Cervical Cancer Screening Rates Drop Sharply Among Young U.S. Women, JAMA Study Finds

Nearly a third of U.S. women in their twenties have never had a cervical cancer screening, according to a study published in JAMA Network Open, and that number has been climbing for almost two decades.

Researchers at the Medical University of South Carolina analyzed National Health Interview Survey data collected between 2005 and 2023. The study included more than 23,500 women ages 21 to 29 and more than 82,700 women ages 30 to 65, all of whom were eligible for screening under current guidelines. What they found wasn't a one-year blip. The proportion of women ages 21 to 29 who reported never receiving cervical cancer screening rose from 12.5 percent in 2005 to 31.9 percent in 2023, according to data published in JAMA Network Open.

That's not a coverage confusion problem or a guideline gray zone. The U.S. Preventive Services Task Force recommends Pap testing every three years starting at age 21. The American College of Obstetricians and Gynecologists issued updated guidance in 2026 that keeps that three-year cadence for women ages 21 to 29, while shifting to prefer primary HPV testing every five years for women 30 to 65. The test exists. The recommendation is clear. And roughly one in three young women in this study had still never walked through that door.

"The results are truly shocking and very concerning," lead author Kalyani Sonawane, PhD, assistant director for data science and analytics at MUSC's Hollings Cancer Center, told Healio.

The gap isn't evenly distributed. According to reporting by CNN on the study, about 39 percent of young women with a high school education had never been screened, compared with 17 percent of those with graduate degrees. Among women ages 30 to 65, nearly 32 percent of those without insurance had never been screened. Researchers also identified racial minorities and women in Southern states as the groups most likely to have never received screening, according to TechTarget's coverage of the findings, the same populations already carrying a disproportionate burden of late-stage cervical cancer diagnoses.

And late-stage diagnoses are going up. Regional-stage and distant-stage cervical cancer incidence increased by roughly 2 percent per year between 2017 and 2023 among women ages 30 to 65, according to data reported by Newsweek. The researchers were careful to say the study wasn't designed to prove causation between screening gaps and rising advanced-disease rates, but the parallel trend lines are hard to ignore.

One complicating wrinkle: HPV vaccination rates among young women have improved significantly over the same period. The study found that the proportion of women ages 21 to 29 reporting at least one HPV vaccine dose rose from 5.7 percent in 2008 to 54 percent in 2019, according to the JAMA Network Open publication. Vaccination protects against the strains that cause most cervical cancers, but it doesn't eliminate the need for screening. Some high-risk HPV types aren't covered by the vaccine, and not every woman in the study cohort was vaccinated before sexual debut.

The study also measured something slightly different from most national surveys, which typically ask whether a woman is "up to date" on screening. Sonawane's team asked whether women had ever been screened at all in their lifetime, a harder number, and a more alarming one.

Cervical cancer screening has a straightforward value proposition: catch precancerous cell changes before they become invasive disease. The American Cancer Society estimates roughly 13,490 new cases of invasive cervical cancer will be diagnosed in 2026, with approximately 4,200 deaths, according to Cancer Health's coverage of the paper. Those numbers reflect decades of progress, but progress that appears to be stalling.

The researchers acknowledged that screening data was self-reported, which introduces recall bias, and that neither the survey nor cancer registry data included HPV status. Those are real limits. But the trend across 18 years and more than 106,000 respondents is difficult to wave off as noise.

What the study doesn't answer is why women aren't getting screened. Researchers didn't examine motivations directly, though separate literature points to the familiar trio: cost, logistics, and anxiety about the exam itself. Those are solvable problems, but they require investment at the system level, not just a reminder from a clinician at an annual visit that fewer and fewer young women are attending.

Sources cited:
- JAMA Network Open (via Today's Clinical Lab) (https://www.clinicallab.com/study-finds-nearly-one-in-three-young-women-in-the-us-never-received-cervical-cancer-screening-28784)
- Healio (https://www.healio.com/news/hematology-oncology/20260908/truly-shocking-nearly-onethird-of-young-women-unscreened-for-cervical-cancer)
- CNN (https://www.cnn.com/2026/09/01/health/cervical-cancer-screening-women-wellness)
- Newsweek (https://www.newsweek.com/1-in-3-young-american-women-have-never-had-a-life-saving-cancer-screening-12380935)
- Cancer Health (https://www.cancerhealth.com/article/third-young-women-never-screened-cervical-cancer)
- TechTarget HealthTech Analytics (https://www.techtarget.com/healthtechanalytics/news/366649183/Study-More-young-women-skip-cervical-cancer-screenings)