Cervical Cancer in Women With Comprehensive Health Care Access: Attributable Factors in the Screening Process

Background: Invasive cervical cancer is highly preventable, yet it continues to occur, even among women who have access to cancer screening and treatment services. To reduce cervi-cal cancer among such women, reasons for its occurrence must be better understood. We examined factors associated with the diagnosis of cervical cancer among women enrolled in health plans. Methods: We identifi ed all cases of invasive cervical cancer ( n = 833) diagnosed from January 1, 1995, through December 31, 2000, among women who were long-term members of seven prepaid comprehensive health plans and reviewed each woman’s medical records for the 3 years prior to her cancer diagnosis. Women were classifi ed into one of three categories based on Pap test histories 4 – 36 months before diagnosis: failure to screen with a Pap test, failure in detection by a Pap test, or failure in follow-up of an abnorma