Association Between Cervical Cancer Screening Guidelines and Preterm Delivery Among Females Aged 18 to 24 Years

Area of Science:

• Reproductive Health
• Oncology
• Public Health

Background:

• Cervical cancer screening reduces mortality but excisional procedures may increase preterm delivery (PTD) risk.
• National guidelines must balance cancer prevention benefits against adverse birth outcome risks.

Purpose of the Study:

• To examine the population-level association between guideline-recommended cervical cancer screenings and PTD risk in young females.
• To inform optimal screening strategies by considering oncological trade-offs and birth outcomes.

Main Methods:

• Cross-sectional study using a difference-in-differences approach.
• Utilized National Vital Statistics System data (1996-2018) for nulliparous births in females aged 18-24.
• Adjusted for maternal education, race/ethnicity, comorbidities, marital status, and prenatal care.

Main Results:

• An additional recommended cervical cancer screening was associated with a 0.073 percentage-point increase in PTD risk.
• No significant association was found with very preterm delivery (VPTD).
• Females with hypertension or diabetes experienced a greater PTD risk increase.

Conclusions:

• Findings suggest additional recommended cervical cancer screenings before birth are linked to increased PTD risk.
• Results can inform simulation models for optimizing cervical cancer screening strategies.
• Balancing screening benefits with potential adverse birth outcomes is critical.