Chartbook on Healthy Living

Measures of Clinical Preventive Services: Screening

Clinical preventive services include screening for early detection of cancer and cardiovascular disease. Measures include:

• Women ages 21-65 years who received a Pap smear in the last 3 years.
• Invasive cervical cancer incidence per 100,000 women age 20 and over.
• Adults who received a blood pressure measurement in the last 2 years and can state whether their blood pressure was normal or high.

Women Who Received a Pap Smear

Women ages 21-65 years who received a Pap smear in the last 3 years, by education and race, 2000-2010

Left Chart:

Right Chart:

Key: AI/AN = American Indian or Alaska Native.
Source: Centers for Disease Control and Prevention, National Center for Health Statistics, National Health Interview Survey, 2000-2010.
Denominator: Women ages 21-65.
Note: Measure is age adjusted. Data for this measure are not collected every year.

• Importance: Screening with Pap smears can detect high-grade precancerous cervical lesions that can be removed before they become cancerous.
• Trends: From 2000 to 2010, the percentage of women ages 21-65 years who received a Pap smear in the last 3 years decreased overall, among White women, among high school graduates and women with any college.
• Groups With Disparities: In all years, the percentage of women who received a Pap smear was lower:
  • Among Asian women compared with White women.
  • Among women with less than a high school education and high school graduates compared with women with any college.

Invasive Cervical Cancer Incidence

Invasive cervical cancer incidence per 100,000 women age 20 years and over, by age and race, 2004-2010

Left Chart:

2008 Achievable Benchmark: 7.4.

Right Chart:

2008 Achievable Benchmark: 7.4.

Key: API = Asian or Pacific Islander; AI/AN = American Indian or Alaska Native.
Source: Centers for Disease Control and Prevention and the National Cancer Institute, National Program of Cancer Registries, United States Cancer Statistics, 2004-2010.
Denominator: Women age 20 and over.
Note: Measures is age adjusted. Lower rates are better.

• Importance: Since the implementation of widespread screening with Pap smears, rates of invasive cervical cancer have fallen dramatically. Most cases now occur among women who have not been appropriately screened.
• Trends: From 2004 to 2010, rates of invasive cervical cancer fell overall and among all age groups. Rates fell among all racial groups except American Indians and Alaska Natives (AI/ANs).
• Groups With Disparities:
  • In 2010, rates of invasive cervical cancer were higher:
  • Among women ages 50-64 compared with women age 65 and over.
  • Among Black women compared with White women.
  • In 2010, rates of invasive cervical cancer were lower among Asian and Pacific Islander (API) women compared with White women.
• Achievable Benchmark:
  • The 2008 top 5 State achievable benchmark was 7.4 per 100,000 women. The top 5 States that contributed to the achievable benchmark are Connecticut, Kansas, Massachusetts, Utah, and Wisconsin.
  • At the current annual rates of decrease, this benchmark would not be attained for over 20 years overall and for most age and racial groups. API women could achieve the benchmark in 5 years and women age 65 and over could achieve it in 10 years.

Adults Who Received a Blood Pressure Measurement and Can State Whether Their Blood Pressure Was Normal or High

Adults who received a blood pressure measurement in the last 2 years and can state whether their blood pressure was normal or high, by insurance and race/ethnicity, 1998-2012

Left Chart:

Right Chart:

Source: Centers for Disease Control and Prevention, National Center for Health Statistics, National Health Interview Survey, 1998-2012.
Denominator: Adult civilian noninstitutionalized population.
Note: White and Black are non-Hispanic. Hispanic includes all races. Measures is age adjusted. Data for this measure are not collected every year.

• Importance: Early detection and treatment of high blood pressure can prevent heart failure, kidney failure, and stroke. Because high blood pressure typically causes no symptoms, screening is essential.
• Trends: From 1998 to 2012, the percentage of adults who received a blood pressure measurement in the last 2 years and can state whether their blood pressure was normal or high did not change overall or for any insurance, racial, or ethnic group.
• Groups With Disparities: In all years, the percentage of adults who received a blood pressure measurement was lower:
  • Among people who were uninsured compared with people with private insurance.
  • Among Hispanics compared with Whites.

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