OBJECTIVES: To examine trends and identify any disparity in the use of cervical cancer screening tests during 2016–2020 in the US

METHODS: The study population included females with >=18-year age in the Optum® de-identified Market Clarity Dataset, which links medical and pharmacy claims with EHR data from providers across the continuum of care. We calculated the use of cervical cancer screening tests in each year between 2016 to 2020 as the percentage of women who were screened among women who were enrolled/had healthcare activity in that year. Trends will be assessed by 2-sided Poisson regression. Annual cervical cancer screening test use will be examined by three modalities: cytology alone, cytology plus HPV testing (co-testing), and HPV testing alone.

RESULTS: The study population ranged in size from 24.3 million females in 2016 to 26.2 million females in 2020. The overall use of cervical preventive care screening decreased from 19.5% in 2016 to 13.4% in 2020 among females aged >=18 years. Commercial enrollees (22.2% in 2016 to 15.5% in 2020) had higher screening rates than Medicaid enrollees (13.3% in 2016 to 10.7% in 2020). The Northeast region (22.1% in 2016 to 15.7% in 2020) had the highest cervical screening rate while the West (15% in 2016 to 9.6% in 2020) had the lowest screening rates. Asians, Hispanics, Blacks, and Whites had a 22.8%, 21.7%, 20.1%, and 19.3% rate of cervical screening in 2016 and this decreased to 15.2%, 15.1%, 14.5%, and 13.2% in 2020, respectively.

CONCLUSIONS: Blacks, Asians, and Hispanics had comparable screening rates as Whites. However, there is a disparity in the cervical screening rates by the insurance type and region. The biggest strength of this study is the large sample size, with millions of females.