Skip to main content

Military Health System

Test of Sitewide Banner

This is a test of the sitewide banner capability. In the case of an emergency, site visitors would be able to visit the news page for addition information.

Surveillance Snapshot: Cervical Cancer Screening Among U.S. Military Service Women in the Millennium Cohort Study, 2003–2015

Image of Lt. Cmdr. Leslye Green, staff obstetrician and gynecologist, Naval Hospital Pensacola (NHP), uses a model to discuss cervical cancer with a patient at NHP. According to the Centers for Disease Control and Prevention (CDC), cervical cancer is highly preventable because screening tests for cervical cancer and vaccines to protect against human papillomavirus (HPV), which is the main cause of cervical cancer, are readily available. Cervical cancer is highly treatable and associated with long survival and good quality of life when it is detected early. (U.S. Navy photo by Mass Communication Specialist 1st Class Brannon Deugan). Lt. Cmdr. Leslye Green, staff obstetrician and gynecologist, Naval Hospital Pensacola (NHP), uses a model to discuss cervical cancer with a patient at NHP. According to the Centers for Disease Control and Prevention (CDC), cervical cancer is highly preventable because screening tests for cervical cancer and vaccines to protect against human papillomavirus (HPV), which is the main cause of cervical cancer, are readily available. Cervical cancer is highly treatable and associated with long survival and good quality of life when it is detected early. (U.S. Navy photo by Mass Communication Specialist 1st Class Brannon Deugan)

The Millennium Cohort Study is a prospective study that was initiated in 2001 and includes over 200,000 current and prior U.S. military service members.1 Questionnaires are sent to participants approximately every 3 years to collect information on service related experiences as well as mental, physical, and behavioral health. Compliance with contemporary cervical cancer screening recommendations was determined among service women enrolled in the Millennium Cohort Study during 2003–2015. Current cervical cancer screening recommendations call for a Pap smear alone every 3 years in women aged 21–65 years or for a human papillomavirus (HPV) DNA test with or without a Pap test every 5 years for women aged 30–65 years.2 Women were considered eligible for screening in a given year if they were aged 21–62 years on the last day of the year, had served in the active component (i.e., at least 9 months in active component pay and strength rosters) for the concurrent year and 2 years before, had not had a hysterectomyA partial or total surgical removal of the uterus. It may also involve removal of the cervix, ovaries, Fallopian tubes, and other surrounding structures. hysterectomy, and had not separated from the military. Women were considered compliant with screening recommendations between 2003–2015 if they had a medical report of a Pap smear in the year of assessment or prior 2 calendar years. Women were also considered compliant with screening recommendations in 2013–2015 if they had HPV DNA testing completed within the previous 5 years.

Overall, among U.S. service women in the Millennium Cohort Study, the compliance rate increased from 61.2% in 2003 to a peak of 83.1% in 2010 then declined to a low of 59.8% in 2015 (Figure). During the first 7 years of the study period, compliance was highest among Air Force personnel. Between 2013 and 2015, compliance was highest among Coast Guard personnel. Compliance was lowest among Navy personnel in all but 1 year (2004) of the 13-year period. Compliance was also consistently higher for service women who had initiated the HPV vaccine than for women who had not (on average 6.3% higher). No differences in compliance were observed by cigarette smoking status, which was used as a surrogate measure of other health behaviors.

Author affiliations: Deployment Health Research Department in the Military Population Health Directorate, Naval Health Research Center, San Diego, CA (Dr. Matsuno, Dr. Porter, Mr. Warner, CAPT Wells); Leidos, San Diego, CA (Dr. Matsuno, Dr. Porter, Mr. Warner).

Disclaimer: One of the authors of this work is a military service member or employee of the U.S. Government. This work was prepared as part of their official duties. Title 17, U.S.C. §105 provides that copyright protection under this title is not available for any work of the U.S. Government. Title 17, U.S.C. §101 defines a U.S. Government work as work prepared by a military service member or employee of the U.S. Government as part of that person’s official duties. This report was supported by the Military Operational Medicine Research Program under work unit no. 60002. The views expressed in this article are those of the authors and do not necessarily reflect the official policy or position of the Department of the Navy, Department of Defense, or the U.S. Government.

 

References

Bulleted List for References

  1. Gray GC, Chesbrough KB, Ryan MA, et al. The Millennium Cohort Study: a 21-year prospective cohort study of 140,000 military personnel. Mil Med. 2002;167(6):483–488.
  2. U.S. Preventive Services Task Force. Final recommendation statement. Cervical cancer: screening. https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/cervical-cancer-screening?ds=1&s=pap. Accessed 9 April 2020.

FIGURE. Cervical screening rates among service women, by branch of service, U.S. Armed Forces, 2003–2015

You also may be interested in...

Morbidity Burdens Attributable to Various Illnesses and Injuries, Deployed Active and Reserve Component Service Members, U.S. Armed Forces, 2021

Article
6/1/2022
5_deployed morbidity

As in previous years, among service members deployed during 2021, injury/poisoning, musculoskeletal diseases and signs/symptoms accounted for more than half of the total health care burden during deployment. Compared to garrison disease burden, deployed service members had relatively higher proportions of encounters for respiratory infections, skin diseases, and infectious and parasitic diseases. The recent marked increase in the percentage of total medical encounters attributable to the ICD diagnostic category "other" (23.0% in 2017 to 44.4% in 2021) is likely due to increases in diagnostic testing and immunization associated with the response to the COVID-19 pandemic.

Absolute and Relative Morbidity Burdens Attributable to Various Illnesses and Injuries, Non-service Member Beneficiaries of the Military Health System, 2021

Article
6/1/2022
6_beneficiary morbidity

In 2021, mental health disorders accounted for the largest proportions of the morbidity and health care burdens that affected the pediatric and younger adult beneficiary age groups. Among adults aged 45–64 and those aged 65 or older, musculoskeletal diseases accounted for the most morbidity and health care burdens. As in previous years, this report documents a substantial majority of non-service member beneficiaries received care for current illness and injury from the Military Health System as outsourced services at non-military medical facilities.

Surveillance snapshot: Illness and injury burdens, reserve component, U.S. Armed Forces, 2021

Article
6/1/2022
reserve snapshot

Hospitalizations, Active Component, U.S. Armed Forces, 2021

Article
6/1/2022
2_hospitalizations

The hospitalization rate in 2021 was 48.0 per 1,000 person-years (p-yrs), the second lowest rate of the most recent 10 years. For hospitalizations limited to military facilities, the rate in 2021 was the lowest for the entire period. As in prior years, the majority (71.2%) of hospitalizations were associated with diagnoses in the categories of mental health disorders, pregnancy-related conditions, injury/poisoning, and digestive system disorders.

Medical Evacuations out of the U.S. Central and U.S. Africa Commands, Active and Reserve Components, U.S. Armed Forces, 2021

Article
6/1/2022
4_Medevacs

The proportions of evacuations out of USCENTCOM that were due to battle injuries declined substantially in 2021. For USCENTCOM, evacuations for mental health disorders were the most common, followed by non-battle injury and poisoning, and signs, symptoms, and ill-defined conditions. For USAFRICOM, evacuations for non-battle injury and poisoning were most common, followed by disorders of the digestive system and mental health disorders.

Absolute and Relative Morbidity Burdens Attributable to Various Illnesses and Injuries, Active Component, U.S. Armed Forces, 2021

Article
6/1/2022
1_active component morbidity

In 2021, as in prior years, the medical conditions associated with the most medical encounters, the largest number of affected service members, and the greatest number of hospital days were in the major categories of injuries, musculoskeletal disorders, and mental health disorders. Despite the pandemic, COVID-19 accounted for less than 2% of total medical encounters and bed days in active component service members.

Ambulatory Visits, Active Component, U.S. Armed Forces, 2021

Article
6/1/2022
3_ambulatory visits

In 2021, the overall numbers and rates of active component service member ambulatory care visits were the highest of any of the last 10 years. Most categories of illness and injury showed modest increases in numbers and rates. The proportions of ambulatory care visits that were accomplished via telehealth encounters fell to under 15% in 2021, compared to 19% in 2020.

Surveillance snapshot: Illness and injury burdens, recruit trainees, U.S. Armed Forces, 2021

Article
6/1/2022
recruit snapshot

The Association Between Two Bogus Items, Demographics, and Military Characteristics in a 2019 Cross-sectional Survey of U.S. Army Soldiers

Article
5/1/2022
Cover 3

Data from surveys may be used to make public health decisions at both the installation and the Department of the Army level. This study demonstrates that a vast majority of soldiers were likely sufficiently engaged and answered both bogus items correctly. Future surveys should continue to investigate careless responding to ensure data quality in military populations.

Surveillance Snapshot: Tick-borne Encephalitis in Military Health System Beneficiaries, 2012–2021

Article
5/1/2022
Cover 4

Tick-borne Encephalitis in Military Health System Beneficiaries, 2012–2021. Tick-borne encephalitis (TBE) is a viral infection of the central nervous system that is transmitted by the bite of infected ticks, mostly found in wooded habitats in parts of Europe and Asia

Evaluation of ICD-10-CM-based Case Definitions of Ambulatory Encounters for COVID-19 Among Department of Defense Health Care Beneficiaries

Article
5/1/2022
Cover 2

This is the first evaluation of ICD-10-CM-based cased definitions for COVID-19 surveillance among DOD health care beneficiaries. The 3 case definitions ranged from highly specific to a lower specificity, but improved balance between sensitivity and specificity.

Update: Sexually Transmitted Infections, Active Component, U.S. Armed Forces, 2013–2021

Article
5/1/2022
Cover 1

This report summarizes incidence rates of the 5 most common sexually transmitted infections (STIs) among active component service members of the U.S. Armed Forces during 2013–2021. In general, compared to their respective counterparts, younger service members, non-Hispanic Black service members, those who were single and other/unknown marital status, and enlisted service members had higher incidence rates of STIs.

Exertional Hyponatremia, Active Component, U.S. Armed Forces, 2006–2021

Article
4/1/2022
Cover 4

Exertional (or exercise-associated) hyponatremia refers to a low serum, plasma, or blood sodium concentration (below 135 mEq/L) that develops during or up to 24 hours following prolonged physical activity. Acute hyponatremia creates an osmotic imbalance between fluids outside and inside of cells.

Exertional Heat Illness at Fort Benning, GA: Unique Insights from the Army Heat Center

Article
4/1/2022
Cover 1

Exertional heat illness (hereafter referred to as heat illness) spans a spectrum from relatively mild conditions such as heat cramps and heat exhaustion, to more serious and potentially life-threatening conditions such as heat injury and exertional heat stroke (hereafter heat stroke).

Heat Illness, Active Component, U.S. Armed Forces, 2021

Article
4/1/2022
Cover 2

From 2020 to 2021, the rate of incident heat stroke was relatively stable while the rate of heat exhaustion increased slightly

Page 3 of 14 , showing items 31 - 45
First < 1 2 3 4 5  ... > Last 
Refine your search
Last Updated: October 26, 2022
Follow us on Instagram Follow us on LinkedIn Follow us on Facebook Follow us on Twitter Follow us on YouTube Sign up on GovDelivery