• Jillian T Henderson, Mona Saraiya, Gladys Martinez, Cynthia C Harper, and George F Sawaya.
• University of California, San Francisco, Bixby Center for Global Reproductive Health, Department of Obstetrics, Gynecology & Reproductive Sciences, San Francisco, CA 94118, USA. HendersonJ@obgyn.ucsf.edu
• Prev Med. 2013 Jan 1; 56 (1): 252925-9.

ObjectiveA shift toward later initiation of cervical cancer screening for women began in 2002. We generated national estimates of screening prevalence rates and guideline-consistent screening among U.S. women ages 15-29 before and after the first evidence-based recommendations for reduced cervical cancer screening.MethodWe used National Survey of Family Growth data to compare self-reported cervical cancer screening in 2002 and 2006-2008, stratified by age (15-17, 18-20, 21-29) and sexual activity. We also assessed receipt of guideline-consistent screening by selected demographic variables.ResultsAmong females ages 15-17, the proportion screened decreased from 23% to 12%, and screening was significantly more likely to be guideline-consistent. Among females ages 18-20, 24% were screened too early in 2006-2008, but among those not yet sexually active, screening declined to 8%, appropriately reflecting new guidelines. In multivariable analysis, private health insurance, pregnancy, and hormonal contraceptive use were associated with guideline-consistent screening among sexually-active women.ConclusionFewer adolescents were being screened before sexual initiation, representing newer guidelines. However, sexually-active young adult women also should have later screening initiation. Factors related to health care access contribute to receipt of screening. Monitoring and provider education are needed to improve guideline-consistent screening, as newer guidelines call for less screening.Copyright © 2012 Elsevier Inc. All rights reserved.

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