U.S. Department of Health and Human Services
Indian Health Service: The Federal Health Program for American Indians and Alaska Natives
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  Quality of IHS Health Care

Performance Measures

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Health Topic: Cancer Screening
More American Indian women report that they have never had a Pap smear test as compared to other ethnic groups. Having a regular Pap smear lowers the chance of cervical cancer. Early testing can find pre-cancerous cervical lesions that can be treated. If cervical cancer is found early, the chance of survival is almost 100% with appropriate treatment and follow-up. Cervical cancer was once the leading cause of cancer death among women. But it has dropped to thirteenth (13th) among all U.S. races, due to the use of Pap smears.

Who should be screened for cervical cancer?
Women between the ages of 21 and 64 should routinely have a pap smear and be screened for cervical cancer.

What is the GPRA measure?
The GPRA measure is the percentage of IHS AI/AN female patients ages 21 to 64 that have had a Pap smear test at least once in the past three years.

How is IHS doing?
How is IHS doing? The United States long-term goal is for 93.0% of female patients ages 21-65 to receive a Pap smear at least once every three years by the year 2020 (Healthy People 2020). The IHS 2012 goal was to achieve the rate of 59.5% for the proportion of female patients ages 21-64 without a documented history of hysterectomy who have had a Pap screen within the previous three years. IHS did not meet this goal and achieved 57.1%. The bars on the graph below show the rate has decreased from 62% in 2002 to 57.1% in 2012. However, beginning in 2010 refusals was removed from the rates. So, the 2002-2009 rates cannot be compared with the 2010-2012 rates.

Percentage of IHS AI/AN Female Patients  with Cervical Cancer Screening (Pap Smear)  (IHS 2013 goal is to establish a new baseline for female patients ages 25-64 with a Pap screen within the last 4 years)  NOTE: A higher score is better

View a table of this chart's data.

Year Percent
2002 62
2003 61
2004 58
2005 60
2006 59
2007 59
2008 59
2009 59
2010 59
2011 58.1
2012 57.1
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To see how IHS is doing on this measure at the Area (regional) levels, click here.