As many as 8 million adult women who should be screened for cervical cancer haven’t had that checkup in the past five years, and they’re missing a chance to prevent or treat the disease before it could kill them, federal health officials said Wednesday.
More than half of women diagnosed with cervical cancer cases had never or rarely been screened, the Centers for Disease Control and Prevention said. A Pap smear or a test for the human papillomavirus (HPV) that causes cervical cancer can catch it early, while it’s still curable, or even prevent cancer.
More than 12,000 American women will be diagnosed with cervical cancer this year, and more than 4,000 will die of it.
“Every visit to a provider can be an opportunity to prevent cervical cancer by making sure women are referred for screening appropriately,” said the CDC’s deputy director, Ileana Arias. “We must increase our efforts to make sure that all women understand the importance of getting screened for cervical cancer. No woman should die from cervical cancer.”
CDC experts reviewed national surveys to find that in 2012, 11.4 percent of women reported they had not been screened for cervical cancer in the past five years. Health insurance seemed to be a big factor: More than 23 percent of women without health insurance and 25 percent of those without a regular doctor or other health care provider said they hadn’t had a screening.
The 2010 Affordable Care Act requires that health insurers provide all cancer screenings for free, with no charge to the patient.
Rates were also higher among minorities. And women living in the South were the most likely to have cervical cancer, with a rate of 8.5 cases per 100,000 women, and a death rate of 2.7 per 100,000. "The South, unfortunately, has the highest cervical cancer burden," Arias told reporters in a telephone briefing.
A lack of transportation may be a factor. So may be mistrust of the health care system.
"We need to close these gaps," Aria said.
A Pap smear looks for abnormal cells that could be cancerous or in the early stages of becoming cancer. They can be removed before that happens.
And vaccinating against the HPV virus that causes most cancers can prevent even the pre-cancerous changes.
The HPV vaccine, recommended for all young women and men, is still underused, the CDC has found. Only one in three girls and one in seven boys have finished the three-dose series that can protect against not only cervical cancer, but cancers of the penis, anus, mouth and throat.
It’s not just a problem of the poor, says Dr. David Fishman, an expert on women’s cancers at Mount Sinai Hospital in New York. “Women who should be having Pap smears are not getting plugged in, and this is a significant problem in our country,” Fishman said.
“The Pap smear, in my opinion, is the most powerful tool in the history of medicine to detect precancerous change such that no woman should ever die from cervical cancer.”
The United States Preventive Services Task Force (USPSTF) and the American Cancer Society do not recommend routine yearly testing. Instead, both recommend that women aged 21 to 65 get a Pap smear or a test for HPV or both every three to five years, depending on circumstances. Women over 65 who have had three “clear” screens in a row are told they don’t need the test any more.
But some experts note that may be too early. A study done earlier this year suggested that women over 65 may have a higher risk of cervical cancer than statistics may suggest.
NBC's Stacey Naggiar and Erika Edwards contributed to this story.