The frequency of Pap smear screening in the United States.
BACKGROUND
U.S. professional medical societies and the national health systems of all other industrialized nations recommend that most women need not undergo Papanicolaou (Pap) smear screening annually. There are no data, however, regarding the frequency at which women actually undergo screening.


OBJECTIVE
To describe the frequency of cervical cancer screening in the United States.


METHODS
National Health Interview Survey, a cross-sectional population-based telephone survey conducted by the National Center for Health Statistics.


METHODS
Representative sample of U.S. women age 21 and older who denied a history of cancer (N = 16,467).


METHODS
Pap smear screening frequency, categorized as no regular screening or screening at 1 of 3 discrete screening intervals (every year, every 2 years, or every 3 years) based on each woman's reported number of Pap smears in the previous 6 years.


RESULTS
The vast majority (93%) of American women report having had at least one Pap smear in their lifetime. Among women with no history of abnormal smears, 55% undergo Pap smear screening annually, 17% report a 2-year screening interval, 16% report being screened every 3 years, and 11% are not being screened regularly. Even the very elderly report frequent screening-38% of women age 75 to 84 and 20% of women age 85 and older reported annual Pap smears. Overall, 20% of women reported having had at least one abnormal Pap smear. Among these women, rates of frequent Pap smear screening are considerably higher-80% undergo annual screening, with only a modest decline in screening frequency with increasing age.


CONCLUSIONS
The majority of American women report being screened for cervical cancer more frequently than recommended. Lengthening the screening interval would not only reduce the volume of specimens that cytotechnologists are required to read, but would also reduce the follow-up testing after abnormal smears.
Sirovich
Brenda E
BE
VA Outcomes Group (111B), Department of Veterans Affairs Medical Center, White River Junction, VT 50009, USA. brenda.sirovich@dartmouth.edu
Welch
H Gilbert
HG
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D008403:Mass Screening / Q000379:methods / Q000706:statistics & numerical data*; D008875:Middle Aged; D065006:Papanicolaou Test; D013689:Telephone; D014481:United States / Q000453:epidemiology; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis / Q000517:prevention & control; D014626:Vaginal Smears / Q000706:statistics & numerical data*