Cervical Cancer Screening Rose Through 2024, but Racial and Regional Gaps Persist

Annual cervical cancer screening rates increased across every demographic group studied from 2019 to 2024, but disparities by race, ethnicity, and region persisted, according to a cross-sectional study published in JAMA Network Open.

Using the Epic Cosmos database, which draws on medical records from more than 1805 hospitals, the investigators examined screening trends before and after the COVID-19 pandemic, noting that longitudinal evidence on such trends across demographic groups has been limited.

The analysis included patients assigned female at birth aged 21 to 64 years with no history of cervical cancer and at least 1 clinical encounter in a given study year; annual samples grew from about 9 million to 16 million. Rates reflected the share screened at least once each year. Among racial and ethnic groups, Hispanic patients had the largest increase, from 9.85% (95% CI, 9.80%-9.90%) in 2019 to 15.51% (95% CI, 15.47%-15.55%) in 2024. Non-Hispanic White patients had the highest rates from 2019 through 2021 but the smallest increase of these groups, from 10.98% to 13.85%. American Indian, Alaska Native, Native Hawaiian, and Pacific Islander patients had the lowest rates in all 6 years.

Rates fell in most groups in 2020, coinciding with the pandemic, and rebounded beginning in 2021. The exception was patients aged 21 to 29 years, whose rates rose every year, from 5.28% to 14.05%. Patients aged 30 to 49 years had the highest rates of any age group each year, and non–English-speaking patients consistently had higher rates than English-speaking patients. Rates in the West and South trailed those in the Midwest and Northeast every year; in 2024, the South had the lowest rate, at 12.27%.

Limitations cited by the investigators included possible coding variation across health systems; reliance on health systems using Epic’s electronic medical record system, which is more commonly adopted by larger, well-resourced systems; and potential selection and collider bias. They added that the descriptive design cannot identify what drove the gains among Hispanic patients. The authors said the persistent inequities warrant attention in future research and public health efforts.

Source: Xie Y, Nguyen L, Le YC, Zamorano A. Cervical cancer screening rates by race and ethnicity, age, language, and census region. JAMA Netw Open. 2026;9(10):e2639938. doi:10.1001/jamanetworkopen.2026.39938