Nonadherence to Cervical Cancer Screening Guidelines in Commercially Insured US Adults, 2013-2021
Menée aux Etats-Unis à partir de données 2013-2021 portant sur une cohorte d'environ 13 millions de femmes, cette étude identifie les facteurs associés à une non adhésion aux recommandations concernant le dépistage du cancer du col de l'utérus
Cervical cancer screening guidelines in the US have evolved rapidly with newer screening modalities, including addition of quintennial cotesting in 2012 and primary HPV testing in 2018 to triennial cytology only,1 leading to widespread public confusion among patients and clincians.2 Evidence from countries like Australia, which shifted to human papillomavirus (HPV)–based screening only, shows that guideline confusion can lead to nonadherence—eg, overscreening and underscreening, defined as shorter and longer than guideline-based screening intervals, respectively.3 Overscreening can lead to unnecessary procedures and cost,4 while underscreening could worsen disparities in cancer burden among racial and ethnic minority individuals.5 However, the impact of these US guideline changes on adherence across modalities and populations remains understudied, raising concerns about widening gaps in care. Therefore, we examined cervical cancer screening guideline adherence among a nationally representative commercially insured cohort in the US to identify factors and modalities associated with nonadherence and test for interactions between race, ethnicity, and modality.
JAMA Network Open , article en libre accès, 2025