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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. More details about these changes can be found at: [https://ibis.health.utah.gov/pdf/opha/resource/brfss/RakingImpact2011.pdf].

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 of 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. The U.S. Preventive Services Task Force recommends cervical cancer screening (Pap smear) every 3 years for women 21 to 65 years old. For women 30 to 65 years old, Pap smears may be conducted every 5 years in conjunction with human papillomavirus (HPV) testing.

How Are We Doing?

Cervical cancer screening rates have continually fallen since 2010 at both the state and national level. Between 2012 and 2020, the percentage of Utah women aged 18 or older who reported receiving a Pap test within the last three years decreased from 70.7% to 62.9% (age-adjusted rates), compared to a national rate of 68.8%. Cervical cancer screening rates in Utah vary by geography, ethnicity, race, socio-economic status, and age. For combined years 2019 and 2020, Central Utah (54.8%), Southwest (55.0%), and Utah County (56.8%) local health districts reported statistically significantly lower cervical cancer screening rates when compared to the state rate (60.9%). Salt Lake County (63.6%) reported a statistically significantly higher rate. See additional data views for screening rates by Utah Small Areas. In 2020, women who identified as Hispanic reported receiving a screening for cervical cancer within the past 3 years at a higher rate (65.3%) than women who identified as non-Hispanic (62.4%), although this was not significantly different. Those who identified racially as Pacific Islander reported the lowest rates (44.9%), while those who identified as Asian (69.8%) and American Indian/Native Alaskan (69.1%) reported the highest rates in 2019-2020. However, none of these were statistically significantly different than the overall state rate. In 2020, and when looking at the highest level of education completed, college graduates (69.7%) and those with some post high school education (68.5%) were more likely to have received a Pap test than those with a high school diploma (63.9%) or those with no high school degree (59.7%). Women in households with annual incomes less than $25,000 (51.6%) were significantly less likely to have had a Pap test in 2020 than women in households with higher incomes (total 67.6%). Women age 18-34 years old (56.1%) were significantly less likely to have had a Pap test in 2020 than women age 50-64 (69.4%) and women age 35-49 (78.5%). The U.S. Preventive Services Task Force does not recommend 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.

How Do We Compare With the U.S.?

Cervical cancer screening rates have continually fallen since 2010 at both the state and national level. Screening rates in Utah have also consistently been lower than national rates. Nationally, the percentage of women aged 18 or older who reported receiving a Pap test in the past three years decreased from 80.7% in 2010 to 68.8% in 2020. In Utah, the percentage of women who received a pap test decreased from 74.3% in 2010 to 62.9% in 2020. The latest state rates from 2020 indicate that only 62.9% have received a cervical cancer screening test within the past 3 years.

What Is Being Done?

The Utah Breast & Cervical Cancer Program (Utah B&C) partners with local health departments, community clinics, hospitals and healthcare professionals to help those with low incomes who do not have adequate insurance gain access to timely breast and cervical cancer screening, diagnostic and treatment services. Eligible women can apply to Utah B&C by calling 800-717-1811 or by submitting an online enrollment form available at: [https://cancerutah.org/do-i-qualify/]. 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. Visit [https://immunize.utah.gov/vaccines-for-children-program/] for more information.

Available Services

The Utah Breast & Cervical Cancer Program (Utah B&C) partners with local health departments, community clinics, hospitals and healthcare professionals to help those with low incomes who do not have adequate insurance gain access to timely breast and cervical cancer screening, diagnostic and treatment services. Eligible women can apply to Utah B&C by calling 800-717-1811 or by submitting an online enrollment form available at: [https://cancerutah.org/do-i-qualify/]. 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. Visit [https://immunize.utah.gov/vaccines-for-children-program/] for more information.

Health Program Information

The 2000 Utah Legislature approved a resolution encouraging private health insurance companies and employers to include insurance coverage for the screening and detection of cervical cancer. As of July 2001, the Utah Breast and Cervical Cancer Program is able to refer Utah women in need of treatment for cervical cancers for full Medicaid benefits. The women must meet all requirements as outlined in the National Breast and Cervical Cancer Treatment Act.


Related Indicators

Relevant Population Characteristics

Economically disadvantaged persons are significantly less likely to get a Pap test. Women are also more likely to receive screening tests as their level of education increases.

Related Relevant Population Characteristics Indicators:


Health Care System Factors

As part of the Affordable Care Act, women can receive free preventive services such as Pap smears.

Related Health Care System Factors Indicators:


Risk Factors

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 a partner with many other partners, having a weakened immune system, not getting the HPV vaccine, and cigarette smoking.

Related Risk Factors Indicators:


Health Status Outcomes

Cervical cancer is one of the most preventable types of cancer with the use of the HPV vaccine. It is also highly treatable when caught early through screening tests.

Related Health Status Outcomes Indicators:




Graphical Data Views

Pap Test Within the Past Three Years, Utah and U.S., 1999-2020

::chart - missing::
confidence limits

BRFSS Utah vs. U.S.YearAge-adjusted Percentage of Women 18+Lower LimitUpper Limit
Record Count: 41
UT Old Methodology199188.2%85.2%90.7%
UT Old Methodology199281.1%77.3%84.3%
UT Old Methodology199379.4%75.4%82.8%
UT Old Methodology199482.5%78.9%85.5%
UT Old Methodology199580.0%76.6%83.0%
UT Old Methodology199680.1%77.2%82.8%
UT Old Methodology199778.2%74.7%81.4%
UT Old Methodology199877.8%74.3%81.1%
UT Old Methodology199980.4%77.2%83.2%
UT Old Methodology200081.8%78.5%84.7%
UT Old Methodology200280.7%77.8%83.2%
UT Old Methodology200479.0%76.8%81.1%
UT Old Methodology200675.1%72.6%77.4%
UT Old Methodology200874.1%71.7%76.4%
UT Old Methodology201074.3%72.5%75.9%
US Old Methodology199188.6%88.1%89.1%
US Old Methodology199282.1%81.5%82.3%
US Old Methodology199383.0%82.4%83.5%
US Old Methodology199482.8%82.2%83.3%
US Old Methodology199582.8%82.2%83.4%
US Old Methodology199683.3%82.8%83.8%
US Old Methodology199783.6%83.2%84.2%
US Old Methodology199883.5%83.1%84.0%
US Old Methodology199984.6%84.1%85.0%
US Old Methodology200085.2%84.7%85.6%
US Old Methodology200285.6%85.2%86.0%
US Old Methodology200484.8%84.5%85.2%
US Old Methodology200683.5%83.1%83.9%
US Old Methodology200882.2%81.9%82.6%
US Old Methodology201080.7%80.3%81.0%
UT New Methodology201270.7%69.2%72.2%
UT New Methodology201470.0%68.6%71.4%
UT New Methodology201666.7%64.9%68.5%
UT New Methodology201863.4%61.6%65.2%
UT New Methodology201959.1%56.9%61.2%
UT New Methodology202062.9%61.0%64.6%
US New Methodology201277.7%77.3%78.0%
US New Methodology201475.1%74.7%75.5%
US New Methodology201672.1%71.7%72.5%
US New Methodology201871.7%71.2%72.2%
US New Methodology202068.8%68.3%69.4%

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/US 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

  • Behavioral Risk Factor Surveillance System Survey Data, US Department of Health and Human Services Centers for Disease Control and Prevention (CDC).
  • Utah Department of Health and Human Services Behavioral Risk Factor Surveillance System (BRFSS) [https://ibis.health.utah.gov/ibisph-view/query/selection/brfss/BRFSSSelection.html]


Pap Test Within the Past Three Years by Local Health District, Utah, 2019 and 2020

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confidence limits

Local Health DistrictAge-adjusted Percentage of Women Aged 18+Lower LimitUpper Limit
Record Count: 14
Bear River60.7%55.4%65.8%
Central54.8%48.7%60.8%
Davis County64.1%59.5%68.4%
Salt Lake County63.6%61.2%66.0%
San Juan50.6%38.2%63.0%
Southeast55.5%46.8%63.9%
Southwest55.0%49.9%60.0%
Summit68.8%57.1%78.6%
Tooele60.4%52.4%67.8%
TriCounty59.6%51.6%67.2%
Utah County56.8%53.6%59.8%
Wasatch57.4%47.7%66.6%
Weber-Morgan63.9%59.4%68.1%
State of Utah60.9%59.5%62.3%

Data Notes

Age-adjusted to U.S. 2000 population.

Data Source

Utah Department of Health and Human Services Behavioral Risk Factor Surveillance System (BRFSS) [https://ibis.health.utah.gov/ibisph-view/query/selection/brfss/BRFSSSelection.html]


Pap Test Within the Past Three Years by Utah Small Area, 2019 and 2020

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confidence limits

Utah Small AreasAge-adjusted Percentage of Women Aged 18+Lower LimitUpper LimitNote
Record Count: 100
Brigham City42.7%28.9%57.7%
Box Elder Co (Other) V256.4%41.6%70.1%
Tremonton****
Logan V259.6%49.8%68.6%
North Logan61.3%44.9%75.4%
Cache (Other)/Rich (All) V271.2%60.0%80.2%
Hyrum56.9%41.4%71.2%*
Smithfield67.1%49.2%81.1%*
Ben Lomond65.1%57.2%72.3%
Weber County (East)53.5%41.8%64.7%
Morgan County63.0%46.6%76.8%*
Ogden (Downtown)65.7%54.5%75.3%
South Ogden64.0%51.4%74.9%
Roy/Hooper63.7%51.7%74.2%
Riverdale65.7%50.2%78.4%
Clearfield Area/Hooper66.5%54.3%76.8%
Layton/South Weber64.2%55.6%71.9%
Kaysville/Fruit Heights68.5%53.8%80.2%
Syracuse58.8%46.9%69.6%
Centerville50.8%35.1%66.4%
Farmington52.8%33.2%71.6%
North Salt Lake76.5%56.1%89.2%*
Woods Cross/West Bountiful61.8%45.9%75.5%*
Bountiful59.5%48.3%69.8%
SLC (Rose Park)67.9%52.4%80.3%
SLC (Avenues)81.0%67.9%89.6%*
SLC (Foothill/East Bench)73.8%59.3%84.5%
Magna54.3%39.1%68.8%
SLC (Glendale) V245.6%27.9%64.5%
West Valley (Center)57.5%44.5%69.5%
West Valley (West) V272.0%59.0%82.0%*
West Valley (East) V271.3%61.1%79.7%
SLC (Downtown) V263.1%51.2%73.5%
SLC (Southeast Liberty)67.0%50.6%80.1%
South Salt Lake56.8%39.8%72.3%
SLC (Sugar House)71.2%59.7%80.5%
Millcreek (South)72.5%60.2%82.1%
Millcreek (East)75.3%61.1%85.5%*
Holladay V262.9%45.2%77.7%
Cottonwood70.4%57.2%80.9%
Kearns V259.4%49.1%68.9%
Taylorsville (E)/Murray (W)46.3%36.0%56.9%
Taylorsville (West)78.9%70.0%85.8%
Murray63.9%51.6%74.6%
Midvale75.3%68.7%81.0%
West Jordan (Northeast) V246.2%32.8%60.1%
West Jordan (Southeast)64.9%49.4%77.9%
West Jordan (W)/Copperton62.3%47.3%75.2%
South Jordan V274.5%64.9%82.2%
Daybreak58.0%46.7%68.4%
Sandy (West)61.0%42.2%77.1%
Sandy (Center) V257.0%40.3%72.3%
Sandy (Northeast)67.5%54.6%78.1%*
Sandy (Southeast)74.2%61.8%83.6%
Draper53.4%40.8%65.6%
Riverton/Bluffdale67.6%57.5%76.2%
Herriman60.3%47.8%71.6%
Tooele County (Other)61.4%45.6%75.1%
Tooele Valley62.7%53.9%70.7%
Eagle Mountain/Cedar Valley40.8%27.3%55.8%
Lehi52.5%41.8%63.0%
Saratoga Springs70.8%58.6%80.5%*
American Fork65.8%57.0%73.6%
Alpine****
Pleasant Grove/Lindon52.1%41.7%62.3%
Orem (North)73.0%64.6%80.1%
Orem (West)64.0%52.3%74.3%
Orem (East)55.7%40.0%70.4%
Provo/BYU53.9%42.2%65.2%
Provo (West City Center)55.9%40.6%70.1%
Provo (East City Center)56.3%40.1%71.3%
Salem City58.2%39.4%74.9%*
Spanish Fork47.9%38.1%57.8%
Springville47.0%34.2%60.2%
Mapleton68.5%53.8%80.3%*
Utah County (South) V252.7%35.6%69.2%
Payson56.3%42.1%69.5%
Park City68.9%54.6%80.3%
Summit County (East)75.3%64.4%83.7%*
Wasatch County57.4%47.7%66.6%
Daggett and Uintah County59.2%49.2%68.4%
Duchesne County61.0%49.4%71.5%
Nephi/Mona72.1%50.7%86.6%*
Delta/Fillmore51.5%38.6%64.2%
Sanpete Valley54.0%45.3%62.4%
Central (Other)53.0%43.6%62.1%
Richfield/Monroe/Salina51.0%39.6%62.2%
Carbon County56.3%45.2%66.8%
Emery County47.2%32.3%62.6%
Grand County56.5%38.0%73.3%
Blanding/Monticello50.8%38.9%62.6%
San Juan County (Other)41.7%28.2%56.6%
St. George57.2%49.1%65.0%
Washington Co (Other) V253.8%38.7%68.3%*
Washington City63.8%50.5%75.3%
Hurricane/La Verkin42.2%26.0%60.2%
Ivins/Santa Clara72.8%57.4%84.1%*
Cedar City50.2%37.0%63.5%
Southwest LHD (Other)40.4%27.6%54.6%
State of Utah60.9%59.5%62.3%

Data Notes

Age-adjusted to U.S. 2000 standard population. *Use caution in interpreting; the estimate has a coefficient of variation >30% and is therefore deemed unreliable by Utah Department of Health and Human Services standards. **The estimate has been suppressed because 1) the relative standard error is greater than 50% or 2) the observed number of events is very small and not appropriate for publication. Maps, methods, and changes to Utah Small Areas may be found on IBIS at the following URL: [https://ibis.health.utah.gov/resource/Guidelines.html].

Data Source

Utah Department of Health and Human Services Behavioral Risk Factor Surveillance System (BRFSS) [https://ibis.health.utah.gov/ibisph-view/query/selection/brfss/BRFSSSelection.html]


Pap Smear in the Past Three Years by Ethnicity, Utah, 2020

::chart - missing::
confidence limits

Hispanic EthnicityAge-adjusted Percentage of Women 18+Lower LimitUpper Limit
Record Count: 3
Hispanic/Latino65.3%58.5%71.5%
Non-Hispanic/Latino62.4%60.5%64.3%
All ethnicities62.9%61.0%64.6%

Data Notes

Age-adjusted to the U.S. 2000 standard population.

Data Source

Utah Department of Health and Human Services Behavioral Risk Factor Surveillance System (BRFSS) [https://ibis.health.utah.gov/ibisph-view/query/selection/brfss/BRFSSSelection.html]


Pap Smear in the Past Three Years by Race, Utah, 2019 and 2020

::chart - missing::
confidence limits

RaceAge-adjusted Percentage of Women Age 18+Lower LimitUpper Limit
Record Count: 7
American Indian/Alaska Native69.1%56.6%79.3%
Asian69.8%55.9%80.9%
Black, African American62.6%45.9%76.8%
Native Hawaiian, Pacific Islander44.9%27.0%64.3%
White61.1%59.6%62.6%
Other67.4%60.2%73.8%
All races61.6%60.1%63.0%

Data Notes

Age-adjusted to the U.S. 2000 standard population.

Data Source

Utah Department of Health and Human Services Behavioral Risk Factor Surveillance System (BRFSS) [https://ibis.health.utah.gov/ibisph-view/query/selection/brfss/BRFSSSelection.html]


Pap Test Within the Past Three Years by Education, Utah Women Aged 25+, 2020

::chart - missing::
confidence limits

Education LevelAge-adjusted Percentage of Women 25+Lower LimitUpper Limit
Record Count: 5
Less than high school59.7%49.2%69.4%
H.S. grad or G.E.D.63.9%59.4%68.1%
Some post high school68.5%65.3%71.5%
College graduate69.7%67.0%72.4%
Total67.4%65.4%69.3%

Data Notes

Age-adjusted to the 2000 standard population.

Data Source

Utah Department of Health and Human Services Behavioral Risk Factor Surveillance System (BRFSS) [https://ibis.health.utah.gov/ibisph-view/query/selection/brfss/BRFSSSelection.html]


Pap Test Within the Past Three Years by Income, Utah, 2020

::chart - missing::
confidence limits

Income CategoryAge-adjusted Percentage of Women 18+Lower LimitUpper Limit
Record Count: 5
<$25,00051.6%46.0%57.1%
$25,000-$49,99961.5%56.7%66.1%
$50,000-$74,99965.6%60.7%70.2%
$75,000+71.2%68.0%74.3%
Total62.9%61.0%64.6%

Data Notes

Age-adjusted to the 2000 standard population.

Data Source

Utah Department of Health and Human Services Behavioral Risk Factor Surveillance System (BRFSS) [https://ibis.health.utah.gov/ibisph-view/query/selection/brfss/BRFSSSelection.html]


Pap Test Within the Past Three Years by Age, Utah, 2020

::chart - missing::
confidence limits

Age GroupPercentage of Women Aged 18+Lower LimitUpper Limit
Record Count: 4
18-3456.1%52.6%59.6%
35-4978.5%75.3%81.3%
50-6469.4%64.8%73.6%
65+36.0%31.6%40.7%

Data Notes

^The U.S. Preventive Services Task Force does not recommend 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 Department of Health and Human Services Behavioral Risk Factor Surveillance System (BRFSS) [https://ibis.health.utah.gov/ibisph-view/query/selection/brfss/BRFSSSelection.html]

References and Community Resources

Utah Breast and Cervical Cancer @ [http://www.cancerutah.org] [[br]] Utah Immunization Vaccines for Children @ [https://immunize.utah.gov/vaccines-for-children-program/] [[br]] Utah Cancer Action Network @ [http://www.ucan.cc] [[br]] National Cancer Institute @ [http://www.cancer.gov] [[br]] American Cancer Society @ [http://www.cancer.org] [[br]] Huntsman Cancer Institute @ [http://www.huntsmancancer.org] [[br]] Centers for Disease Control and Prevention @ [http://www.cdc.gov] [[br]] American Society of Clinical Oncology @ [http://www.asco.org]

More 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:

Medical literature can be queried at the PubMed website.

Page Content Updated On 01/02/2024, Published on 02/26/2024
The information provided above is from the Utah Department of Health's Center for Health Data IBIS-PH web site (http://epht.health.utah.gov). The information published on this website may be reproduced without permission. Please use the following citation: " Retrieved Sun, 26 May 2024 0:23:07 from Utah Department of Health, Center for Health Data, Indicator-Based Information System for Public Health Web site: http://epht.health.utah.gov ".

Content updated: Mon, 26 Feb 2024 11:14:58 MST