Journal of the American Board of Family Medicine : JABFM · 2026
Characterizing Cervical Cancer Screening in the US: Preparing for the Era of Self-Collection.
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Soltani Lisa F, Addis Ilana, Lin Paul, Kamdar Neil, O'Dwyer Marie Claire, Young Alisa P, Harper Diane M
Аннотация
BACKGROUND: Cervical cancer screening (CCS) is shifting from in-office to self-screening. The primary aim of this study is to define a baseline distribution of in-office CCS providers by specialty and the race/ethnicity and age of those screened.
METHODS: We extracted electronic health record data (Truveta-multiple health systems in 34 states) of individuals eligible for CCS aged 21 to 65, documented between January 1, 2017-December 31, 2022. Those with a hysterectomy before 2017, had any gynecological cancer at any time, or had evidence of CCS after the hysterectomy, except if there was a history of cervical intraepithelial neoplasia grade 2 or 3 (CIN 2/3) disease were excluded. We reported the total number of CCS and colposcopies per eligible patient and the specialty of the performing clinician (medical taxonomy).
RESULTS: Among the 2,439,331 individuals included in the study, the average age was 42.9 (SD 11.7). There were 3,412,148 CCSs linked with 1 of 3 provider specialties: obstetrics & gynecology (OG), family medicine (FM), and general internal medicine (GIM). OG provided less than half of all CCS, dropping to 31.6% of those 50 to 65. While only 70.5% (1,718,914) of the population received at least 1 CCS during the study, the mean CCS per patient was 2.6 (SD 2.7). The rate of colposcopy after a CCS was 3.9%.
CONCLUSIONS AND RELEVANCE: Family and Internal Medicine clinicians provide the majority of CCS in the US (61.9%), particularly for people aged 50 to 65 (68.4%), when cervical cancer risk is the highest.
METHODS: We extracted electronic health record data (Truveta-multiple health systems in 34 states) of individuals eligible for CCS aged 21 to 65, documented between January 1, 2017-December 31, 2022. Those with a hysterectomy before 2017, had any gynecological cancer at any time, or had evidence of CCS after the hysterectomy, except if there was a history of cervical intraepithelial neoplasia grade 2 or 3 (CIN 2/3) disease were excluded. We reported the total number of CCS and colposcopies per eligible patient and the specialty of the performing clinician (medical taxonomy).
RESULTS: Among the 2,439,331 individuals included in the study, the average age was 42.9 (SD 11.7). There were 3,412,148 CCSs linked with 1 of 3 provider specialties: obstetrics & gynecology (OG), family medicine (FM), and general internal medicine (GIM). OG provided less than half of all CCS, dropping to 31.6% of those 50 to 65. While only 70.5% (1,718,914) of the population received at least 1 CCS during the study, the mean CCS per patient was 2.6 (SD 2.7). The rate of colposcopy after a CCS was 3.9%.
CONCLUSIONS AND RELEVANCE: Family and Internal Medicine clinicians provide the majority of CCS in the US (61.9%), particularly for people aged 50 to 65 (68.4%), when cervical cancer risk is the highest.