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Cervical Cancer Screening

2 women discussing medical file

Once assessment and planning have been completed, including analysis of the collected data, the next step is implementing the strategies and interventions that will comprise the workplace health program. The intervention descriptions on this page include the public health evidence-baseThe development, implementation, and evaluation of effective programs and policies in public health through application of principles of scientific reasoning, including systematic uses of data and information systems, and appropriate use of behavioral science theory and program planning models. for each intervention, details on designing interventions for cervical cancer screening, and links to examples and resources.

Multi-component interventions that include communications/media, education, reduction of barriers, and enhanced access to care will increase employees’ awareness of and participation in screening, prevention, and treatment.

Before implementing any interventions, the evaluation plan should also be developed. Potential baseline, process, health outcomes, and organizational change measures for these programs are listed under evaluation of cervical cancer screening programs.

Cervical cancer is the easiest female cancer to prevent, because there is a vaccine and a screening test available. It also is highly curable when found and treated early.

  • In 2007, 12,280 women in the United States were diagnosed with cervical cancer, and 4,021 died from the disease1
  • The direct medical care costs associated with cervical cancer were estimated to equal $1.7 billion in 1996 dollars2
  • The 5-year survival rate for patients diagnosed with localized cervical cancer is 92%
  • Cervical cancer is diagnosed at an early stage more often in whites (53%) than in African Americans (44%) and in women younger than 50 (62%) than in women 50 and older (37%)
  • The most common cause of cervical cancer is the human papillomavirus (HPV). Tobacco use and obesity also increase the risk of cervical cancer

The United States Preventive Services Task Force recommends:

The Pap test is conducted by scraping cells from the cervix of the uterus and sending them to a laboratory for cytologic assessment. Newer screening methods for cervical cancer include thin-layer preparations, computer-assisted screening and testing for human papillomavirus (HPV). At present, the U.S. Preventive Services Task Force finds insufficient evidence to compare these with the Pap test. However, all these methods are FDA-approved and appropriate to consider for a health benefits package.

In Rankings of Preventive Services for the U.S. Population, the Partnership for Prevention provides an approach to ranking preventive services according to their clinically preventable burden (CPB) and cost effectiveness (CE). CPB is the disease, injury and premature death that would be prevented if the service were delivered to all people in the target population. With this approach, cervical cancer screeningScreening means checking your body for cancer before there are signs or symptoms of the disease. The routine performance of screening tests may find many kinds of cancer early, when treatment is likely to work best. received a ranking of 7 on a scale of 1-10, with 10 the highest ranking.

One study estimated that the cost-effectiveness ratio of a conventional Pap test repeated every three years up to the age of 75 was $11,830 per quality adjusted life year (QALY) saved (in year 2000 dollars).3 In comparison with other preventive interventions and with cost-effectiveness benchmarks, cervical cancer screening is highly cost-effective.4 The harms of screening for cervical cancer are small compared to the benefits. False-positive screening results may lead to unnecessary treatment of low-grade lesions, unnecessary evaluations and biopsies, and psychological stress.

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Health-related programs for cervical cancer screening

Employee programs refer to activities that include active employee involvement, such as classes, seminars or competitions. Employee programs are frequently provided on-site at the workplace.

Employee health surveys in the workplace provide assessment and implementation opportunities

One-on-one patient education is recommended to increase cervical cancer screening
  • One-on-one education is defined as communication of information to individual clients by telephone or through face-to-face encounters, conducted by a healthcare or allied health professional (e.g., health educator) or by a lay health advisor or volunteer
  • The education sessions can occur in clinical settings, homes, or worksites
  • The education content can address a general target population or be tailored to the unique circumstances and characteristics of specific individuals that are identified through individual assessments
  • One-on-one education can be supplemented by the use of:
    • Brochures
    • Informational letters, or
    • Reminders (printed or telephone)
Worksite-wide education campaigns increase use of screening services

Tools and Resources (more)

  • The Centers for Disease Control and Prevention's (CDC) Inside Knowledge Campaign includes a number of education materials such as fact sheets, campaign messages, and links to support and provider organizations to raise awareness of the five main types of gynecologic cancer: cervical, ovarian, uterine, vaginal, and vulvar
  • Additional CDC resources for cervical cancer are available including basic information, statistics, podcasts, and links to other organizations
  • The Partnership for Prevention’s Investing in Health: Evidence-Based Health Promotion Practices for the Workplace describes multiple workplace programs to encourage cancer screening, including speaking events, reminders, flyers, and other approaches. This booklet can be downloaded from the website or ordered
  • The local chapter of the American Cancer Society (ACS) may offer educational programs, brochures, and other services. Chapter locations are listed on the ACS website

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Health-related policies for cervical cancer screening  

Workplace policies promote a corporate “culture of good healthThe creation of a working environment where employee health and safety is valued, supported and promoted through workplace health programs, policies, benefits, and environmental supports. Building a Culture of Health involves all levels of the organization and establishes the workplace health program as a routine part of business operations aligned with overall business goals. The results of this culture change include engaged and empowered employees, an impact on health care costs, and improved worker productivity..”

The primary workplace based supports for encouraging cervical cancer screening are education programs and health benefits.

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Health benefits to support cervical cancer screening5

Employee health benefits are part of an overall compensation package and affect an employee’s willingness to seek preventive services and clinical care.

Provide coverage for clinical preventive services such as cervical cancer screening
Require health plans to send reminders to both employee members and providers about cervical cancer screening
  • Employee and provider reminders tell people that it is time to schedule a Pap test or that they are late (recall) for a recommended screening
  • Employee reminders can be mailed as a letter or postcard or communicated as part of a telephone call
  • Additional information about the health benefits of the screening, strategies to overcome barriers to screening and assistance with scheduling a screening test can also be included as part of the reminder

Tools and Resources (more)


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Environmental support for cervical cancer screening

Environmental support provides a worksite physically designed to encourage good health.

The primary workplace-based supports for encouraging cervical cancer screening are education programs and health benefits.


Tools and Resources

  • In addition to the following suggestions for health-related programs and policies, health benefits, and environmental support for cervical cancer screening programs, see recommendations for obesity, physical activity, and tobacco use that relate to cervical cancer risk
  • The American Cancer Society’s Workplace Solutions (http://www.acsworkplacesolutions.com/) has a number of cancer programs
  • Why Invest? Recommendations for Improving Your Prevention Investment is a report developed by the Partnership for Prevention with support from CDC that includes examples from organizations investing in preventive services for their employees and recommendations to employers for increasing the coverage and use of preventive services

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