Cervical Cancer Screening

Percentage of women 21-64 years of age who were screened for cervical cancer using either of the following criteria:
*  Women age 21-64 who had cervical cytology performed every 3 years
*  Women age 30-64 who had cervical cytology/human papillomavirus (HPV) co-testing performed every 5 years

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All women are at risk for cervical cancer, but it occurs most often in women over the age of 30. In 2017, approximately 12,820 women were diagnosed with cervical cancer in the U.S., resulting in an estimated 4,210 deaths (Howlader et al. 2017). If pre-cancerous lesions are detected early by Pap tests and treated, the likelihood of survival is nearly 100 percent (American Cancer Society 2017). In 2015, women with no health insurance and recent immigrants were least likely to have a Pap test (American Cancer Society 2017).

U.S. Preventive Services Task Force (USPSTF) (2012)
"The USPSTF recommends screening for cervical cancer in women aged 21 to 65 years with cytology (Papanicolaou smear) every 3 years or, for women aged 30 to 65 years who want to lengthen the screening interval, screening with a combination of cytology and HPV testing every 5 years." (A recommendation)

"The USPSTF recommends against screening for cervical cancer in women younger than age 21 years." (D recommendation)

"The USPSTF recommends against screening for cervical cancer in women older than age 65 years who have had adequate prior screening and are not otherwise at high risk for cervical cancer." (D recommendation)

"The USPSTF recommends against screening for cervical cancer in women who have had a hysterectomy with removal of the cervix and who do not have a history of a high-grade precancerous lesion (cervical intraepithelial neoplasia grade 2 or 3) or cervical cancer." (D recommendation).

"The USPSTF recommends against screening for cervical cancer with HPV testing, alone or in combination with cytology, in women younger than age 30 years." (D recommendation)

Higher score equals better quality

American Cancer Society. 2017. "Cancer Prevention & Early Detection Facts & Figures 2017-2018." Atlanta: American Cancer Society.

U.S. Preventive Services Task Force. 2012. "Screening for Cervical Cancer: U.S. Preventive Services Task Force Recommendation Statement." Ann Intern Med. 156(12):880-91. 

Howlader, N., A.M. Noone, M. Krapcho, D. Miller, K. Bishop, C.L. Kosary, M. Yu, J. Ruhl, Z. Tatalovich, A. Mariotto, D.R. Lewis, H.S. Chen, E.J. Feuer, and K.A. Cronin. "SEER Cancer Statistics Review, 1975-2014." Washington, DC: National Cancer Institute, 2017. Available at https://seer.cancer.gov/csr/1975_2014

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To ensure the measure is only looking for a cervical cytology test only after a woman turns 21 years of age, the youngest age in the initial population is 23.

Patient self-report for procedures as well as diagnostic studies should be recorded in 'Procedure, Performed' template or 'Diagnostic Study, Performed' template in QRDA-1.

Include only cytology and HPV "co-testing"; in co-testing, both cytology and HPV tests are performed (i.e., the samples are collected and both tests are ordered, regardless of the cytology result) on the same date of service. Do not include reflex testing. In addition, if the medical record indicates the HPV test was performed only after determining the cytology result, this is considered reflex testing and does not meet criteria for the measure.

TBD

Women 23-64 years of age with a visit during the measurement period

Equals Initial Population

Women who had a hysterectomy with no residual cervix or a congenital absence of  cervix.

Exclude patients whose hospice care overlaps the measurement period.

Women with one or more screenings for cervical cancer. Appropriate screenings are defined by any one of the following criteria:

- Cervical cytology performed during the measurement period or the two years prior to the measurement period for women who are at least 21 years old at the time of the test
 
- Cervical cytology/human papillomavirus (HPV) co-testing performed during the measurement period or the four years prior to the measurement period for women who are at least 30 years old at the time of the test

Not Applicable

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For every patient evaluated by this measure also identify payer, race, ethnicity and sex

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