• Article

Trends in cervical cancer screening in Title X-funded health centers — United States, 2005–2015

What is already known about this topic?

Cervical cancer screening is critical to early detection and treatment of precancerous cells and cervical cancer. During 2005-2012, screening guidelines were updated to recommend less frequent screening. In 2015, 83% of women reported being screened according to recommendations. Since 1970, Title X-funded health centers have been a source of cervical cancer screening for primarily socioeconomically disadvantaged women seeking contraceptive and related preventive health care.

What is added by this report?

The percentage of female Title X clients screened annually for cervical cancer declined from 51% in 2005 to 21% in 2015 with the largest single-year declines occurring in the years after major recommendation updates (2010 and 2013). Provision of other recommended preventive health services (chlamydia testing and contraception), especially to young females under the recommended starting age (21 years) for cervical cancer screening, increased.

What are the implications for public health practice?

The downward trend in Title X cervical cancer screening each year is consistent with current evidence-based recommendations. Aggregate administrative data are useful to describe overall trends in the percentage of Title X clients that received a Pap test. Analyses of client-level and encounter-level records are needed, however, to assess providers' adherence to screening recommendations and variations in screening practices.


Fowler, C. I., Saraiya, M., Moskosky, S. B., Miller, J. W., Gable, J., & Mautone-Smith, N. (2017). Trends in cervical cancer screening in Title X-funded health centers — United States, 2005–2015. Morbidity and Mortality Weekly Report (MMWR), 66(37), 981-985. https://doi.org/10.15585/mmwr.mm6637a4

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