{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,10]],"date-time":"2025-09-10T22:40:45Z","timestamp":1757544045512,"version":"3.40.5"},"reference-count":31,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2021,12,29]],"date-time":"2021-12-29T00:00:00Z","timestamp":1640736000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100008308","name":"Comprehensive Cancer Center, City of Hope","doi-asserted-by":"publisher","award":["P30CA013696"],"award-info":[{"award-number":["P30CA013696"]}],"id":[{"id":"10.13039\/100008308","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2022,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Cervical cancer screening guidelines have evolved over time with the incorporation of human papillomavirus (HPV) testing along with cytology. Current screening guidelines recommend cytological screening every 3\u00a0years or HPV testing with or without cytology every 5\u00a0years in women age 30\u201365\u00a0years. We examined the use of cervical cancer screening among average\u2010risk Medicaid beneficiaries.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Retrospective cohort study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Population<\/jats:title><jats:p>Women age 30\u201364\u00a0years at average risk for cervical cancer who underwent cervical cancer screening with cytology, co\u2010testing or primary HPV testing from 2013 to 2016.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The IBM Watson Health Multi\u2010State Medicaid MarketScan Database was used. Subsequent screening rates within 3\u00a0years of the index test were examined.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main outcome measure<\/jats:title><jats:p>The rate of repeat cervical cancer screening was analysed using a cumulative incidence function.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 265\u00a0083 patients were identified. Overall, 43.1% (<jats:italic>n<\/jats:italic>\u00a0=\u00a0114\u00a0312) had index co\u2010testing, 55.2% (<jats:italic>n<\/jats:italic>\u00a0=\u00a0146\u00a0309) had cytology and 1.7% (<jats:italic>n<\/jats:italic>\u00a0=\u00a04462) had primary HPV testing. The cumulative incidence of early, repeat cervical cancer screening was 3.9% at 12\u00a0months, 22.7% at 24\u00a0months and 33.3% at 36\u00a0months. During the period from 12 to 24\u00a0months after follow up, 20.9% of women underwent repeat screening while 19.4% underwent repeat screening 24\u201336\u00a0months after the index test. Among women who did not undergo repeat cervical cancer screening, a yearly gynaecological examination was performed in only 16\u00a0627 (10.7%) during year 2 and in 11\u00a0116 (8.8%) during year 3.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Among average\u2010risk Medicaid beneficiaries, cervical cancer screening is frequently overused. Women who do not undergo cervical cancer screening are unlikely to undergo routine gynaecological examination.<\/jats:p><\/jats:sec><jats:sec><jats:title>Tweetable Abstract<\/jats:title><jats:p>Among average\u2010risk Medicaid beneficiaries, cervical cancer screening is frequently overused.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1471-0528.17050","type":"journal-article","created":{"date-parts":[[2021,12,9]],"date-time":"2021-12-09T15:22:56Z","timestamp":1639063376000},"page":"1104-1111","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Patterns of cervical cancer screening among Medicaid beneficiaries"],"prefix":"10.1111","volume":"129","author":[{"given":"Jacquelyn","family":"Dillon","sequence":"first","affiliation":[{"name":"Duke University  Durham North Carolina USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ling","family":"Chen","sequence":"additional","affiliation":[{"name":"Columbia University College of Physicians and Surgeons  New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexander","family":"Melamed","sequence":"additional","affiliation":[{"name":"Columbia University College of Physicians and Surgeons  New York New York USA"},{"name":"Herbert Irving Comprehensive Cancer Center  New York New York USA"},{"name":"New York Presbyterian Hospital  New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Caryn M.","family":"St. Clair","sequence":"additional","affiliation":[{"name":"Columbia University College of Physicians and Surgeons  New York New York USA"},{"name":"Herbert Irving Comprehensive Cancer Center  New York New York USA"},{"name":"New York Presbyterian Hospital  New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"June Y.","family":"Hou","sequence":"additional","affiliation":[{"name":"Columbia University College of Physicians and Surgeons  New York New York USA"},{"name":"Herbert Irving Comprehensive Cancer Center  New York New York USA"},{"name":"New York Presbyterian Hospital  New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fady","family":"Khoury\u2010Collado","sequence":"additional","affiliation":[{"name":"Columbia University College of Physicians and Surgeons  New York New York USA"},{"name":"Herbert Irving Comprehensive Cancer Center  New York New York USA"},{"name":"New York Presbyterian Hospital  New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Allison","family":"Gockley","sequence":"additional","affiliation":[{"name":"Columbia University College of Physicians and Surgeons  New York New York USA"},{"name":"Herbert Irving Comprehensive Cancer Center  New York New York USA"},{"name":"New York Presbyterian Hospital  New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Melissa","family":"Accordino","sequence":"additional","affiliation":[{"name":"Columbia University College of Physicians and Surgeons  New York New York USA"},{"name":"Herbert Irving Comprehensive Cancer Center  New York New York USA"},{"name":"New York Presbyterian Hospital  New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dawn L.","family":"Hershman","sequence":"additional","affiliation":[{"name":"Columbia University College of Physicians and Surgeons  New York New York USA"},{"name":"Herbert Irving Comprehensive Cancer Center  New York New York USA"},{"name":"New York Presbyterian Hospital  New York New York USA"},{"name":"Joseph L. 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