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Improvements in Cervical Cancer Testing Needed

Cervical Cancer Nearly Preventable by Widespread Use of Pap Test, Says Nonprofit Group

Geographic Differences continued...

Insurance was an important factor in whether women were screened for the disease. In 2001, 31% of uninsured women didn't get a Pap test, compared with only 15% of women with health insurance.

Cervical cancer and its death rates also varied greatly from state to state. Nationwide, cervical cancer strikes about 9 out of every 100,000 women. The average U.S. mortality rate is 2.7 per 100,000 women.

Some states beat those numbers.

Cervical cancer rates were lowest in North Dakota, where the incidence rate was 5.5 cases per 100,000 women. It was highest in Washington, D.C. (14.3 per 100,000 women).

Death rates also vary. Some states have both the high incidence and the high death rates: Texas, New Mexico, West Virginia and Arkansas. Mortality rates ranged from 1.3 to 6.1 per 100,000 women. The rate was highest in Washington, D.C. States with the lowest death rates include Minnesota, Wisconsin, Massachusetts, Connecticut, and Washington.

Policy Notes

The Pap test, in use for 60 years, is almost universally available. It's covered by every state Medicaid program.

However, only 23 states and Washington, D.C., have some type of Pap screening coverage requirement for public and private insurers, says the report. HPV testing is covered without restrictions when medically necessary in 46 states and Washington, D.C., but it's often not part of routine screening.

"Only North Carolina mandates coverage for all FDA-approved cervical cancer screening technologies, including HPV testing," says the report. Rankings will be updated in 2006.

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