Estimating the Annual Proportion of U.S. Women Receiving Cervical Cancer Screening Tests by Age Group and Race and Ethnicity, 2008–2023

INTRODUCTION: The United States has no national cervical cancer screening registry and available data sources for estimating screening have limitations: population surveys may overestimate screening and insurance claims data are nonrepresentative with limited demographic information. By combining multiple data sources, we estimated the annual proportion of the U.S. women aged 20-64 years who received cervical cytology and/or human papillomavirus (HPV) tests, overall and by race/ethnicity, during 2008-2023. METHODS: Using commercial and public insurance databases and national surveys, we estimated the annual proportion of privately insured, publicly insured, and uninsured women who had cervical cytology/HPV tests. We derived population screening estimates by averaging the privately and publicly insured and uninsured estimates, weighted for insurance market share. Estimates for Hispanic, Asian, Black, and White women were developed using racial/ethnic-specific insurance market shares. We calculated absolute (ADs) and relative differences (RDs) by data source and demographic groups. RESULTS: During 2008-2023, the estimated proportion of women aged 20-64 years with an annual cervical cytology/HPV test decreased from 38.0% to 23.3%. Compared with single data sources, this combined estimate was, on average, 5.1% lower than privately insured data, 12.8% higher than publicly insured data, and 22.3% lower than self-report data. By race and ethnicity, compared with the overall estimate, the proportion tested was highest in Asian (average AD = 1.7%; RD = 5.8%) and lowest in Hispanic women (average AD = 3.0%; RD = 9.9%). CONCLUSIONS: These national estimates calculated by combining different data sources incorporate strengths of claims and survey data and could be useful for assessing screening participation and monitoring cervical precancer diagnoses in the United States.