Assessment of trends in cervical cancer screening rates using healthcare claims data: United States, 2003-2014.
Assessment of trends in cervical cancer screening rates using healthcare claims data: United States, 2003-2014.
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DOI：
10.1016/j.pmedr.2018.01.010
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发表时间：
2018-03-01
影响因子：
2.8
通讯作者：
Flagg, Elaine W
中科院分区：
文献类型：
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作者：
Watson, Meg;Benard, Vicki;Flagg, Elaine W
对宫颈癌自然史认识的提高导致了筛查建议的改变，包括在常规筛查中增加了人乳头瘤病毒（HPV）检测。大多数关于筛查趋势的研究都使用了国家自我报告的调查数据。为了更好地了解宫颈癌筛查的最新趋势，包括细胞学（巴氏涂片检查）和人乳头瘤病毒联合检查（HPV + 巴氏涂片检查），我们使用医疗保健索赔数据来检查筛查做法和趋势。我们分析了2005-2014年期间连续三年或更长时间连续入组的18-65岁商业保险女性的筛查情况，以确定接受宫颈抹片检查或联合检查的宫颈癌筛查者。我们按年龄组和年份检查筛查的流行程度。在我们研究期间的后几年，在所有被检查年龄组的女性中，筛查率（无论筛查方法如何）显著下降。尽管总体筛查率有所下降，但除18-20岁人群外，所有年龄组的联合检测率均有所上升。2014年，30-39岁的女性总体筛查率最高（77.5%），联合检测使用率最高（44.4%）；这一组在一段时间内筛查的总体下降幅度也最低（-4.5%）。这些来自医疗保健索赔的筛查措施低于来自全国一般人群调查的自我报告筛查。需要更多的研究来探索这些差异的原因，以确保妇女接受适当的筛查，并更好地了解为什么在商业保险妇女人群中筛查率下降。
Improved understanding of the natural history of cervical cancer has led to changes in screening recommendations, including the addition of the human papillomavirus (HPV) testing as an option in routine screening. Most studies of screening trends have used national self-reported survey data. To better understand recent trends in cervical cancer screening, including cytology (Papanicolaou, or Pap, tests) and human papillomavirus co-tests (HPV + Pap test), we used healthcare claims data to examine screening practices and trends. We analyzed screening among commercially-insured females ages 18-65 during 2005-2014 who were continuously enrolled during three or more contiguous calendar years, to identify those who received cervical cancer screening with a Pap test or co-test. We examined screening prevalence by age group and year. During the latter years of our study period, screening prevalence (regardless of screening method) declined significantly for women in all age groups examined. Despite declines in overall screening, the prevalence of co-testing increased in all age groups except those aged 18-20. In 2014, women aged 30-39 had the highest overall screening uptake (77.5%) and the highest use of co-testing (44.4%); this group also had the lowest overall declines in screening over the time period (-4.5%). These screening measures from healthcare claims were lower than self-reported screening from national surveys of the general population. More research to explore the reasons for these differences is needed to ensure that women are receiving appropriate screening, and to better understand why screening prevalence is declining among this population of commercially insured women.