Cancer Causes & Control

, Volume 21, Issue 7, pp 1081–1090

Meeting the cervical cancer screening needs of underserved women: The National Breast and Cervical Cancer Early Detection Program, 2004–2006

  • Florence K. L. Tangka
  • Brett O’Hara
  • James G. Gardner
  • Joanna Turner
  • Janet Royalty
  • Kate Shaw
  • Susan Sabatino
  • Ingrid J. Hall
  • Ralph J. Coates
Original paper

DOI: 10.1007/s10552-010-9536-3

Cite this article as:
Tangka, F.K.L., O’Hara, B., Gardner, J.G. et al. Cancer Causes Control (2010) 21: 1081. doi:10.1007/s10552-010-9536-3

Abstract

Objective

To examine the extent to which the only national organized screening program in the US, the National Breast and Cervical Cancer Early Detection Program (NBCCEDP), has helped to meet the cervical cancer screening needs of underserved women.

Methods

Low-income, uninsured women 18–64 years of age are eligible for free cervical cancer screening services through NBCCEDP. We used data from the US Census Bureau to estimate the number of eligible women, based on insurance status and income. The estimates were adjusted for hysterectomy status using the National Health Interview Survey and the Behavioral Risk Factor Surveillance System. We used administrative data from NBCCEDP to obtain the number of women receiving NBCCEDP-funded Papanicolaou (Pap) tests. We then calculated the percentage of NBCCEDP-eligible women who received free cervical cancer screening through NBCCEDP. We also used the NHIS to calculate the percentage of NBCCEDP-eligible women screened nationally and the percentage unscreened.

Results

In 2004–2006, nearly 9% (775,312 of 8.9 million) of NBCCEDP-eligible women, received NBCCEDP-funded Pap test. Rates varied substantially by age groups, race, and ethnicity. NBCCEDP-eligible women 40–64 years of age had a higher screening rate (22.6%) than eligible women 18–39 years of age (2.3%). Non-Hispanic women had a higher screening rate (9.3%) than Hispanic women (7.3%). Among non-Hispanics, the screening rate was highest among American Indian and Alaska Native (AIAN) women (36.1%) and lowest among women of different race combinations (4.6%), The percentage of eligible women screened in each state ranged from 2.0 to 38.4%.

Conclusions

Although NBCCEDP provided cervical cancer screening services to 775,312 low-income, uninsured women, this number represented a small percentage of those eligible. In 2005, more than 34% of NBCCEDP-eligible women (3.1 million women) did not receive recommended Pap tests from either NBCCEDP or other sources.

Keywords

Cervical cancerPap tests utilizationScreening ratesMedically underserved

Copyright information

© US Government 2010

Authors and Affiliations

  • Florence K. L. Tangka
    • 1
  • Brett O’Hara
    • 4
  • James G. Gardner
    • 1
  • Joanna Turner
    • 5
  • Janet Royalty
    • 1
  • Kate Shaw
    • 2
  • Susan Sabatino
    • 1
  • Ingrid J. Hall
    • 1
  • Ralph J. Coates
    • 3
  1. 1.Division of Cancer Prevention and ControlCenters for Disease Control and Prevention, DCPCAtlantaUSA
  2. 2.Division for Heart Disease and Stroke PreventionCenters for Disease Control and PreventionAtlantaUSA
  3. 3.Office of Public Health GenomicsCenters for Disease Control and PreventionAtlantaUSA
  4. 4.Data Integration DivisionUS Census BureauWashingtonUSA
  5. 5.Housing and Household Economic Statistics DivisionUS Census BureauWashingtonUSA