FIGURE 2.

Algorithm for assigning failure type in the cervical cancer screening process. * Abnormal screening results defined as atypical squamous cell of undetermined significance (ASC‐US)/HPV+ or more severe result. The 2012 national cervical cancer screening guidelines were used to determine this for those who had Pap test alone, co‐testing or HPV reflex. Determination depends on age as per clinical guidelines. **Abnormal results that should receive follow‐up testing on alternate time intervals and not immediate colposcopy [i.e., NILM / high‐risk (hr) HPV positive or ASC‐US/ hrHPV negative] as per management guidelines for cervical abnormalities.13,14 The latter two abnormal results were considered screening test failures because findings may not have warranted an immediate colposcopy referral. Although some of these results may have been the second or third abnormal findings under the co‐testing or HPV reflex algorithm, they were treated equally as the first co‐testing/HPV reflex result for the purpose of this analysis given uncertainty in follow‐up regimens (i.e., they do not always trigger immediate colposcopy referral depending on if it is the first or second/repeated test). Further, the design of the lookback period in this study precluded determining if a result was from a repeat test. †Six women had missing results for Pap test and were excluded as it was not possible to correctly assign their care gap.