Human Papillomavirus Vaccination and Pap Smear Uptake among Young Women in the United States: Role of Provider and Patient

Fangjian Guo, Jacqueline M. Hirth, Abbey B. Berenson

Research output: Contribution to journalArticlepeer-review

13 Scopus citations


Background: It as been reported that Pap smear use is higher among U.S. women who received the human papillomavirus (HPV) vaccine than unvaccinated women. This study assessed the role of provider and patient in the difference of Pap smear use by vaccination status. Methods: We conducted a cross-sectional study of 5416 young women (21-30 years of age) with detailed information on Pap smear use and HPV vaccination status from the National Health Interview Survey (NHIS) 2013-2015. Vaccinated women received at least one dose of HPV vaccine. Main outcomes included Pap smear in the past year, provider's recommendation for Pap smear, and patient-initiated Pap smear. Results: The prevalence of Pap smear in the past year was much higher among vaccinated women than unvaccinated women (67.5% vs. 52.8%, p < 0.001). Compared with unvaccinated women, vaccinated women were more likely to receive a provider's recommendation for Pap testing (60.8% vs. 50.8%, p < 0.001), to obtain Pap testing after receiving a provider's recommendation (75.1% vs. 67.9%, p = 0.004), and to initiate Pap testing themselves (57.7% vs. 38.2%, p < 0.001). However, among women who visited an obstetrician/gynecologist (OB/GYN) in the past year, the positive association between HPV vaccination and Pap smear recommendation and uptake vanished. Conclusions: Unvaccinated women who have not visited an OB/GYN in the past year are less likely to receive a recommendation for Pap testing from their providers or to initiate Pap testing themselves without a provider's recommendation. They should be encouraged to visit an OB/GYN provider for cervical cancer screening.

Original languageEnglish (US)
Pages (from-to)1114-1122
Number of pages9
JournalJournal of Women's Health
Issue number10
StatePublished - Oct 2017


  • cancer screeninghealth communication
  • cervical cancer
  • human papillomavirus vaccine
  • papanicolaou test

ASJC Scopus subject areas

  • General Medicine


Dive into the research topics of 'Human Papillomavirus Vaccination and Pap Smear Uptake among Young Women in the United States: Role of Provider and Patient'. Together they form a unique fingerprint.

Cite this