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Current cervical cancer screening practices of Dane County, Wisconsin primary care clinicians
Lucille Marchand1, Maureen Van Dinter, Marlon Mundt
1University of Wisconsin, Department of Family Medicine, 777 S. Mills St, Madison, Wis. 53715-1896, USA. lmarchan@fammed.wisc.edu
Purpose:
This study explores clinician Papanicolaou (Pap) smear collection and management strategies in light of current research, guidelines, and recommendations.
Methods:
Two hundred thirty eligible obstetrician/gynecologists, family physicians, and advance practice nurses in Dane County, Wisconsin completed a survey. Descriptive statistics.
Results:
The wooden spatula is most frequently (68%) used to collect ectocervical cells; the Cytobrush (75%) for endocervical cells. Most clinicians (63%) collect ectocervical cells first, endocervical cells second. Eighty-nine percent of clinicians are familiar with liquid-based Pap smears; 57% use them. Most clinicians (59%) prepare the cervix as needed prior to collecting a sample. Management of inflammation is variable. Forty-five percent of clinicians have no age limit in discontinuing Pap smears; 43% continue after benign hysterectomy. Training for doing Pap smears occurs primarily in residency (89%) or graduate nursing education (83%).
Conclusions:
Despite current research and guidelines, great variability exists among clinicians in Pap smear collection and management. Textbooks, articles, and clinician training must emphasize optimal collection technique and management to improve Pap smear quality and decrease unnecessary costs.