Impact of Widespread Cervical Cancer Screening

Daniel X. Yang, Pamela R. Soulos, Brigette Davis, Cary P. Gross, James B. Yu

Research output: Contribution to journalArticlepeer-review

58 Scopus citations


Objectives: With recent approval of standalone HPV testing and increasing uptake of HPV vaccination, some have postulated that we are moving toward a "post-Pap" era of cervical cancer prevention. However, the total number cases that have been prevented by Pap smear screening as well as its impact on racial disparities are unknown. Methods: We estimated national cervical cancer incidence from 1976 to 2009 using the Surveillance, Epidemiology, and End Result database. Screening data were obtained from the literature and National Cancer Institute Progress Reports. We examined early, late, and race-specific trends in cancer incidence, and calculated the estimated number of cancers prevented over the past 3 decades. Results: From 1976 to 2009, there was a significant decrease in the incidence of early-stage cervical cancer, from 9.8 to 4.9 cases per 100,000 women (P<0.001). Late-stage disease incidence also decreased, from 5.3 to 3.7 cases per 100,000 women (P<0.001). The incidence among black women decreased from 26.9 to 9.7 cases per 100,000 women (P<0.001), a greater decline compared with that of white women and women of other races. After adjusting for "prescreening era" rates of cervical cancer, we estimate that Pap smears were associated with a reduction of between 105,000 and 492,000 cases of cervical cancer over the past 3 decades in the United States. Conclusions: A large number of early-stage and late-stage cervical cancers were prevented and racial disparity in cancer rates were reduced during an era of widespread Pap smear screening.

Original languageEnglish (US)
Pages (from-to)289-294
Number of pages6
JournalAmerican Journal of Clinical Oncology: Cancer Clinical Trials
Issue number3
StatePublished - 2018
Externally publishedYes

Bibliographical note

Funding Information:
J.B.Y. is supported by CTSA grant KL2 RR024138 from the National Center for Advancing Translational Science (NCATS), a component of the National Institutes of Health (NIH), and NIH Roadmap for Medical Research. J.B.Y. and C.P.G. have research funding from 21st Century Oncology LLC.

Publisher Copyright:
© 2016 Wolters Kluwer Health, Inc. All rights reserved.


  • cancer screening
  • cervical neoplasms
  • HPV DNA test
  • incidence
  • Papanicolaou test


Dive into the research topics of 'Impact of Widespread Cervical Cancer Screening'. Together they form a unique fingerprint.

Cite this