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    Cervical Cancer: Uninsured Are Diagnosed Later

    Lack of Insurance Linked to Late-Stage Diagnosis

    No Insurance, Less Screening continued...

    American Cancer Society epidemiologist Stacey Fedewa, MPH, says it is common for screening to decline or stop altogether when women approach the age of menopause.

    ACS recommends that:

    • All women begin cervical cancer screening by the age of 21, and that women between the ages of 21 and 29 have a Pap test every three years.
    • Women between the ages of 30 and 65 have a Pap test and a human papillomavirus (HPV) test every five years or a Pap test alone every three years.
    • Women over the age of 65 who have had regular screenings should not continue screening unless they have had abnormal results indicative of an increased risk for the cancer.

    'Pap Screening Saves Lives'

    NYU School of Medicine Director of Gynecologic Oncology John Curtin, MD, says older women who did not have regular Pap tests when they were younger should be screened but often aren't.

    Curtin is a past president of the Society of Gynecologic Oncology.

    "For these women, the guidelines that say you can stop screening at 65 do not apply," he tells WebMD.

    Fedewa tells WebMD that the larger risk for late-stage diagnosis in uninsured women is probably due to the fact that these women aren't being screened at all.

    When they do get screened, uninsured and underinsured women also have higher rates of abnormal screening results and lower rates of abnormal screening follow-up than women with insurance.

    Curtin adds that it remains unclear if the health care reforms upheld by the Supreme Court last month will increase screening rates among lower-income women.

    What is clear, he says, is that cervical cancer could be eliminated in the U.S. if all eligible women were screened and got the follow-up care they needed.

    "Many decades after its arrival, the Pap smear remains a great public health tool that saves lives," he says.

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