Cervical Cancer Screening (CCS-E)

The measure assesses the percentage of members 21–64 years of age who are recommended for routine cervical cancer screening and were appropriately screened for cervical cancer using either of the following criteria:

• Members 21–64 years of age recommended for routine cervical cancer screening who had cervical cytology performed within the last 3 years.
• Members 30–64 years of age recommended for routine cervical cancer screening who had cervical high-risk human papillomavirus (hrHPV) testing within the last 5 years.
• Members 30–64 years of age recommended for routine cervical cancer screening who had cervical cytology/high-risk human papillomavirus (hrHPV) cotesting within the last 5 years.

Why It Matters?

Cervical cancer can be detected in its early stages by regular screening. Due to the success of cervical cancer screening in the U.S., dramatic decreases have been observed in both mortality and incidence of invasive cervical cancer. The current incidence rate is 6.9 cervical cancer cases per 100,000 women per year in the U.S., and the mortality rate associated with cervical cancer is 2.3 deaths per 100,000 per year.¹ The National Cancer Institute (NCI) estimated that there were 13,240 new cervical cancer cases and 4,170 related deaths in 2018.²

Human papillomavirus (HPV) causes virtually all cases of cervical cancer and associated precancerous lesions.³ Cervical intraepithelial neoplasia, known as CIN, is a precancerous condition where abnormal cells are found on the surface of the cervix.⁴ There are three stages of CIN, with the likelihood of becoming cancer and spreading to nearby normal tissues increasing from stage 1 to stage 3.⁴ Although vaccines to prevent most HPV infections that can cause cervical cancer are available, those who have been vaccinated should continue to be screened regularly.⁵ Three screening strategies can detect cervical precancers and cancers: cytology testing, high-risk HPV (hrHPV) testing and cytology supplemented with HPV screening (cotesting).

The US Preventive Services Task Force (USPSTF) recommends screening for cervical cancer every 3 years with cytology alone in women 21–29. Screening with hrHPV testing is not recommended for women younger than 30 because it results in more harms than benefits. The USPSTF recommends three cervical cancer screening strategies starting at age 30: cytology alone, hrHPV testing alone or cotesting every 5 years.⁵ The USPSTF notes that the recommendation statement applies to all asymptomatic individuals with a cervix. The American Cancer Society (ACS) similarly recommend cervical cancer screening for all individuals with a cervix.⁶ Additional guidelines from the University of California San Francisco Center of Excellence for Transgender Health,⁷ World Professional Association for Transgender Health,⁸ and The Fenway Institute⁹ recommend applying screening guidelines for cisgender women to transgender and gender diverse individuals with a cervix.

Historical Results – National Averages

Performance results for this measure are currently unavailable.