旨在评估 2010 年《患者保护和平价医疗法案》(ACA) 的实施是否与接受子宫颈抹片检查的女性患病率的变化有关。这项研究利用了公开的疾病控制中心国家家庭成长调查 (NSFG)数据集。这是一项连续横断面研究。对照组被定义为在《平价医疗法案》全面实施之前（2011-2013 年）和全面实施后（2017-2019 年）接受癌症筛查和预防干预措施的女性。主要结果是自我报告接受巴氏涂片检查。次要结果包括 HPV 疫苗接种和乳房 X 光检查率。从全国代表性数据集中收集匿名患者信息，并利用 STATA 18 进行分析。从 NSFG 获得的两个研究队列包括 2011-2013 年做出回应的女性 (n = 5601)，被视为“ACA 实施前” （Pre ACA），以及那些在 2017-2019 年做出回应的人（n = 6141）“后 ACA 实施”（Post ACA）。 Pre ACA 组中 21 岁及以上且曾接受过子宫颈抹片检查的女性比例 (96.0%) 高于 Post ACA 组 (94.1%) (OR 0.66 (0.49-0.91))。相比之下，HPV 疫苗接种率上升，乳房 X 光检查率在 ACA 后时期保持稳定。尽管实施了卫生政策以增加获得预防措施的机会，但曾经接受过子宫颈抹片检查的妇女比例有所下降，这表明需要采取进一步的干预措施来改善宫颈癌的获得癌症筛查是有必要的。

To assess if implementation of the 2010 Patient Protection and Affordable Care Act (ACA) was associated with changes in the prevalence of women having ever received a pap smear.This study utilised the publicly available Centre for Disease Control National Survey of Family Growth (NSFG) data set. This was a serial cross-sectional study. The comparison groups were defined as women who received cancer screening and prevention interventions prior to full implementation of the ACA (2011-2013) and post full implementation (2017-2019). The primary outcome was self-reporting receipt of a Papanicolaou (Pap) smear. Secondary outcomes included HPV vaccination and mammogram rates. Anonymized patient information was collected from the nationally representative dataset, and analyses were performed utilising STATA 18.The two study cohorts obtained from the NSFG included women who responded in 2011-2013 (n = 5601), deemed to be 'Pre-ACA implementation' (Pre ACA), and those who responded in 2017-2019 (n = 6141) 'Post-ACA implementation' (Post ACA). The proportion of women who were 21 years and older and ever had a Pap smear in the Pre ACA group (96.0%) was higher than that of the Post ACA group (94.1%) (OR 0.66 (0.49-0.91)). In contrast, HPV vaccination rates rose, and mammogram rates remained stable in the Post ACA period.A decrease in proportion of women ever having had a Pap smear despite implementation of health policies to increase access to preventive measures suggests further interventions to improve access to cervical cancer screening are warranted.