TABLE 2. Comparison of cervical cancer screening rates*,† before, during, and after stay-at-home order,§ by age group — Kaiser Permanente Southern California, January 1–September 30, 2019, and January 1–September 30, 2020.
| Period (relative to stay-at-home order) | Pap tests rate† |
HPV tests rate† |
||||
|---|---|---|---|---|---|---|
| Women aged 21–29 yrs |
Women aged 30–65 yrs |
|||||
| 2019 | 2020 | Rate ratio¶ (95% CI) | 2019 | 2020 | Rate ratio¶ (95% CI) | |
| Jan 1–Mar 18 (before stay-at-home order) |
3.00 |
2.78 |
0.92 (0.91–0.94) |
1.89 |
1.82 |
0.97 (0.95–0.98) |
| Mar 19–Jun 11 (during stay-at-home order) |
2.63 |
0.59 |
0.22 (0.22–0.23) |
1.69 |
0.30 |
0.18 (0.17–0.18) |
| Jun 12–Sep 30 (after stay-at-home order) | 2.64 | 1.89 | 0.71 (0.70–0.73) | 1.66 | 1.26 | 0.76 (0.75–0.77) |
Abbreviations: CI = confidence interval; HPV = human papillomavirus; Pap = Papanicolaou cervical cancer test.
* Cervical cancer screening test used is a Pap test for women aged 21–29 years, and Pap test and HPV testing for women aged 30–65 years through July 15, 2020, and HPV testing alone after July 15, 2020. A combination of HPV testing and HPV and Pap (cotesting) is used in this group per U.S. Preventive Services Task Force guidelines; HPV testing rate was examined for simplicity.
† Tests per 100 person-months. For women aged 21–29 years, rates were calculated as (Pap tests per person-month) x 100. For women aged 30–65 years, rates were calculated as (HPV tests per person-month) x 100.
§ Three contiguous but distinct periods in the year 2020 were analyzed. “Before Stay-At-Home Order” refers to all clinic encounter dates in 2020 before the state of California announced its stay-at-home executive order on March 19, 2020 (i.e., January 1–March 18, 2020). “During Stay-At-Home Order” refers to the entire period in which the state stay-at-home order was in effect, from the announcement of the order to the reopening of most essential businesses in Phase 3 of the reopening plan supervised by the California Department of Public Health (March 19–June 11, 2020). “After Stay-At-Home Order ” is inclusive of all dates after the reopening until the study cutoff date (June 12–September 30, 2020).
¶ 2020 Rate/2019 Rate.