Back to Top Skip to main content

Surveillance Snapshot: Cervical Cancer Screening Among U.S. Military Service Women in the Millennium Cohort Study, 2003–2015

Lt. Cmdr. Leslye Green, staff obstetrician and gynecologist, Naval Hospital Pensacola (NHP), uses a model to discuss cervical cancer with a patient at NHP. According to the Centers for Disease Control and Prevention (CDC), cervical cancer is highly preventable because screening tests for cervical cancer and vaccines to protect against human papillomavirus (HPV), which is the main cause of cervical cancer, are readily available. Cervical cancer is highly treatable and associated with long survival and good quality of life when it is detected early. (U.S. Navy photo by Mass Communication Specialist 1st Class Brannon Deugan) Lt. Cmdr. Leslye Green, staff obstetrician and gynecologist, Naval Hospital Pensacola (NHP), uses a model to discuss cervical cancer with a patient at NHP. According to the Centers for Disease Control and Prevention (CDC), cervical cancer is highly preventable because screening tests for cervical cancer and vaccines to protect against human papillomavirus (HPV), which is the main cause of cervical cancer, are readily available. Cervical cancer is highly treatable and associated with long survival and good quality of life when it is detected early. (U.S. Navy photo by Mass Communication Specialist 1st Class Brannon Deugan)

Recommended Content:

Medical Surveillance Monthly Report

The Millennium Cohort Study is a prospective study that was initiated in 2001 and includes over 200,000 current and prior U.S. military service members.1 Questionnaires are sent to participants approximately every 3 years to collect information on service related experiences as well as mental, physical, and behavioral health. Compliance with contemporary cervical cancer screening recommendations was determined among service women enrolled in the Millennium Cohort Study during 2003–2015. Current cervical cancer screening recommendations call for a Pap smear alone every 3 years in women aged 21–65 years or for a human papillomavirus (HPV) DNA test with or without a Pap test every 5 years for women aged 30–65 years.2 Women were considered eligible for screening in a given year if they were aged 21–62 years on the last day of the year, had served in the active component (i.e., at least 9 months in active component pay and strength rosters) for the concurrent year and 2 years before, had not had a hysterectomy, and had not separated from the military. Women were considered compliant with screening recommendations between 2003–2015 if they had a medical report of a Pap smear in the year of assessment or prior 2 calendar years. Women were also considered compliant with screening recommendations in 2013–2015 if they had HPV DNA testing completed within the previous 5 years.

Overall, among U.S. service women in the Millennium Cohort Study, the compliance rate increased from 61.2% in 2003 to a peak of 83.1% in 2010 then declined to a low of 59.8% in 2015 (Figure). During the first 7 years of the study period, compliance was highest among Air Force personnel. Between 2013 and 2015, compliance was highest among Coast Guard personnel. Compliance was lowest among Navy personnel in all but 1 year (2004) of the 13-year period. Compliance was also consistently higher for service women who had initiated the HPV vaccine than for women who had not (on average 6.3% higher). No differences in compliance were observed by cigarette smoking status, which was used as a surrogate measure of other health behaviors.

Author affiliations: Deployment Health Research Department in the Military Population Health Directorate, Naval Health Research Center, San Diego, CA (Dr. Matsuno, Dr. Porter, Mr. Warner, CAPT Wells); Leidos, San Diego, CA (Dr. Matsuno, Dr. Porter, Mr. Warner).

Disclaimer: One of the authors of this work is a military service member or employee of the U.S. Government. This work was prepared as part of their official duties. Title 17, U.S.C. §105 provides that copyright protection under this title is not available for any work of the U.S. Government. Title 17, U.S.C. §101 defines a U.S. Government work as work prepared by a military service member or employee of the U.S. Government as part of that person’s official duties. This report was supported by the Military Operational Medicine Research Program under work unit no. 60002. The views expressed in this article are those of the authors and do not necessarily reflect the official policy or position of the Department of the Navy, Department of Defense, or the U.S. Government.

REFERENCES

1. Gray GC, Chesbrough KB, Ryan MA, et al. The Millennium Cohort Study: a 21-year prospective cohort study of 140,000 military personnel. Mil Med. 2002;167(6):483–488.

2. U.S. Preventive Services Task Force. Final recommendation statement. Cervical cancer: screening. https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/cervical-cancer-screening?ds=1&s=pap. Accessed 9 April 2020.

FIGURE. Cervical screening rates among service women, by branch of service, U.S. Armed Forces, 2003–2015

You also may be interested in...

Update: Incidence of Inguinal Hernia and Repair Procedures and Rate of Subsequent Pain Diagnoses, Active Component Service Members, U.S. Armed Forces, 2010–2019

Article
9/1/2020
Senegalese and Vermont National Guard medical care professionals repair a hernia at the Hopital de la Paix in Ziguinchor, Senegal, Feb. 14, 2018. Vermont Guardsmen work alongside Senegalese medical personnel to obtain real-world experience while providing valuable medical services as part of a Medical Readiness Training Exercise. (U.S. Army National Guard photo by Sgt. Avery Cunningham)

Recommended Content:

Medical Surveillance Monthly Report

Update: Routine Screening for Antibodies to Human Immunodeficiency Virus, Civilian Applicants for U.S. Military Service and U.S. Armed Forces, Active and Reserve Components, January 2015–June 2020

Article
9/1/2020
Spc. Jayson Sanchez of the Army Reserve’s 77th Sustainment Brigade receives a blood draw from phlebotomist Nikole Horrell during the mass medical-readiness event hosted Aug. 8-9, 2015 by the Army Reserve’s 99th Regional Support Command at Joint Base McGuire-Dix-Lakehurst, N.J., in an effort to increase Soldier readiness throughout the northeastern United States. More than 300 Army Reserve and Army National Guard Soldiers had the opportunity to take care of their Periodic Health Assessments, dental exams, vision screenings, HIV blood draws, immunizations, hearing tests, LOD processing and temporary/permanent profiles during the event. (U.S. Army photo by Sgt. Salvatore Ottaviano, 99th Readiness Division)

Recommended Content:

Medical Surveillance Monthly Report

Update: Surveillance of Spotted Fever Rickettsioses at Army Installations in the U.S. Central and Atlantic Regions, 2012–2018

Article
9/1/2020
This photograph depicts a dorsal view of a female Gulf Coast tick, Amblyomma maculatum. This tick species is a known vector for Rickettsial organisms, Rickettsia parkeri, and Ehrlichia ruminantium, formerly Cowdria ruminantium. R. parkeri is a member of the spotted fever group of rickettsial diseases affecting humans, while E. ruminantium causes heartwater disease, an infectious, noncontagious, tick-borne disease of domestic, and wild ruminants, including cattle, sheep, goats, antelope, and buffalo. Note the considerably smaller scutum, or shield covering only a small region of its dorsal abdomen, unlike its male counterpart, an example of which can be seen in PHIL 10877, and 10878, which sports a scutum covering its entire dorsal abdomen. The smaller scutum in the female enables its abdomen to expand considerably, leading to an engorged appearance after ingesting its host blood meal. (Content provider: CDC/ Dr. Christopher Paddock)

Recommended Content:

Medical Surveillance Monthly Report

DHA recognizes 25 years of AFHSB's health surveillance journal

Article
8/12/2020
Medical technicians wearing masks and entering information on a computer

25 Years of Surveillance Reporting in Monthly Journal

Recommended Content:

Armed Forces Health Surveillance Branch | Medical Surveillance Monthly Report

Commentary: The Limited Role of Vaccines in the Prevention of Acute Gastroenteritis

Article
8/1/2020
This is a medical illustration of drug-resistant, Shigella sp. bacteria, presented in the Centers for Disease Control and Prevention (CDC) publication entitled, Antibiotic Resistance Threats in the United States, 2019 (Content provider: CDC/Antibiotic Resistance Coordination and Strategy Unit; Photo credit:  CDC/Stephanie Rossow).

Commentary: The Limited Role of Vaccines in the Prevention of Acute Gastroenteritis

Recommended Content:

Medical Surveillance Monthly Report

Diarrhea and Associated Illness Characteristics and Risk Factors Among British Active Duty Service Members at Askari Storm Training Exercise, Nanyuki, Kenya, January–June 2014

Article
8/1/2020
This illustration was updated in the Centers for Disease Control and Prevention’s (CDC’s) Antibiotic Resistance Threats in the United States, 2019. This illustration depicts a three-dimensional computer-generated image of a cluster of drug-resistant, curly-cue shaped, Campylobacter sp. bacteria. The artistic recreation was based upon scanning electron microscopic imagery (Content provider: CDC/Antibiotic Resistance Coordination and Strategy Unit; Photo credit:  CDC/Alissa Eckert).

Diarrhea and Associated Illness Characteristics and Risk Factors Among British Active Duty Service Members at Askari Storm Training Exercise, Nanyuki, Kenya, January–June 2014

Recommended Content:

Medical Surveillance Monthly Report

Update: Incidence of Acute Gastrointestinal Infections and Diarrhea, Active Component, U.S. Armed Forces, 2010–2019

Article
8/1/2020
This illustration was updated in the Centers for Disease Control and Prevention’s (CDC’s) Antibiotic Resistance Threats in the United States, 2019. This illustration depicts a three-dimensional, computer-generated image of a group of extended-spectrum ß-lactamase-producing Enterobacteriaceae bacteria, in this case, Escherichia coli. The artistic recreation was based upon scanning electron microscopic imagery. This is an excellent visual example of the long, whip-like, peritrichous flagellae, sprouting from what appear to be random points on the organism’s exterior, as well as the numerous shorter, and finer fimbriae, imparting a furry look to the bacteria (Content provider: CDC/Antibiotic Resistance Coordination and Strategy Unit; Photo credit:  CDC/Alissa Eckert).

Update: Incidence of Acute Gastrointestinal Infections and Diarrhea, Active Component, U.S. Armed Forces, 2010–2019

Recommended Content:

Medical Surveillance Monthly Report

Surveillance Snapshot: Norovirus Outbreaks in Military Forces, 2015–2019

Article
8/1/2020
Based on electron microscopic imagery, this three-dimensional illustration provides a graphical representation of a single norovirus virion. Though subtle, the different colors represent different regions of the organism’s outer protein shell, or capsid (Content provider: CDC/Jessica A. Allen; Photo credit: CDC/Alissa Eckert).

Surveillance Snapshot: Norovirus Outbreaks in Military Forces, 2015–2019

Recommended Content:

Medical Surveillance Monthly Report

Epidemiology of Functional Neurological Disorder, Active Component, U.S. Armed Forces, 2000-2018

Article
7/1/2020
MRI film (iStock.com/temet)

Epidemiology of Functional Neurological Disorder, Active Component, U.S. Armed Forces, 2000-2018

Recommended Content:

Medical Surveillance Monthly Report

Hearing Conservation Measures of Effectiveness Across the Department of Defense

Article
7/1/2020
Kori Reese, an audiology technician at Naval Branch Health Clinic Jacksonville’s occupational health clinic, conducts a hearing exam with Airman Diosney Moraga. Naval Hospital Jacksonville and Navy Medical Readiness and Training Command Jacksonville won the Chief of Naval Operation’s Award for Achievement in Ashore Safety (large non-industrial command) for Fiscal Year 2019. (U.S. Navy photo by Jacob Sippel).

Recommended Content:

Medical Surveillance Monthly Report

Alcohol-Related Emergency Department Visits, Hospitalizations, and Co-Occurring Injuries, Active Component, U.S. Armed Forces, 2009–2018

Article
7/1/2020
Sailors simulate a drunk driving accident during a Keep What You've Earned fair on Naval Base Kitsap Bangor. The fair encourages responsible alcohol use by celebrating the achievements in the sailors' Navy careers and actively engages sailors as advocates for responsible drinking. (U.S. Navy photo by Mass Communication Specialist 3rd Class Chris Brown)

Recommended Content:

Medical Surveillance Monthly Report

Animal-Related Injuries in Veterinary Services Personnel, U.S. Army, 2001–2018

Article
6/1/2020
Robin Jones (right), a retired Soldier and current veterinarian who works at the Fort Stewart Veterinary Treatment Facility, is being assisted by Spc. Krystall Shaw, an animal care specialist assigned to the clinic, as Jones uses a stethoscope on a patient to listen for proper breathing at the Fort Stewart Veterinary Treatment Facility on Fort Stewart, Georgia, April 10, 2020. The staff at the clinic continues to provide aid to working and privately owned animals during the COVID-19 pandemic. (U.S. Army photo by Sgt. Zoe Garbarino)

Recommended Content:

Medical Surveillance Monthly Report

Brief Report: Direct Care Cost of Heat Illness to the Army, 2016–2018

Article
6/1/2020
Thermometer (Photo credit: U.S. Army)

Brief Report: Direct Care Cost of Heat Illness to the Army, 2016–2018

Recommended Content:

Medical Surveillance Monthly Report

Summary of the 2018–2019 Influenza Season Among Department of Defense Service Members and Other Beneficiaries

Article
6/1/2020
A flu shot vaccination sits on a table at 184th Sustainment Command headquarters in Monticello, Mississippi on Feb. 8, 2020. The single best way to prevent seasonal flu is to get vaccinated each year, but good wellness habits like covering your cough and washing your hands often can help prevent the spread of germs. (Mississippi Army National Guard photo by Staff Sgt. Veronica McNabb)

Recommended Content:

Medical Surveillance Monthly Report

Letter to the Editor: G6PD Deficiency in the Tafenoquine Era

Article
6/1/2020
CDC/James Gathany This image shows a female Anopheles funestus mosquito that had landed on a human skin surface and was in the process of obtaining its blood meal. A. funestus is a known vector for the parasitic disease malaria.

Letter to the Editor: G6PD Deficiency in the Tafenoquine Era

Recommended Content:

Medical Surveillance Monthly Report
<< < 1 2 3 4 5  ... > >> 
Showing results 1 - 15 Page 1 of 12

DHA Address: 7700 Arlington Boulevard | Suite 5101 | Falls Church, VA | 22042-5101

Some documents are presented in Portable Document Format (PDF). A PDF reader is required for viewing. Download a PDF Reader or learn more about PDFs.