Screening. The Community Guide. [https://www.thecommunityguide.org/about/What-Works-Cancer-Screening-insert.pdf]. Published August 2012. Accessed September 7, 2016. 5. Clinical Advisor. Cancer screening rates are short of the goal. [http://www.clinicaladvisor.com/newsline/colorectal-breast-cervical-cancer-screening-rates-drop/article/418000/]. Accessed September 7, 2016. }}

Available Services

State of Alaska Breast and Cervical Health Check, BCHC 1-800-410-6266 [http://dhss.alaska.gov/dph/wcfh/pages/bchc/about/default.aspx] YWCA Encore Plus Program 907-644-9600 [http://ywcaak.org/] Alaska Breast and Cervical Health Partnership [http://alaskagetscreened.com/]
Page Content Updated On 08/22/2017, Published on 09/21/2017
The information provided above is from the Alaska Department of Health and Social Services' Center for Health Data and Statistics, Alaska Indicator-Based Information System for Public Health (Ak-IBIS) web site (http://ibis.dhss.alaska.gov). The information published on this website may be reproduced without permission. Please use the following citation: " Retrieved Tue, 18 September 2018 from Alaska Department of Health and Social Services, Center for Health Data and Statistics, Alaska Indicator-Based Information System for Public Health web site: http://ibis.dhss.alaska.gov ".

Content updated: Thu, 21 Sep 2017 10:16:42 AKDT
The information provided above is from the Alaska Department of Health and Social Services' Center for Health Data and Statistics AK-IBIS web site (http://ibis.dhss.alaska.gov/). The information published on this website may be reproduced without permission. Please use the following citation: " Retrieved Tue, 18 September 2018 6:18:19 from Alaska Department of Health and Social Services, Center for Health Data and Statistics, Indicator-Based Information System for Public Health Web site: http://ibis.dhss.alaska.gov/ ".

Content updated: Thu, 21 Sep 2017 10:16:42 AKDT