Asking About Cervical Cancer Screening in National Surveys: Implications for Health Literacy and Research.

Abstract

In 2022, the Behavioral Risk Factor Surveillance System (BRFSS) changed their question wording to ask participants whether they had ever had a "cervical cancer screening test" rather than asking specifically about Pap or HPV tests. This resulted in a drop from 93.7% of respondents reporting a prior Pap test in the 2020 BRFSS to 61.4% of respondents reporting a prior cervical cancer screening test in 2022. A comparable drop was not observed in the National Health Interview Survey from 2021 to 2023, which did not change their question wording. Thus, the observed decrease in positive responses to this question in the BRFSS survey from 2020 to 2022 is unlikely to accurately reflect screening behavior and instead highlights a lack of knowledge about cervical cancer screening tests and the purpose of Pap tests. Clinicians and public health practitioners should use this information to improve education and awareness regarding cervical cancer screening tests, especially with the advent of additional screening options such as HPV self-collection, to enhance public understanding and informed choice.