Nearly 1 in 3 women aged 21 to 29 have never had cervical screening

What happened

About 31.9% of US women ages 21 to 29 said in 2023 that they had never had a cervical cancer screening. In 2005 the figure was 12.5%. That is according to a JAMA Network Open research letter published Aug. 27, 2026, as first reported by Healthline News.

The number holds up against the primary source. It also needs context before it becomes advice, and we'll get to that.

What the study found

Researchers at MUSC Hollings Cancer Center analyzed nine cycles of the National Health Interview Survey between 2005 and 2023. The pooled sample was 23,502 women aged 21 to 29 and 82,760 aged 30 to 65. Screening was self-reported, and the denominators were corrected for hysterectomy.

• Women 21 to 29 who had never been screened: 12.5% in 2005, 31.9% in 2023.
• The average annual rise was 5.2%, and it steepened to 7.9% per year from 2010 to 2023.
• Women 30 to 65: 5.3% rose to 14.8%.
• In 2023, among women 21 to 29, never-screened was 44.3% for Asian women versus 28.8% for non-Hispanic White women.
• By education, it was 39.0% for high-school graduates and 35.0% for those with a college or associate's degree, versus 17.1% for those with a master's or doctoral degree.

Insurance is where the headline coverage runs ahead of the data. Among women in their 20s, 41.8% of the uninsured had never been screened, but the difference was not statistically significant (the reported interval for this comparison is internally inconsistent, so we do not cite the ratio). The insurance gap was clearer in women 30 to 65, at 1.40 (1.12 to 1.61).

HPV vaccination moved the other way. Among women 21 to 29, at least one dose rose from 5.7% in 2008 to 54.0% in 2019, the latest year the letter reports.

What it does not show

• It does not show who is overdue. One screening years ago counts as screened. The measure is a lifetime snapshot of self-report, a distinction the lead author stressed in MUSC's release.
• It may include women who aren't yet due. The USPSTF starts screening at 21, the American Cancer Society at 25, and the 21-to-29 band doesn't appear to be split. That's our inference, not something the authors state.
• It relies on memory. The authors list recall bias as a limitation, and neither the survey nor cancer registries record HPV status. It is also US-only.
• It does not show cause and effect. The authors did not test a link between never-screening and cancer.
• It does not explain why. The letter does not report reasons women gave for not being screened.

Two housekeeping notes. This is a short research letter with limited methods detail, and some prevalence ratios in its published tables look internally inconsistent, so we've leaned only on figures that hold together. Also, Healthline's page title says screening rates are "declining." The measured quantity is the share never screened, and it rose.

What it means for you

If you're not sure whether you've ever been screened, that's worth settling. Ask a clinician which test and schedule fit your age and history.

• USPSTF (2018, Grade A): women 21 to 29 should have a Pap test every 3 years.
• American Cancer Society: start at 25 and continue through 65, with primary HPV testing every 5 years preferred.

Context

A 2025 JAMA Network Open study used overlapping survey methods but a different measure: not being up to date on screening. Among women 21 to 29, that rose from 14.2% in 2005 to 29.1% by 2019, and not knowing screening was needed was the most common reason given. The two papers' numbers shouldn't be compared directly, but they point the same way.

Guidance may also shift. A 2024 USPSTF draft added clinician- or patient-collected HPV testing for ages 30 to 65. We did not confirm whether a final version exists, so check with your clinician.

The study was NIH-funded. Two authors disclosed fees from GRAIL and Value Analytics Lab, both outside the submitted work.