Nearly a quarter of patients who are eligible for cervical cancer screening are overdue for their current tests, researchers said in study findings published in JAMA Network Open. The number grew nearly 10% since 2005—representing a steady increase in missed screening over time—and was higher in different sociodemographic groups because of factors related to social determinants of health.

In the cross-sectional study, researchers looked at data from 20,557 U.S. women eligible for cervical cancer screening and found that those without up-to-date screening significantly increased from 14.4% in 2005 to 23.0% in 2019 among all sociodemographic groups. Of note, the decline developed before the COVID-19 pandemic–driven decrease in overall cancer screening rates. The rates were significantly higher among Asian (31.4%) than non-Hispanic White (20.1%) patients, LGBTQIA+ (32.0%) than heterosexual (22.2%) patients, patients living in rural (26.2%) than urban (22.6%) areas, and patients without insurance (41.7%) than private insurance (18.1%).

The most common reason patients across all groups cited for not receiving timely screening was lack of knowledge, ranging from 47.2% of those identifying as LGBTQIA+ to 64.4% of Hispanic ethnicity. Lack of access decreased significantly as a primary reason (from 21.8% in 2005 to 9.7% in 2019), whereas lack of knowledge and not receiving recommendations from healthcare professionals increased significantly (from 45.2% to 54.8% and from 5.9% to 12.0%, respectively).

“The findings revealed that barriers to screening significantly varied by sociodemographic factors, suggesting that cultural adaptation of interventions will be an important factor in the success of efforts to increase cervical cancer screening uptake among priority populations in the United States, including women of Asian race and Hispanic ethnicity, women without insurance, women living in rural areas, and/or those identifying as LGBTQIA+,” the researchers concluded. “Along with increasing human papillomavirus vaccine coverage, improving cervical cancer screening rates represents an important strategy for national campaigns to eliminate cervical cancer as a public health concern.”

Find oncology nursing strategies to reverse cancer screening declines in ONS Voice.