A rising number of women have never been screened for cervical cancer. Here are the risks

A Rising Number of Women Skip Cervical Cancer Screening

Healfromzero.com – A rising number of women across the United States have never received a cervical cancer screening, according to a landmark analysis published in JAMA Network Open on August 27. The findings, drawn from a CDC-administered national survey of more than 106,000 women, show that roughly one in three women aged 21 to 29 had never been screened by 2023 — nearly triple the share recorded in 2005. The shortfall extends well beyond young adults: an estimated 9.2 million women across all eligible age groups have gone without a single screen, leaving precancerous changes undetected and untreated.

What Two Decades of Survey Data Show

Researchers tracked self-reported screening history from 2005 through 2023. In the youngest cohort, the share never screened jumped from 12.5% to approximately 32%, a shift that translates to about 6.2 million young women without a single opportunity to catch early cellular changes. Among women aged 30 to 65, the never-screened proportion climbed from 5.3% to close to 15% over the same window.

Disparities cut sharply along demographic lines. In 2023, roughly 44% of Asian women aged 21 to 29 reported no prior screen, compared with about 29% of White women in that bracket. Education mattered just as much: approximately 39% of young women whose highest credential was a high-school diploma had never been screened, while only around 17% of those holding a master’s or doctoral degree shared that gap. For the older group, insurance status proved decisive — nearly 32% of uninsured women aged 30 to 65 had never been screened, against roughly 11% of privately insured women.

The Biological Stakes Behind the Numbers

Dr. Leana Wen, an emergency physician and clinical associate professor at George Washington University who formerly served as Baltimore’s health commissioner, underscored why the trend warrants alarm. More than nine in ten cervical cancers originate from a persistent infection with high-risk human papillomavirus strains, transmitted through intimate skin-to-skin contact. Most immune systems clear the virus quietly; in others, the infection endures and drives abnormal cervical cell changes that, over years, can progress from precancerous lesions into invasive malignancy.

“Screening can identify high-risk HPV or abnormal cervical cells. Precancerous lesions can then be monitored or removed before they develop into cancer. Women who have never been screened have missed this opportunity entirely.”

Wen noted that forming a screening habit in young adulthood sets the trajectory for continued preventive care later, when absolute cancer risk climbs. The HPV vaccine, offered to both sexes, can halve the incidence of certain HPV-linked cancers and adds a second protective layer when combined with periodic screening.

Limitations and Unresolved Questions

The authors flagged several caveats. Because screening history was self-reported, respondents may have misremembered whether or when a screen took place. The survey design cannot isolate the specific reasons screening rates fell — candidates include restricted clinic access, insurance gaps, procedural discomfort, and simple unawareness of recommended intervals. Importantly, the study cannot prove that reduced screening directly produced worse cancer outcomes, though accompanying trends are troubling: among women aged 30 to 64, later-stage cervical cancer incidence rose by more than 2% per year after 2017, and women 65 and older also experienced increases in advanced disease.

Frequently Asked Questions

How often should a woman get screened? Current U.S. guidance recommends a Pap test every three years, or a combined Pap-and-HPV test every five years, beginning at age 21 and continuing through age 65. Women over 65 who have had adequate prior negative results may stop screening.

What does a screening visit actually involve? A Pap test collects a small cell sample from the cervix for microscopic examination. An HPV test detects high-risk viral strains in the same sample. Both procedures take only a few minutes and require no special preparation.

Can the HPV vaccine replace screening? No. The vaccine reduces the likelihood of infection with covered strains but does not eliminate all high-risk types, nor does it treat existing infections. Regular screening remains essential even for fully vaccinated women.

Where can a woman get screened if she lacks insurance? Community health centers, Planned Parenthood clinics, and state or county health departments offer low-cost or sliding-scale cervical cancer screening. The CDC maintains a searchable directory of nearby sites.