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Title: Federal Support for Family Planning Clinics Associated with Dramatic Gains in Cervical Cancer Screening

Citation Type: Journal Article

Publication Year: 2016

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Abstract: Increasing cervical cancer screening has long been a social priority (Department of Health and Human Services, 2014 and Gardner, 2006). Since the 1990s, policymakers have used a variety of federal and state public policy approaches to encourage use of the Pap smear, the cervical cancer screening test. These approaches include a federal program to reimburse health care providers directly for the cost of providing Pap smears to low-income women (Centers for Disease Control and Prevention, 2014 and Bitler and Carpenter, 2014), state laws that mandate that insurers cover Pap smears (Bitler & Carpenter, 2012), and the addition of family planning servicesincluding Pap smearsto Medicaid coverage (Adams et al., 2013 and Wherry, 2013). These efforts successfully increased Pap smear use among key groups of women with low screening rates, such as the uninsured or low-income women (Adams et al., 2013, Bitler and Carpenter, 2012, Bitler and Carpenter, 2014 and Wherry, 2013). However, the scope of these public policy efforts was limited because they were implemented during a period when most women of reproductive age already received regular Pap smears (National Center for Health Statistics, 2009). Figure 1 traces the growth in Pap smear use among women aged 15 to 45 from 1959, the first year data were collected, to the present day. Between 1988 and 2010, the fraction of reproductive-age women who had a Pap smear every 3 years, as recommended by guidelines at the time (Waxman, 2005), remained between 85% and 90%. Similarly, the fraction of reproductive-age women who had ever had a Pap smear in their lifetime exceeded 90% throughout the 1990s and 2000s. In contrast, both regular and lifetime Pap smear use grew dramatically between 1959, when fewer than one-fifth of all reproductive-age women had a Pap smear in the last year, and the mid-1970s. Between 1965 and 1976, the fraction of women receiving a Pap smear in the last year, as recommended by guidelines at the time (Waxman, 2005), increased from 42% to 70%. Lifetime use of the Pap smear also increased from 70% in 1970, the first year this information was collected, to 95% in 1976.

Url: http://www.sciencedirect.com/science/article/pii/S1049386715001899

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Authors: Nikpay, Sayeh S

Periodical (Full): Women's Health Issues

Issue: 2

Volume: 26

Pages: 176-181

Data Collections: IPUMS USA

Topics: Gender, Health, Other

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