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 for cervical cancer include the public health evidence-base 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 2017, nearly 13,000 women in the United States were diagnosed with cervical cancer, and about 4,000 died from the disease11
- The average annual medical cost of cervical cancer varies widely depending on the phase of treatment. For example, the average mean cost of care during the last year of life could be as high as $118,000*(a) for patients younger than 65 years and as high as $79,000 for those older than 65.2
- 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 (46%) than in African Americans (36%) and in women younger than 50 (57%) than in women 50 and older (31%).3
- The most common cause of cervical cancer is the human papillomavirus (HPV). Tobacco also increases the risk of cervical cancer.
The United States Preventive Services Task Force recommends thisexternal icon cervical cancer screening schedule for women aged 21 to 65 years.
The two tests for cervical cancer screening are the Pap test and the human papillomavirus (HPV) test. Both tests begin by scraping cells from the cervix of the uterus and sending them to a laboratory.
The Pap test is a cytologic assessment that looks for changes that might become cervical cancer. The HPV test looks for the virus (human papillomavirus) that can cause these cell changes. Most health plans under the Affordable Care Act must cover a set of preventive services — including cervical cancer screening tests — at no cost to the employee.
In Rankings of Preventive Services for the U.S. Populationexternal icon, 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 screening 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).4 In comparison with other preventive interventions and with cost-effectiveness benchmarks, cervical cancer screening is highly cost-effective.5 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.
*Cost were measured in a2010 US dollars.
1. U.S. Cancer Statistics Working Group. U.S. Cancer Statistics Data Visualizations Tool, based on 2019 submission data (1999-2017): U.S. Department of Health and Human Services, Centers for Disease Control and Prevention and National Cancer Institute; www.cdc.gov/cancer/dataviz, released in June 2020.
2. . Mariotto AB, Robin Yabroff K, Shao Y, Feuer EJ, Brown ML. Projections of the cost of cancer care in the United States: 2010–2020. J Natl Cancer Inst. 2011;103(2):117–128.
3. Howlader N, Noone AM, Krapcho M, Miller D, Brest A, Yu M, Ruhl J, Tatalovich Z, Mariotto A, Lewis DR, Chen HS, Feuer EJ, Cronin KA (eds). SEER Cancer Statistics Review, 1975-2017, National Cancer Institute. Bethesda, MD, https://seer.cancer.gov/csr/1975_2017/external icon, based on November 2019 SEER data submission, posted to the SEER web site, April 2020.
4. Mandelblatt JS, Lawrence WF, Womack SM, Jacobson D, Bin YI, Yi-Ting H. et al. Benefits and costs of using HPV testing to screen for cervical cancer. JAMA. 2002; 287(18): 2372-2381.
5. Eichler H, Kong SX, Gerth WC, Mavros P, Jonsson B. Use of cost-effectiveness analysis in health-care resource allocation decision-making: how are cost-effectiveness thresholds expected to emerge? Value Health. 2004; 7(5): 518-528.