1.3 Million Older Women Still Receive Cervical Cancer Screening-Related Services

In 2019, Medicare fee-for-services spent $83.5 million on these potentially unnecessary services

While annual use of cervical cancer screening-associated services is decreasing in the Medicare fee-for-service population, more than 1.3 million older women received these services in 2019, according to a study published online in JAMA Internal Medicine.

Jin Qin, Sc.D., from the U.S. Centers for Disease Control and Prevention in Atlanta, and colleagues examined annual use trends in cervical cancer screening-associated services (e.g., cytology and human papillomavirus [HPV] tests, colposcopy, and cervical procedures [loop electrosurgical excision procedure, cone biopsy, and ablation]) among Medicare fee-for-service beneficiaries (1999 through 2019). The analysis included more than 15 million women annually (aged 65 to 114 years).

The researchers found that during the study period, the percentage of women who received at least one cytology or HPV test decreased from 18.9 percent (2.9 million) in 1999 to 8.5 percent (1.3 million) in 2019, a reduction of 55.3 percent. Similarly, colposcopy and cervical procedures decreased by 43.2 and 64.4 percent, respectively.

There was an average annual reduction in the use of cytology or HPV testing of 4.6 percent from 1999 to 2019. There was a decrease in the use rates of colposcopy and cervical procedures before 2015, which plateaued from 2015 to 2019.

In 2019, the total Medicare expenditure for all services rendered was about $83.5 million. Approximately 3 percent of women older than 80 received at least one service in 2019, costing $7.4 million.

“The study results suggest that more than 1.3 million women in the Medicare fee-for-service program recently received cervical cancer screening-associated services after age 65 years at a substantial cost but of unclear clinical appropriateness,” the authors write.

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