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Health Indicator Report of Cancer Screening - Pap Test

The National Cancer Institute states that, based on solid evidence, regular screening of appropriate women for cervical cancer with a Pap test reduces mortality from cervical cancer by at least 80 percent. This is because of all cancers, cervical cancer is one of the most amenable to prevention and early detection through screening. Regular Pap tests can detect pre-cancers caused by human papillomavirus (HPV), which, when treated, can stop cervical cancer before it develops. Pap tests can also lead to earlier diagnosis of cervical cancer that may result in more effective treatment.
*Comparable data for the United States for "current" with cervical cancer screening recommendations are only available for 2014 and 2016 at this time.

Notes

The cervical cancer screening questions are only administered in the BRFSS in even-numbered years. In 2012, the U.S. Preventive Services Task Force updated their recommendations for cervical cancer screening. Currently, it is recommended that women ages 21-65 years have a Pap test every 3 years. Women ages 30-65 years could alternatively be screened with a combination of a Pap test and a human papillomavirus (HPV) test every 5 years. The BRFSS does not ask whether women have received a combination Pap test and HPV test, therefore the percent of women who are up-to-date for cervical cancer screening may be underestimated.   Some of the data presented were collected before the updated 2012 recommendations were released. Therefore, in 2002-2010 a woman was considered current with cervical cancer screening if she was ages 18-65 years and had a Pap test within the past 3 years. Estimates for 2011 and forward should not be compared to earlier years (please refer to Data Interpretation Issues).

Data Source

Behavioral Risk Factor Surveillance System Survey Data, U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, together with New Mexico Department of Health, Injury and Behavioral Epidemiology Bureau.

Data Interpretation Issues

Data for this indicator report are from the Behavioral Risk Factor Surveillance System (BRFSS), an ongoing survey of adults regarding their health-related behaviors, health conditions, and preventive services. Data are collected in all 50 states, D.C., and U.S. territories. Responses have been weighted to reflect the New Mexico adult population by age, sex, ethnicity, geographic region, marital status, education level, home ownership and type of phone ownership. The survey is conducted using scientific telephone survey methods for landline and cellular phones (with cellular since 2011). The landline phone portion of the survey excludes adults living in group quarters such as college dormitories, nursing homes, military barracks, and prisons. The cellular phone portion of the survey includes adult students living in college dormitories but excludes other group quarters. Beginning with 2011, the BRFSS updated its surveillance methods by adding in calls to cell phones and changing its weighting methods. These changes improve BRFSS' ability to take into account the increasing proportion of U.S. adults using only cellular telephones as well as to adjust survey data to improve the representativeness of the estimates generated from the survey. Results have been adjusted for the probability of selection of the respondent, and have been weighted to the adult population by age, gender, phone type, detailed race/ethnicity, renter/owner, education, marital status, and geographic area. Lastly and importantly, these changes mean that the data from years prior to 2011 are not directly comparable to data from 2011 and beyond. Please see the [https://ibis.health.state.nm.us/view/docs/Query/BRFSS/BRFSS_fact_sheet_Aug2012.pdf BRFSS Method Change Factsheet]. The "missing" and "don't know" responses are removed before calculating a percentage.

Definition

Estimated percentage of New Mexican women ages 21-65 years (who have not had a hysterectomy) who have had a Pap test in the past three years.

Numerator

Number of New Mexican Women ages 21-65 years from the Behavioral Risk Factor Surveillance System (BRFSS) who reported that they have had a Pap test in the past three years.

Denominator

Number of New Mexican women ages 21-65 years from the Behavioral Risk Factor Surveillance System (BRFSS).

Healthy People Objective: C-15, Increase the proportion of women who receive a cervical cancer screening based on the most recent guidelines

U.S. Target: 93.0 percent

Other Objectives

New Mexico Cancer Plan 2012-2017 Objectives: 1. By 2017, increase by 6% the proportion of NM women ages 21 through 65 (who report not having had a hysterectomy) who have had a Pap test in the past 3 years, from a 2010 baseline of 85.8% to 91%.

How Are We Doing?

The percent of New Mexican women ages 21-65 years who have had a Pap test in the past three years has declined slightly over the past decade.

How Do We Compare With the U.S.?

The percent of New Mexican women ages 21-65 years who have had a Pap test in the past three years was lower than the national median percent in 2014.

What Is Being Done?

The New Mexico Breast and Cervical Cancer Early Detection Program (NMBCCP) is dedicated to improving access to high-quality, age-appropriate cervical cancer screening and diagnostic services for low-income women who are uninsured or under-insured, and helping them access resources for treatment when necessary. To do this, the NMBCCP supports changes within provider practices and health systems to increase screening opportunities. In addition, data and surveillance systems, such as monitoring screening quality measures, are used to develop more organized, systematic approaches to cancer screening and to improve service delivery. These approaches are supported by the New Mexico Department of Health and are being implemented by many healthcare organizations and health systems throughout New Mexico. Visit the NMBCCP website at: http://archive.cancernm.org/bcc/index.html

Evidence-based Practices

The NMBCCP supports New Mexico health care providers and health systems in using evidence-based interventions such as patient reminders, risk assessment tools, reducing structural barriers (e.g., expanding clinic hours), provider reminder and recall systems, and provider assessment and feedback on performance. All of these activities have been shown to increase cervical cancer screening rates, and are recommended by The Guide to Community Preventive Services, a collection of evidence-based findings of the Community Preventive Services Task Force, established by the U.S. Department of Health and Human Services.

Available Services

The New Mexico Breast and Cervical Cancer Early Detection Program provides free cervical cancer screening and diagnostic services to New Mexico women ages 21 years and older who lack health insurance and who live at or below 250% of the federal poverty level. More information can be found online at http://www.cancernm.org/bcc/index.html or by calling toll-free 1-877-852-2585.

Health Program Information

The NMBCCP endorses the cervical cancer screening recommendations of the US Preventive Services Task Force (USPSTF). The USPSTF has concluded that for women ages 21 to 65 years, there is high certainty that the benefits of screening for cervical cancer (fewer deaths and new cases) outweigh the harms. The current USPSTF recommendations, in place since 2012, state that Pap testing should occur every three years for women ages 21-65 years who have normal screening results. Additionally, women ages 30-65 years may increase their rescreening interval to five years by having an HPV test at the same time as their Pap test (i.e., co-testing) if the results of both tests are normal. Routine screening with Pap tests is not recommended for women younger than 21 years, nor is it recommended for women older than 65 years if they have received adequate recent screening with normal results. Routine screening is also not recommended for women who no longer have a cervix due to a hysterectomy for benign disease. The USPSTF recommendation applies to all women who have a cervix, regardless of sexual history. It does not apply, however, to women who have received a diagnosis of a high-grade precancerous cervical lesion or cervical cancer, women with in utero exposure to diethylstilbestrol, or women who are immuno-compromised (such as those who are HIV positive). The USPSTF notes that screening with Pap tests or HPV testing can also sometimes lead to harms, mainly false positive screening results requiring additional diagnostic testing. Adverse pregnancy outcomes associated with treatment of screening-detected disease can also occur, although changes to screening guidelines for young women in recent years have been enacted to minimize this.
Page Content Updated On 08/21/2017, Published on 10/31/2017
The information provided above is from the New Mexico Department of Health's NM-IBIS web site (http://ibis.health.state.nm.us). The information published on this website may be reproduced without permission. Please use the following citation: "Retrieved Mon, 18 March 2019 from New Mexico Department of Health, Indicator-Based Information System for Public Health Web site: http://ibis.health.state.nm.us".

Content updated: Tue, 31 Oct 2017 13:08:55 MDT