The association between affordable care act implementation and the prevalence of women having ever received a Pap smear
Year: 2024
Type: article
Study design: Observational Study
Abstract: BACKGROUND: To assess if implementation of the 2010 Patient Protection and Affordable Care Act (ACA) was associated with changes in the prevalence of women having ever received a pap smear. METHODS: This study utilised the publicly available Centre for Disease Control National Survey of Family Growth (NSFG) data set. This was a serial cross-sectional study. The comparison groups were defined as women who received cancer screening and prevention interventions prior to full implementation of the ACA (2011-2013) and post full implementation (2017-2019). The primary outcome was self-reporting receipt of a Papanicolaou (Pap) smear. Secondary outcomes included HPV vaccination and mammogram rates. Anonymized patient information was collected from the nationally representative dataset, and analyses were performed utilising STATA 18. RESULTS: = 6141) 'Post-ACA implementation' (Post ACA). The proportion of women who were 21 years and older and ever had a Pap smear in the Pre ACA group (96.0%) was higher than that of the Post ACA group (94.1%) (OR 0.66 (0.49-0.91)). In contrast, HPV vaccination rates rose, and mammogram rates remained stable in the Post ACA period. CONCLUSION: A decrease in proportion of women ever having had a Pap smear despite implementation of health policies to increase access to preventive measures suggests further interventions to improve access to cervical cancer screening are warranted.
Authors: Eric M. Ganz, Benjamin Brown, Heather Smith, Lawren Wellisch, Megha Gupta, Stephen M. Wagner
Language: English
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,390
OpenAlex ID: W4401822062