Pap smear noncompliance among female obstetrics-gynecology residents

We wish to determine how well female obstetrics and gynecology (OB/GYN) residents in the United States follow recommendations for routine Pap smears in managing their own health care and to identify the reasons for noncompliance.

A survey was mailed to 1693 female OB/GYN residents in the U.S. Factors associated with noncompliance were determined by chi-square. Logistic regression analysis was used to identify independent prognostic factors and calculate the odds ratio (OR).

Six hundred eleven (36%) surveys were returned with compliance information. Noncompliance was reported by 33%. Lack of time or inconvenience was cited as the most common reason (93%) for noncompliance, followed by consideration of themselves as low risk for cervical disease (41%) and fear of or embarrassment in seeing a doctor (14%). On multivariate analysis, independent risk factors for noncompliance during residency included noncompliance prior to residency (OR 4.6, P<0.0001) and Asian ethnicity (OR 2.1, P = 0.02), whereas East Indian ethnicity (OR 3.0, P = 0.06) and having no children (OR 1.6, P = 0.07) were near significant.

A substantial proportion of female OB/GYN residents do not follow standard recommendations for routine Pap smears. Although the principal reason for noncompliance given was lack of available time and/or inconvenience during residency, this behavior predated residency and was associated with specific ethnic groups.