Do age-based discontinuation recommendations influence cervical cancer screening rates? Evidence from the United States' Behavioral Risk Factor Surveillance System, 2016 and 2018.

Lilly Estenson, Narae Kim, Mireille Jacobson

Abstract read

In one paragraph

Article in Preventive medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it

0cells of the map it votes in

0citing papers in PubMed

–field-weighted citation impact

1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors.

Lilly EstensonLeonard Davis School of Gerontology, University of Southern California, Los Angeles, CA, USA.

Narae KimLeonard Davis School of Gerontology, University of Southern California, Los Angeles, CA, USA. Electronic address: naraekim@usc.edu.

Mireille JacobsonLeonard Davis School of Gerontology, University of Southern California, Los Angeles, CA, USA; USC Schaeffer Center for Health Policy & Economics, University of Southern California, Los Angeles, CA, USA.

Funding

Medicaid versus Private Coverage for Low-Income Families: What are the Tradeoffs between Cost-Sharing and Access to CareR01HS026488 · AHRQ · UNIVERSITY OF SOUTHERN CALIFORNIA · PI JACOBSON, MIREILLE · 2019 to 2021

$835k

The Welfare Consequences of Oncology Drug ShortagesR21CA173047 · NCI · RAND CORPORATION · PI JACOBSON, MIREILLE · 2013 to 2014

$448k

AHRQ HHS R01 HS022741AHRQ HHS R01 HS026488NCI NIH HHS R21 CA173047

6 · The paper itself

Abstract

The United States Preventive Services Task Force (USPSTF) recommends that women with adequate prior screening and average cervical cancer risk discontinue routine cervical cancer screening after age 65. This study's objective was to estimate how the USPSTF recommendation affects Papanicolaou (Pap) test rates among women at age 66 in the United States. We used nationally representative 2016 and 2018 Behavioral Risk Factor Surveillance System data for women ages 56-76 (n = 226,031) and a regression discontinuity design to estimate changes in annual Pap test rates at age 66. Among women age 66-76, 22.5% reported receiving a Pap test within the past one year. At age 66, annual Pap rates declined by 5.9 percentage points (p.p.) (95% Confidence Interval [CI]: -7.7, -4.1) off a pre-66 rate of 39%. The change varied by race/ethnicity, education, and marital status. Pap rates did not change discretely for non-Hispanic Black women (0.8 p.p.; 95% CI: -5.4, 7.1) but did for women from other racial/ethnic groups. The decline was larger for women who graduated college (-9.0 p.p.; 95% CI: -12.0, -5.9) than for women without a college degree and for women who were never married (-9.4 p.p., 95% CI: -17.3, -1.5) than for women who were married/partnered or divorced/separated. The USPSTF recommendation to discontinue cervical cancer screening after age 65 leads to a sharp decline in Pap test rates at age 66 but disparately affects women based on race, education and marital status. Further study is needed to assess the consequences of these changes.

Indexed as

Uterine Cervical NeoplasmsAgedBehavioral Risk Factor Surveillance SystemEarly Detection of CancerEthnicityFemaleHumansMass ScreeningPapanicolaou TestUnited StatesVaginal SmearsAge discontinuation recommendationsCancer screeningCervical cancerHealthcare disparitiesOlder adultsPapinicolaou testPractice guidelinePreventive health servicesUSPSTF

Identifiers

PMID37182584

DOI10.1016/j.ypmed.2023.107543

PMCPMC12875211

What OpenQuestion holds

Textmetadata

LicenceCC BY-NC-ND

Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.