Definition

Estimated percentage of women ages 21-65 years who have had a Pap test in the past three years.

Numerator

The number of women ages 21-65 years who reported having a Pap test in the last three years.

Denominator

The total number of female survey respondents ages 21-65 years excluding those who responded "don't know" or "refused" to the numerator question.

Data Interpretation Issues

Data from the New Jersey Risk Factor Survey are intended to represent non-institutionalized adults in households with telephones. Data are collected using a random sample of all possible telephone numbers. Prior to analysis, data are weighted to represent the population distribution of adults by age, sex, and "race"/ethnicity. As with all surveys, however, some residual bias may result from nonresponse (e.g., refusal to participate in the survey or to answer specific questions) and measurement error (e.g., social desirability or recall). Attempts are made to minimize such error by use of a strict calling protocol (up to 15 calls are made to reach each household), good questionnaire design, standardization of interviewer behavior, interviewer training, and frequent, on-site interviewer monitoring and supervision. Starting in 2011, BRFSS protocol requires that the NJBRFS incorporate a fixed quota of interviews from cell phone respondents along with a new weighting methodology called iterative proportional fitting or "raking". The new weighting methodology incorporates additional demographic information (such as education, race, and marital status) in the weighting process. These methodological changes were implemented to account for the underrepresentation of certain demographic groups in the land line sample (which resulted in part from the increasing number of U.S. households without land line phones). Comparisons between 2011 and prior years should therefore be made with caution. (More details about these changes can be found at [http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6122a3.htm].)

Why Is This Important?

Cervical cancer is one of the most curable cancers if detected early through routine screening. Almost all cases of cervical cancer are caused by infection with high-risk types of the human papillomavirus (HPV). The HPV vaccine protects against the HPV types that most often cause cervical cancer. Women who have had an HPV vaccine still need to have routine Pap smears because the vaccine does not fully protect against all the strains of the virus and other risk factors that can cause cervical cancer. HPV is transmitted through sexual contact. Any woman who is sexually active is at risk for developing cervical cancer. Other risk factors include giving birth to many children, having sexual relations at an early age, having multiple sex partners or partners with many other partners, cigarette smoking, and use of oral contraceptives. The US Preventive Services Task Force (USPSTF) recommends screening for cervical cancer every 3 years with cervical cytology alone in women aged 21 to 29 years. For women aged 30 to 65 years, the USPSTF recommends screening every 3 years with cervical cytology alone, every 5 years with high-risk human papillomavirus (hrHPV) testing alone, or every 5 years with hrHPV testing in combination with cytology (cotesting).

Healthy People Objective: Increase the proportion of women who receive a cervical cancer screening based on the most recent guidelines

U.S. Target: 93.0 percent
State Target: 93.6 percent

Other Objectives

'''Healthy New Jersey 2020 Objective CA-14''': Increase the proportion of women aged 21 to 65 years who receive a cervical cancer screening based on the most recent guidelines to 93.6% for the total population, 94.9% among Whites, 99.3% among Blacks, 94.7% among Hispanics, and 79.8% among Asians.

How Are We Doing?

In 2020, approximately 80% of respondents reported that they had received a Pap test within the past three years.

Available Services

NJDOH has many programs and partnerships related to cancer resources, cancer information, and cancer prevention: [http://nj.gov/health/ces/].

Health Care System Factors

Since August 2018, the [https://www.uspreventiveservicestaskforce.org/Page/Document/UpdateSummaryFinal/cervical-cancer-screening2 United States Preventive Services Task Force] has recommended screening women aged 22 to 29 years every 3 years with '''cervical cytology alone''' and screening women aged 20 to 65 years every 3 years with '''cervical cytology alone''', every 5 years with '''high-risk human papillomavirus (hrHPV) testing alone''', or every 5 years with '''hrHPV testing in combination with cytology''' (cotesting). [Last reviewed: 1/26/20] Health care system factors that are positively associated with self-report of cervical cancer screening according to current guidelines include having adequate '''health care coverage''' and '''visiting a doctor or obstetrician/gynecologist (OB/GYN) in the past 12 months'''. ([https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6093265/ Hall et al., 2018]) Note: [https://www-doh.state.nj.us/doh-shad/query/builder/njbrfs/PapTest/PapTestAA11_.html Custom data views] of the estimated prevalence of adherence to cervical cancer screening guidelines among New Jersey women by selected '''sociodemographic and other characteristics''' (including '''health care coverage''' and '''visiting a doctor in the past 12 months''') can be generated using the New Jersey Behavioral Risk Factor Survey interactive query module.

Risk Factors

Factors that are negatively associated with self-report of cervical cancer screening according to current guidelines include having '''less than a high school education''', being a '''US resident for less than 10 years''', and being '''non-Hispanic Asian'''. ([https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6093265/ Hall et al., 2018]) Note: [https://www-doh.state.nj.us/doh-shad/query/builder/njbrfs/PapTest/PapTestAA11_.html Custom data views] of the estimated prevalence of adherence to cervical cancer screening guidelines among New Jersey women by selected '''sociodemographic and other characteristics''' (including '''education level''', '''immigration status''', and '''race/ethnicity''') can be generated using the New Jersey Behavioral Risk Factor Survey interactive query module.

Health Status Outcomes

According to the [https://www.cancer.gov/types/cervical/hp/cervical-screening-pdq National Cancer Institute], regular cervical cancer screening using the Pap test decreases '''cervical cancer incidence and mortality''' by at least 80%, while HPV-based screening provides 60% to 70% greater protection against '''invasive cervical carcinoma''' compared with cytology. [Last reviewed: 1/27/20]

Data Notes

All prevalence estimates are age-adjusted to the U.S. 2000 standard population.   ** No data is available for 2019.

Data Source

Behavioral Risk Factor Survey, Center for Health Statistics, New Jersey Department of Health, [http://www.state.nj.us/health/chs/njbrfs/]

Data Notes

All prevalence estimates are age-adjusted to the U.S. 2000 standard population.   Women aged 18+ with intact cervix who had pap smear within the past two years.

Data Source

Behavioral Risk Factor Survey, Center for Health Statistics, New Jersey Department of Health, [http://www.state.nj.us/health/chs/njbrfs/]

Data Notes

All prevalence estimates are age-adjusted to the U.S. 2000 standard population.   ** No data is available for 2019. In 2013 and 2018, Asians did not meet CDC minimum sample size (i.e., N<50).

Data Source

Behavioral Risk Factor Survey, Center for Health Statistics, New Jersey Department of Health, [http://www.state.nj.us/health/chs/njbrfs/]

Data Notes

All prevalence estimates are age-adjusted to the U.S. 2000 standard population.

Data Source

Behavioral Risk Factor Survey, Center for Health Statistics, New Jersey Department of Health, [http://www.state.nj.us/health/chs/njbrfs/]

Data Notes

All prevalence estimates are age-adjusted to the U.S. 2000 standard population.   *2019 data is not included in the average estimated prevalence. No data is available for 2019.

Data Source

Behavioral Risk Factor Survey, Center for Health Statistics, New Jersey Department of Health, [http://www.state.nj.us/health/chs/njbrfs/]