Complete Health Indicator Report of Cervical Cancer Screening (Pap)
Definition
The proportion of women 18 years or older who reported having a Pap test in the last three years.Numerator
The proportion of women 18 years or older who reported having a Pap test in the last three years.Denominator
The total number of female survey respondents aged 18 or older excluding those who responded "don't know" or "refused" to the numerator question.Data Interpretation Issues
To reduce bias and more accurately represent population data, the BRFSS has changed survey methodology. In 2010, it began conducting surveys by cellular phone in addition to landline phones. It also adopted "iterative proportional fitting" (raking) as its weighting method.Why Is This Important?
Cervical cancer is one of the most curable cancers if detected early through routine screening. Almost all cases of cervical cancer are caused by infection with high-risk types of the human papillomavirus (HPV). The HPV vaccine protects against the HPV types that most often cause cervical cancer. Women who have had an HPV vaccine still need to have routine Pap smears because the vaccine does not fully protect against all the strains of the virus and other risk factors that can cause cervical cancer. HPV is transmitted through sexual contact. Any woman who is sexually active is at risk for developing cervical cancer. Other risk factors include giving birth to many children, having sexual relations at an early age, having multiple sex partners or partners with many other partners, cigarette smoking, and use of oral contraceptives. Cervical cancer screening should begin about three years after a woman begins having intercourse but no later than 21 years of age. Cervical screening should be performed every year with conventional Pap tests or every two years with liquid-based Pap tests. Beginning at age 30, women who have had three normal test results in a row may undergo screening every two to three years.Healthy People Objective C-15:
Increase the proportion of women who receive a cervical cancer screening based on the most recent guidelinesU.S. Target: 93.0 percent
State Target: 83.6 percent
How Are We Doing?
Between 1991 and 2012, the percentage of Utah women aged 18 or older who reported receiving a Pap test within the last three years decreased from 88.2 percent to 70.2 percent. The 2010 and 2012 average percentage was significantly lower among American Indian/Native Alaskan (55.6) women.How Do We Compare With the U.S.?
Nationally, the percentage of women aged 18 or older who reported receiving a Pap test in the past three years decreased from 87.7 percent in 1989 to 77.4 percent in 2012. Since 1994, the percentage of Utah women aged 18 or older who reported receiving a Pap has been below that seen for U.S. women.What Is Being Done?
The Utah Cancer Control Program (UCCP) provides free to low cost Pap tests and pelvic exams to women who meet age and income guidelines. Eligible women with abnormal screening exams are offered diagnostic evaluation by participating providers. In addition, the UCCP provides education about the need for early detection and the availability of screening services, collects outcomes data, and disseminates information about cervical cancer. In addition, the Utah Department of Health initiated the Utah Cancer Action Network (UCAN), a statewide partnership whose goal is to reduce the burden of cancer. The mission of the UCAN is to lower cancer incidence and mortality in Utah through collaborative efforts directed toward cancer prevention and control. As a result of this planning process, objectives and strategies have been developed by community partners regarding the early detection of cervical, testicular, prostate, skin, breast, and colorectal cancers as well as the promotion of physical activity, healthy eating habits, and smoking cessation.Available Services
The Utah Cancer Control Program (UCCP) provides free and low cost Pap tests and pelvic exams to women who meet age and income guidelines. Eligible women with abnormal screening exams are offered diagnostic evaluation by participating providers. As of July 1, 2001, the UCCP is able to refer Utah women in need of treatment for cervical cancers and precancerous lesions to Medicaid for full benefits. The women must meet all requirements as outlined in the National Breast and Cervical Cancer Treatment Act. In addition, the Utah Immunization Vaccines for Children (VFC) program provides low cost HPV vaccines to females ages 9 to 18 who meet income guidelines.Health Program Information
In 1976, the Utah Department of Health received a cervical cancer grant from the National Cancer Institute. In 1980, the Utah Department of Health began providing clinical breast exams and Pap tests on a sliding fee scale. In 1993, state funding was appropriated for mammography. That same year, the Utah Cancer Control Program (UCCP) first received a capacity building grant from the Centers for Disease Control and Prevention to conduct breast and cervical cancer screening in Utah. A comprehensive grant was awarded to the program in 1994 to continue breast and cervical cancer screening. Since 1994, the UCCP and partners, including local health departments, mammography facilities, pathology laboratories, and private providers, have worked together to ensure the appropriate and timely provision of clinical services. The UCCP continues to receive funding from the CDC for breast and cervical cancer screening. Additionally, the UCCP receives funding to implement comprehensive cancer control strategies that were identified by the Utah Cancer Action Network (UCAN) statewide partnership.Related Indicators
Relevant Population Characteristics
Any woman who is sexually active is at risk for developing cervical cancer. Other risk factors include having sexual relations at an early age, having multiple sex partners or partners with many other partners, and cigarette smoking.Related Relevant Population Characteristics Indicators:
Related Health Status Outcomes Indicators:
Graphical Data Views
Percentage of Women Age 18+ Who Reported Having Pap Test Within the Past Three Years, Utah and U.S., 1991-2000, 2002, 2004, 2006, 2008, 2010, and 2012
| BRFSS Utah vs. U.S. | Year | Age-adjusted Percentage of Women 18+ | Lower Limit | Upper Limit | ||
|---|---|---|---|---|---|---|
Record Count: 34 | ||||||
| UT Old Methodology | 1991 | 88.2% | 85.2% | 90.7% | ||
| UT Old Methodology | 1992 | 81.1% | 77.3% | 84.3% | ||
| UT Old Methodology | 1993 | 79.4% | 75.4% | 82.8% | ||
| UT Old Methodology | 1994 | 82.5% | 78.9% | 85.5% | ||
| UT Old Methodology | 1995 | 80.0% | 76.6% | 83.0% | ||
| UT Old Methodology | 1996 | 80.1% | 77.2% | 82.8% | ||
| UT Old Methodology | 1997 | 78.2% | 74.7% | 81.4% | ||
| UT Old Methodology | 1998 | 77.8% | 74.3% | 81.1% | ||
| UT Old Methodology | 1999 | 80.4% | 77.2% | 83.2% | ||
| UT Old Methodology | 2000 | 81.8% | 78.5% | 84.7% | ||
| UT Old Methodology | 2002 | 80.7% | 77.8% | 83.2% | ||
| UT Old Methodology | 2004 | 79.0% | 76.8% | 81.1% | ||
| UT Old Methodology | 2006 | 75.1% | 72.6% | 77.4% | ||
| UT Old Methodology | 2008 | 74.1% | 71.7% | 76.4% | ||
| UT Old Methodology | 2010 | 74.0% | 72.2% | 75.6% | ||
| US Old Methodology | 1991 | 88.6% | 88.1% | 89.1% | ||
| US Old Methodology | 1992 | 82.1% | 81.5% | 82.3% | ||
| US Old Methodology | 1993 | 83.0% | 82.4% | 83.5% | ||
| US Old Methodology | 1994 | 82.8% | 82.2% | 83.3% | ||
| US Old Methodology | 1995 | 82.8% | 82.2% | 83.4% | ||
| US Old Methodology | 1996 | 83.3% | 82.8% | 83.8% | ||
| US Old Methodology | 1997 | 83.6% | 83.2% | 84.2% | ||
| US Old Methodology | 1998 | 83.5% | 83.1% | 84.0% | ||
| US Old Methodology | 1999 | 84.6% | 84.1% | 85.0% | ||
| US Old Methodology | 2000 | 85.2% | 84.7% | 85.6% | ||
| US Old Methodology | 2002 | 85.6% | 85.2% | 86.0% | ||
| US Old Methodology | 2004 | 84.8% | 84.5% | 85.2% | ||
| US Old Methodology | 2006 | 83.5% | 83.1% | 83.9% | ||
| US Old Methodology | 2008 | 82.2% | 81.9% | 82.6% | ||
| US Old Methodology | 2010 | 80.6% | 80.2% | 80.9% | ||
| UT New Methodology | 2010 | 74.2% | 72.7% | 75.7% | ||
| UT New Methodology | 2012 | 70.2% | 68.7% | 71.6% | ||
| US New Methodology | 2010 | 83.0% | 82.0% | 84.0% | ||
| US New Methodology | 2012 | 77.4% | 77.0% | 77.8% | ||
Data Notes
Age-adjusted to the 2000 standard population. UT/US Old Methodology: Previous BRFSS methodology used "post-stratification" which was used to weight data by age, gender, and local health district (LHD). UT New Methodology: To reduce bias and more accurately represent population data, the BRFSS has changed survey methodology. It began conducting surveys by cellular phone in addition to landline phones. It also adopted "iterative proportional fitting" (raking) as its weighting method. With raking, education, race/ethnicity, marital status, home ownership/renter, and telephone source are included in the weighting procedure.Data Sources
- Utah Data: Behavioral Risk Factor Surveillance System, Office of Public Health Assessment, Utah Department of Health
- U.S. Data: Behavioral Risk Factor Surveillance System (BRFSS), Division of Behavioral Surveillance, CDC Office of Surveillance, Epidemiology, and Laboratory Services
Pap Test Within the Past Three Years by Local Health District, Utah, 2010 and 2012
| Local Health District | Age-adjusted Percentage of Women Aged 18+ | Lower Limit | Upper Limit | |||
|---|---|---|---|---|---|---|
Record Count: 13 | ||||||
| Bear River | 68.9% | 64.6% | 73.0% | |||
| Central | 65.9% | 60.3% | 71.1% | |||
| Davis County | 76.8% | 73.6% | 79.8% | |||
| Salt Lake County | 74.0% | 72.3% | 75.7% | |||
| Southeast (<2015) | 68.1% | 62.6% | 73.2% | |||
| Southwest | 70.9% | 65.9% | 75.4% | |||
| Summit | 77.3% | 70.1% | 83.1% | |||
| Tooele | 72.9% | 67.9% | 77.4% | |||
| TriCounty | 65.3% | 59.6% | 70.7% | |||
| Utah County | 68.8% | 66.0% | 71.5% | |||
| Wasatch | 70.2% | 62.4% | 76.9% | |||
| Weber-Morgan | 74.7% | 71.1% | 78.1% | |||
| State of Utah | 72.3% | 71.2% | 73.3% | |||
Data Notes
To reduce bias and more accurately represent population data, the BRFSS has changed survey methodology. It began conducting surveys by cellular phone in addition to landline phones. It also adopted "iterative proportional fitting" (raking) as its weighting method. The data used in creating this graph was calculated using the new weighting methodology. Age-adjusted to U.S. 2000 population.Data Source
Utah Data: Behavioral Risk Factor Surveillance System, Office of Public Health Assessment, Utah Department of HealthPap Test Within the Past Three Years by Utah Small Area, 2010 and 2012
| Utah Small Areas | Age-adjusted Percentage of Women Aged 18+ | Lower Limit | Upper Limit | Note | ||
|---|---|---|---|---|---|---|
Record Count: 67 | ||||||
| Brigham City | 60.3% | 48.2% | 71.2% | |||
| Box Elder Co (Other) | 78.6% | 66.6% | 87.2% | |||
| Logan | 70.9% | 64.3% | 76.8% | |||
| Cache Co (Oth)/Rich Co (All) | 66.4% | 59.2% | 72.9% | |||
| Ben Lomond | 70.4% | 62.7% | 77.0% | |||
| Morgan Co (All)/Weber Co (E) | 73.3% | 64.5% | 80.6% | |||
| Ogden (Downtown) | 74.8% | 65.1% | 82.6% | |||
| South Ogden | 73.5% | 63.2% | 81.7% | |||
| Roy/Hooper | 77.3% | 67.5% | 84.8% | |||
| Riverdale | 81.7% | 73.0% | 88.0% | |||
| Clearfield/Hill AFB | 77.6% | 70.4% | 83.5% | |||
| Layton | 75.9% | 68.3% | 82.1% | |||
| Syracuse/Kaysville | 75.3% | 67.9% | 81.4% | |||
| Farmington/Centerville | 75.8% | 62.8% | 85.4% | |||
| Woods Cross/North Salt Lake | 89.1% | 79.5% | 94.5% | * | ||
| Bountiful | 73.8% | 65.8% | 80.5% | |||
| SLC (Rose Park) | 66.3% | 56.4% | 74.9% | |||
| SLC (Avenues) | 83.6% | 74.9% | 89.8% | |||
| SLC (Foothill/U of U) | 79.0% | 69.6% | 86.1% | |||
| Magna | 70.6% | 59.3% | 79.8% | |||
| SLC (Glendale) | 76.1% | 67.2% | 86.2% | |||
| West Valley (West) | 76.1% | 69.3% | 81.7% | |||
| West Valley (East) | 77.1% | 69.3% | 83.4% | # | ||
| West Valley (East) V2 | 79.2% | 63.3% | 89.4% | * ## | ||
| SLC (Downtown) | 68.9% | 59.7% | 76.8% | |||
| South Salt Lake | 67.7% | 54.5% | 78.6% | |||
| Millcreek | 76.2% | 70.5% | 81.2% | |||
| Holladay | 70.9% | 62.8% | 77.9% | |||
| Cottonwood | 67.3% | 58.3% | 75.2% | |||
| Kearns | 78.6% | 66.7% | 87.1% | # | ||
| Kearns V2 | 73.6% | 60.5% | 83.5% | ## | ||
| Taylorsville (E)/Murray (W) | 75.1% | 65.7% | 82.7% | |||
| Taylorsville (West) | 62.8% | 51.3% | 73.0% | ## | ||
| Murray | 68.9% | 60.7% | 76.0% | |||
| Midvale | 70.5% | 59.6% | 79.5% | |||
| West Jordan (NE) | 78.8% | 69.1% | 86.0% | # | ||
| West Jordan (NE) V2 | 75.2% | 62.0% | 85.0% | * ## | ||
| West Jordan (SE) | 83.7% | 72.9% | 90.8% | |||
| West Jordan (W)/Copperton | 83.7% | 72.4% | 90.9% | |||
| South Jordan | 74.7% | 68.0% | 80.5% | |||
| Sandy (Center) | 69.7% | 62.4% | 76.1% | |||
| Sandy (NE) | 78.2% | 67.9% | 85.9% | |||
| Sandy (SE) | 83.7% | 72.9% | 90.8% | |||
| Riverton/Draper | 75.8% | 69.8% | 81.0% | |||
| Tooele Co | 73.0% | 68.0% | 77.5% | |||
| Lehi/Cedar Valley | 70.2% | 60.8% | 78.2% | |||
| American Fork/Alpine | 69.0% | 61.8% | 75.3% | |||
| Pleasant Grove/Lindon | 75.5% | 66.9% | 82.5% | |||
| Orem (North) | 69.7% | 57.4% | 79.7% | |||
| Orem (West) | 76.7% | 64.9% | 85.5% | * | ||
| Orem (East) | 61.8% | 50.0% | 72.4% | |||
| Provo (North)/BYU | 65.4% | 56.4% | 73.3% | |||
| Provo (South) | 67.3% | 58.5% | 75.1% | |||
| Springville/Spanish Fork | 71.4% | 64.6% | 77.3% | |||
| Utah Co (South) | 68.3% | 59.4% | 76.1% | |||
| Summit Co | 76.3% | 68.8% | 82.4% | |||
| Wasatch Co | 65.2% | 57.2% | 72.4% | |||
| TriCounty LHD | 65.9% | 60.3% | 71.1% | |||
| Juab/Millard/Sanpete Co | 67.0% | 60.3% | 73.0% | |||
| Sevier/Piute/Wayne Co | 65.4% | 51.0% | 77.4% | |||
| Carbon/Emery Co | 71.5% | 65.2% | 77.0% | |||
| Grand/San Juan Co | 62.6% | 52.1% | 72.0% | |||
| St George | 72.6% | 65.7% | 78.6% | |||
| Washington Co (Other) | 74.7% | 67.3% | 81.0% | |||
| Cedar City | 60.7% | 47.7% | 72.4% | |||
| Southwest LHD (Other) | 75.2% | 60.7% | 85.6% | |||
| State | 72.3% | 71.2% | 73.3% | |||
Data Notes
To reduce bias and more accurately represent population data, the BRFSS has changed survey methodology. It began conducting surveys by cellular phone in addition to landline phones. It also adopted "iterative proportional fitting" (raking) as its weighting method. The data used in creating this graph was calculated using the new weighting methodology. Age-adjusted to U.S. 2000 standard population. #Due to Utah Small Area reclassification, these numbers only include data for 2010. ##Due to Utah Small Area reclassification, these numbers only include data for 2012. A description of the Utah Small Areas may be found on IBIS at the following URL: http://ibis.health.utah.gov/query/Help.html. *Use caution in interpreting, the estimate has a coefficient of variation >30% and is therefore deemed unreliable by Utah Department of Health standards.Data Source
Utah Data: Behavioral Risk Factor Surveillance System, Office of Public Health Assessment, Utah Department of HealthPercentage of Women Age 18+ Who Reported Having Had a Pap Smear in the Past Three Years by Ethnicity, Utah, 2010 and 2012
| Hispanic Ethnicity | Age-adjusted Percentage of Women 18+ | Lower Limit | Upper Limit | |||
|---|---|---|---|---|---|---|
Record Count: 3 | ||||||
| Hispanic | 76.6% | 72.8% | 79.9% | |||
| Non-Hispanic | 71.8% | 70.7% | 72.9% | |||
| All Utahns | 72.3% | 71.2% | 73.3% | |||
Data Notes
To reduce bias and more accurately represent population data, the BRFSS has changed survey methodology. It began conducting surveys by cellular phone in addition to landline phones. It also adopted "iterative proportional fitting" (raking) as its weighting method. The data used in creating this graph was calculated using the new weighting methodology. Age-adjusted to the U.S. 2000 standard population.Data Source
Utah Data: Behavioral Risk Factor Surveillance System, Office of Public Health Assessment, Utah Department of HealthPercentage of Women Age 18+ Who Reported Having Had a Pap Smear in the Past Three Years by Race, Utah, 2010 and 2012
| Race | Age-adjusted Percentage of Women Age 18+ | Lower Limit | Upper Limit | |||
|---|---|---|---|---|---|---|
Record Count: 6 | ||||||
| American Indian/Native Alaskan | 55.6% | 40.1% | 70.0% | |||
| Asian | 74.7% | 65.8% | 81.9% | |||
| Black | 74.5% | 57.3% | 86.4% | |||
| Pacific Islander | 60.2% | 40.8% | 76.8% | |||
| White | 73.3% | 72.1% | 74.5% | |||
| All Races | 73.3% | 72.2% | 74.4% | |||
Data Notes
To reduce bias and more accurately represent population data, the BRFSS has changed survey methodology. It began conducting surveys by cellular phone in addition to landline phones. It also adopted "iterative proportional fitting" (raking) as its weighting method. The data used in creating this graph was calculated using the new weighting methodology. Age-adjusted to the U.S. 2000 standard population based on 3 age groups: 18-34, 35-49, and 50+.Data Source
Utah Data: Behavioral Risk Factor Surveillance System, Office of Public Health Assessment, Utah Department of HealthPercentage of Women Age 25+ Who Reported Having Pap Test Within the Past Three Years by Education, Utah, 2010 and 2012
| Education Level | Age-adjusted Percentage of Women 25+ | Lower Limit | Upper Limit | |||
|---|---|---|---|---|---|---|
Record Count: 4 | ||||||
| Less Than High School | 69.5% | 64.5% | 74.1% | |||
| H.S. Grad or G.E.D. | 74.4% | 72.2% | 76.6% | |||
| Some Post High School | 76.0% | 74.3% | 77.7% | |||
| College Graduate | 80.1% | 78.4% | 81.7% | |||
Data Notes
To reduce bias and more accurately represent population data, the BRFSS has changed survey methodology. It began conducting surveys by cellular phone in addition to landline phones. It also adopted "iterative proportional fitting" (raking) as its weighting method. The data used in creating this graph was calculated using the new weighting methodology. Age-adjusted to the 2000 standard population.Data Source
Utah Data: Behavioral Risk Factor Surveillance System, Office of Public Health Assessment, Utah Department of HealthPercentage of Women Age 18+ Who Reported Having Pap Test Within the Past Three Years by Income, Utah, 2010 and 2012
| Income Category | Age-adjusted Percentage of Women 18+ | Lower Limit | Upper Limit | |||
|---|---|---|---|---|---|---|
Record Count: 5 | ||||||
| <$25,000 | 65.9% | 63.2% | 68.4% | |||
| $25,000-$49,999 | 72.2% | 69.8% | 74.4% | |||
| $50,000-$74,999 | 75.4% | 72.4% | 78.1% | |||
| $75,000+ | 77.7% | 75.3% | 80.0% | |||
| Total | 72.3% | 71.2% | 73.3% | |||
Data Notes
To reduce bias and more accurately represent population data, the BRFSS has changed survey methodology. It began conducting surveys by cellular phone in addition to landline phones. It also adopted "iterative proportional fitting" (raking) as its weighting method. The data used in creating this graph was calculated using the new weighting methodology. Age-adjusted to the 2000 standard population.Data Source
Utah Data: Behavioral Risk Factor Surveillance System, Office of Public Health Assessment, Utah Department of HealthPercentage of Women Age 18+ Who Reported Having Pap Test Within the Past Three Years by Age, Utah, 2010 and 2012
| Age Group | Percentage of Women Aged 18+ | Lower Limit | Upper Limit | Note | ||
|---|---|---|---|---|---|---|
Record Count: 4 | ||||||
| 18-34 | 67.7% | 65.3% | 69.9% | |||
| 35-49 | 82.9% | 81.1% | 84.5% | |||
| 50-64 | 78.2% | 76.0% | 80.2% | |||
| 65+ | 54.3% | 51.2% | 57.4% | ^ | ||
Data Notes
To reduce bias and more accurately represent population data, the BRFSS has changed survey methodology. It began conducting surveys by cellular phone in addition to landline phones. It also adopted "iterative proportional fitting" (raking) as its weighting method. The data used in creating this graph was calculated using the new weighting methodology. ^The USPSTF recommends against screening for cervical cancer in women older than 65 years who have had adequate prior screening and are not otherwise high risk for cervical cancer.Data Source
Utah Data: Behavioral Risk Factor Surveillance System, Office of Public Health Assessment, Utah Department of HealthReferences and Community Resources
Utah Cancer Control Program @ www.cancerutah.org Utah Cancer Action Network @ www.ucan.cc National Cancer Institute @ www.cancer.gov American Cancer Society @ www.cancer.org Huntsman Cancer Institute @ www.huntsmancancer.org Centers for Disease Control and Prevention @ www.cdc.gov American Society of Clinical Oncology @ www.asco.orgMore Resources and Links
Evidence-based community health improvement ideas and interventions may be found at the following sites:Additional indicator data by state and county may be found on these Websites:
- CDC Prevention Status Reports for all 50 states
- County Health Rankings
- Kaiser Family Foundation's StateHealthFacts.org
- CDC WONDER DATA2010, the Healthy People 2010 Database.
Medical literature can be queried at the PubMed website.
Page Content Updated On 08/07/2014,
Published on 08/08/2014
