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Alabama Value:
Percentage of women ages 21-44 who reported receiving a Pap smear within the past three years
Alabama Rank:
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Percentage of women ages 21-44 who reported receiving a Pap smear within the past three years
US Value: 77.1%
Top State(s): Mississippi: 85.2%
Bottom State(s): Alaska: 67.9%
Definition: Percentage of women ages 21-44 who reported receiving a Pap smear within the past three years
Data Source and Years(s): CDC, Behavioral Risk Factor Surveillance System, 2020
Suggested Citation: America's Health Rankings analysis of CDC, Behavioral Risk Factor Surveillance System, United Health Foundation, AmericasHealthRankings.org, accessed 2024.
Cervical cancer is preventable with screening tests and vaccines, and highly treatable when caught early. Increased screening in the form of routine Pap tests has contributed to significant declines in cervical cancer mortality over the past 40 years. In 2019, an estimated 18.3 million women were not up-to-date on their cervical cancer screening. Screening rates declined sharply during the COVID-19 pandemic, but have gradually returned to near baseline since clinics resumed routine screening.
The American Cancer Society estimates that there will be approximately 14,000 new cases of invasive cervical cancer diagnosed in 2023, and 4,300 cervical cancer deaths. The main cause of cervical cancer is the human papillomavirus (HPV), a group of common viruses transmitted during sexual contact. It is estimated that nearly all sexually active people will get HPV at some point during their lifetimes, but recommended HPV vaccinations effectively protect against and reduce rates of cancer-causing strains.
The Centers for Disease Control and Prevention (CDC) estimates that the medical cost of cervical cancer care in the U.S. was $2.3 billion in 2020. Early-stage cervical cancer is much less expensive to treat. Increasing cervical cancer screening rates can reduce health care costs and save lives.
According to America’s Health Rankings data, the prevalence of cervical cancer screening is higher among:
Additional studies have found that rates of cervical cancer screening are higher among:
The CDC recommends regular screening via Pap and/or HPV tests, as well as HPV vaccination in early adolescence to prevent cervical cancer. The U.S. Preventive Services Task Force (USPSTF) strongly recommends women ages 21-29 get a Pap test every three years. For women ages 30-65, the USPSTF recommends either: a) a Pap test every three years, b) HPV testing every five years, or c) a combined HPV and Pap test every five years. Women with HIV have a higher risk of cervical cancer compared to women without HIV, and should follow the screening recommendations in the federally approved clinical Guidelines for the Prevention and Treatment of Opportunistic Infections in Adults and Adolescents with HIV.
The Community Guide lists several interventions that are effective in increasing cervical cancer screening, including:
Additional strategies to improve cervical cancer screening rates among women include:
Healthy People 2030 aims to increase the proportion of women ages 21-65 who receive cervical cancer screening.
Dorsainvil, Merlyn A. “Increasing Cervical Cancer Screening in Underserved Populations.” Journal of Christian Nursing 34, no. 3 (July 2017): 152–58. https://doi.org/10.1097/CNJ.0000000000000405.
Hernández-Ramírez, Raúl U, Meredith S Shiels, Robert Dubrow, and Eric A Engels. “Cancer Risk in HIV-Infected People in the USA from 1996 to 2012: A Population-Based, Registry-Linkage Study.” The Lancet HIV 4, no. 11 (November 2017): e495–504. https://doi.org/10.1016/S2352-3018(17)30125-X.
Miller, Maureen J., Lanfang Xu, Jin Qin, Erin E. Hahn, Quyen Ngo-Metzger, Brian Mittman, Devansu Tewari, et al. “Impact of COVID-19 on Cervical Cancer Screening Rates Among Women Aged 21–65 Years in a Large Integrated Health Care System — Southern California, January 1–September 30, 2019, and January 1–September 30, 2020.” MMWR. Morbidity and Mortality Weekly Report 70, no. 4 (January 29, 2021): 109–13. https://doi.org/10.15585/mmwr.mm7004a1.
Sabatino, Susan A., Trevor D. Thompson, Mary C. White, Jean A. Shapiro, Tainya C. Clarke, Jennifer M. Croswell, and Lisa C. Richardson. “Cancer Screening Test Use?U.S., 2019.” American Journal of Preventive Medicine 63, no. 3 (September 2022): 431–39. https://doi.org/10.1016/j.amepre.2022.02.018.
Suk, Ryan, Young-Rock Hong, Suja S. Rajan, Zhigang Xie, Yenan Zhu, and Jennifer C. Spencer. “Assessment of US Preventive Services Task Force Guideline–Concordant Cervical Cancer Screening Rates and Reasons for Underscreening by Age, Race and Ethnicity, Sexual Orientation, Rurality, and Insurance, 2005 to 2019.” JAMA Network Open 5, no. 1 (January 18, 2022): e2143582. https://doi.org/10.1001/jamanetworkopen.2021.43582.
Tracy, J. Kathleen, Alison D. Lydecker, and Lynda Ireland. “Barriers to Cervical Cancer Screening Among Lesbians.” Journal of Women’s Health 19, no. 2 (February 2010): 229–37. https://doi.org/10.1089/jwh.2009.1393.
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