A new analysis published in JAMA Network Open reveals a deeply concerning trend: roughly 15.4 million U.S. women between ages 21 and 65 have never been screened for cervical cancer. Among women aged 21–29, the share who had never been screened jumped from 12.5% in 2005 to nearly 32% in 2023. For women aged 30–65, the rate tripled from 5.3% to 14.8% over the same period — a group where cervical cancer incidence peaks.

Experts point to a tangle of contributing factors: confusion over updated screening intervals, a mistaken belief that HPV vaccination eliminates the need for Pap smears, insurance gaps, and systemic barriers for women with disabilities and minority populations. Asian, Black, and Latino women, as well as those without insurance or with lower education levels, showed disproportionately lower screening rates. Meanwhile, incidence of regional- and distant-stage cervical cancer has been climbing since 2017.

By the Numbers

• 31.9% of women aged 21–29 had never been screened in 2023, up from 12.5% in 2005
• 14.8% of women aged 30–65 had never been screened in 2023, up from 5.3% in 2005
• Asian women aged 30–65 were 2.27x more likely to have never been screened vs. White women
• Regional-stage cervical cancer incidence rose 2.3% annually from 2017–2023 among women aged 30–64
• Cervical cancer screening prevalence was 53% lower among women with substantial self-care difficulty

Why it matters: Cervical cancer is largely preventable — but only if women are screened. The rise in never-screened women, running parallel to increasing late-stage diagnoses, signals a preventive care crisis. Clinicians are urged to ask at every visit: Has this patient ever been screened? And if not — offer it today.