New University of Kentucky research published in JAMA Network Open reveals concerning declines in cervical cancer screening rates among women in the U.S. during the COVID-19 pandemic, especially in rural areas.  

The study led by UK Markey Cancer Center researcher Ty Borders, Ph.D., analyzed nationally representative survey data from the National Cancer Institute to examine Pap test screening rates before and during the pandemic. A Pap test (or Pap smear) is a screening method that can detect cervical cancer or cell changes that may lead to cervical cancer, allowing for early detection and treatment. 

Results showed that the odds of a woman receiving a Pap test in the past year were 30% lower in 2022 compared to 2019, before the pandemic began.  

The substantial decline is concerning, given that cervical cancer is largely preventable with regular screening and early intervention says Borders, a professor in the UK College of Nursing and director of the Rural and Underserved Health Research Center.  

The study also found increased disparities in screening rates between rural and urban women. In 2022, only 48.6% of rural women reported receiving a Pap test in the past year, compared to 64% of urban women.  

Women from rural areas have historically had higher rates of cervical cancer incidence and mortality, so a widening urban-rural gap in screening during the pandemic is particularly troubling, Borders says.  

“The findings point to a need to expand access to cervical cancer screenings among all women, but especially those residing in rural areas, to prevent a possible uptick in future cervical cancer incidence and mortality,” said Borders. 

Disruptions to health care services during COVID-19 lockdowns likely contributed to the declines in screening, as many clinics temporarily suspended or scaled back routine procedures like Pap tests.  

Based on the results, health care providers may want to consider extra measures to ensure patients are up to date with recommended screenings, including expanding the availability of appointments for cervical cancer screenings and reminding patients of screening due dates. 

This study was supported by cooperative agreement U1CRH30041 from the Federal Office of Rural Health Policy (FORHP), Health Resources & Services Administration (HRSA), and the U.S. Department of Health and Human Services (HHS). The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement, by FORHP, HRSA, HHS, or the U.S. Government.