Improved screenings good news for women: Trends point to higher disease detection for women, including cancer and chlamydia

WE'VE COME A LONG WAY, BABY. Yes, women in the workplace, in the board room, in political office-and in healthcare-have come a long way. A status report on Health Plan Employer Data and Information Set (HEDIS) measures specifically targeting women is showing upward trends, or at least steady statistics. Private health plans showed improvement in 35 out of 42 effectiveness of care HEDIS measures in 2005.

Some of these gaps exist in measures such as breast cancer screenings, where there's only been a small improvement. Unfortunately, there is a large number of uninsured women-19% of women (ages 18 to 64) are uninsured because they either cannot afford individual policies, do not qualify for Medicaid or don't have access to employer-sponsored plans, according to the Henry J. Kaiser Family Foundation. These uninsured women are less likely to seek medical care, fill prescriptions or access preventive screenings such as mammograms and Pap smears, primarily because of cost.

Although many of the HEDIS measures affect men and women alike, there are clearly measures that apply only to women-chlamydia, cervical and breast cancer, prenatal and postpartum care and osteoporosis management.

Screenings for chlamydia have improved over the past six years, but rates remain low. They have jumped from 18.5% to 34.4% for ages 16 to 20 between 1999 and 2005, and from 16.0% to 35.2% for ages 21 to 25 during the same period. "Health plans surprised me with these improvements," says O'Kane. "It is a hard measure but an important one. Physicians need to know who is sexually active, information they are uncomfortable asking. On the other hand, early detection can prevent infertility from pelvic inflammatory disease. There is a case for better treatment."

Breast cancer screenings have become a highly accepted screening tool and have saved lives through early detection, but they have still been plagued with some controversy-from its effectiveness and accuracy to screening intervals and appropriate ages for screenings. O'Kane is concerned that these debates may have caused a decline in mammograms.

The number peaked at 74.4% in 2001, higher than the 70.4% in 1996, but lower than the 72.0% in 2005.

Cervical cancer screenings are estimated to reduce rates by 80%, according to the National Cancer Institute. The risk of developing invasive cervical cancer is three to 10 times greater in women who have not been screened. However, a woman's lifetime risk of cervical cancer is only estimated to 0.7%.

HEDIS figures show that health plans are doing a good job of identifying and screening women who have not had previous screenings or insufficient ones. The trend between 1996 and 2005 indicates an increase, 70.5% to 81.8%.