OBJECTIVES: To examine trends and identify any disparity in the use of PAP smear 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 pap smear 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.

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 pap smear preventive care screening decreased from 10.7% in 2016 to 8.0% in 2020 among females aged >=18 years. Commercial enrollees (10.4% in 2016 to 8.1% in 2020) had higher screening rates than Medicaid enrollees (5.4% in 2016 to 5.4% in 2020). The Northeast region (12.2% in 2016 to 9.7% in 2020) had the highest cervical screening rate while the West (7.5% in 2016 to 5.8% in 2020) had the lowest screening rates. Asians, Blacks, Hispanics, and Whites had a 12.1%, 10.6%, 10.4%, and 11.0% rate of cervical screening in 2016 and this decreased to 9.2%, 8.7%, 8.4%, and 8.0% in 2020, respectively.

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