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U.S. Department of Health and Human Services Office of Disease Prevention and Health Promotion

Increase the proportion of females who get screened for cervical cancer — C‑09 Data Methodology and Measurement

On this page:  About the National Data  |  Methodology  |  History

About the National Data

Data

Data Source:  National Health Interview Survey (NHIS), CDC/NCHS

Baseline: 75.0 percent of females aged 21 to 65 years received a cervical cancer screening based on the most recent guidelines in 2019

Target: 79.2 percent

Numerator
Number of females aged 21 to 65 years who received cervical cancer screening based on the most recent USPSTF recommendation and who have not had a hysterectomy.
Denominator
Number of females aged 21 to 65 years who have not had a hysterectomy, excluding those with a history of cervical cancer.
Target-setting method
Percentage point improvement
Target-setting method details
Percentage point improvement from the baseline using Cohen's h effect size of 0.10.
1
Target-setting method justification
Trend data were evaluated for this objective but it was not possible to project a target because the slope of the line was not statistically significant, and the trend was moving away from the desired direction. A percentage point improvement was calculated using Cohen's h effect size of 0.1. This method was used because the Healthy People 2030 Workgroup Subject Matter Experts (SMEs) expected the overall percentage to continue to be difficult to change. Although this target is ambitious, the SMEs believed that progress may be made through multicomponent interventions, especially for medically underserved women.

Methodology

Questions used to obtain the national baseline data

(For additional information, please visit the data source page linked above.)

From the 2021 National Health Interview Survey:

Numerator:
For female sample adults 18+ who were ever told they have cancer (variables: CANKIND1_A, CANKIND2_A, CANKIND3_A), was cervical cancer mentioned?
  1. Mentioned
  2. Not mentioned
  3. Refused
  4. Not ascertained
  5. Don't know
A hysterectomy is when the uterus or womb is removed, this is different from having your tubes tied. Have you had a hysterectomy?
  1. Yes
  2. No
  3. Refused
  4. Don't know
There are two different kinds of tests to check for cervical cancer. One is a Pap smear or Pap test and the other is the HPV or Human Papillomavirus test. Have you EVER HAD a test or tests to check for cervical cancer?
  1. Yes
  2. No
  3. Refused
  4. Don't know
At your MOST RECENT cervical cancer screening, did you have a Pap test?
  1. Yes
  2. No
  3. Refused
  4. Don't know
When did you have your MOST RECENT test to check for cervical cancer?
  1. Within the past year (anytime less than 12 months ago)
  2. Within the past 2 years (1 year but less than 2 years ago)
  3. Within the past 3 years (2 years but less than 3 years ago)
  4. Within the past 5 years (3 years but less than 5 years ago)
  5. Within the past 10 years (5 years but less than 10 years ago)
  6. 10 years ago or more
  7. Refused
  8. Don't know
At your MOST RECENT cervical cancer screening, did you have an HPV test?
  1. Yes
  2. No
  3. Refused
  4. Don't know

Methodology notes

Healthy People 2030 uses the current U.S. Preventive Services Task Force (USPSTF) Grade A recommendation to measure this objective: 1. For women aged 21 to 29 years: a Pap test every 3 years; and 2. For women aged 30 to 65 years: a) Pap test every 3 years; or b) a high-risk HPV (hrHPV) test alone every 5 years; or c) a hrHPV test in combination with a Pap test every 5 years. The USPSTF also recommends against routine Pap smear screening for women who have had a total hysterectomy.
Data for this objective include women aged 21 to 65 years who were screened for cervical cancer, as outlined in the USPSTF recommendation. Additionally, women aged 30 to 65 years were also considered up to date if they reported being screened for cervical cancer within the past 3 years but reported not knowing whether they had a Pap test or HPV test at their most recent visit or refused to state which test they had had. Women who reported having a hysterectomy were excluded from the analyses.
The denominator does not include respondents who reported ever having cervical cancer.

Age-adjustment notes

This Indicator uses Age-Adjustment Groups:

  • Total: 21-34, 35-44, 45-65
  • Race/Ethnicity: 21-34, 35-44, 45-65
  • Educational Attainment: 25-34, 35-44, 45-65
  • Family Income (percent poverty threshold): 21-34, 35-44, 45-65
  • Health Insurance Status (21-64 years): 21-34, 35-44, 45-64
  • Geographic Location: 21-34, 35-44, 45-65
  • Marital Status: 21-34, 35-44, 45-65
  • Country of Birth: 21-34, 35-44, 45-65
  • Disability Status: 21-34, 35-44, 45-65
  • Veteran Status: 21-34, 35-44, 45-65
  • Sexual Orientation: 21-34, 35-44, 45-65

History

Comparable HP2020 objective
Modified, which includes core objectives that are continuing from Healthy People 2020 but underwent a change in measurement.
Changes between HP2020 and HP2030
This objective differs from Healthy People 2020 objective C-15 in that the measure was revised to match updated screening recommendations put forth by the U.S. Preventative Services Task Force (USPSTF).
Revision History
  • Revised. 

    In 2023, due to the 2019 NHIS survey redesign and a revised denominator to exclude women with a history of cervical cancer, the baseline was changed from 80.5% in 2018 to 75.0% in 2019 and the target was changed from 84.3% to 79.2%.
  • Revised. 

    In 2024, the following categories were recalculated with the use of a newer variable: Never married, American Indian or Alaska Native only, Native Hawaiian or Other Pacific Islander only, 2 or more races only, Not Hispanic or Latino American Indian or Alaska Native only, Not Hispanic or Latino Native Hawaiian or Other Pacific Islander only, Not Hispanic or Latino 2 or more races only. Estimates from data year 2022 or earlier may vary slightly from estimates previously reported. The baseline, baseline year and target were not affected.

1. Effect size h=0.1 was chosen to correspond with 10% improvement from a baseline of 50%.