Specialty differences in primary care physician reports of papanicolaou test screening practices: a national survey, 2006 to 2007

K Robin Yabroff ¹, Mona Saraiya , Helen I Meissner

⁰National Cancer Institute and the National Institutes of Health, Bethesda, and Information Management Services, Silver Spring, Maryland, USA. yabroffr@mail.nih.gov

Annals of Internal Medicine +

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November 4, 2009

View abstract on PubMed

Summary

Primary care physicians show inconsistent Papanicolaou (Pap) test screening recommendations, often leading to overuse. Interventions are needed to align practice with current cervical cancer screening guidelines.

Area Of Science

Public Health
Gynecology
Preventive Medicine

Background

Cervical cancer screening guidelines were updated in 2002-2003.
Limited data exist on current primary care physician (PCP) Papanicolaou (Pap) test screening practices.
Key areas of practice include screening initiation, frequency, and cessation.

Purpose Of The Study

To assess current Pap test screening practices among PCPs in the United States.
To evaluate the consistency of PCP recommendations with established screening guidelines.
To identify factors influencing screening recommendations.

Main Methods

A cross-sectional survey was conducted.
A nationally representative sample of 1212 primary care physicians participated between 2006-2007.
Recommendations were assessed using clinical vignettes, creating a guideline-consistent recommendation measure.

Main Results

Most physicians (91.0%) reported providing Pap tests to eligible patients.
Screening practices varied significantly by physician specialty (P < 0.001).
Only 22.3% of physicians had guideline-consistent recommendations for Pap test initiation and cessation, with significant variation by specialty.

Conclusions

PCP Pap test screening recommendations are frequently inconsistent with guidelines, suggesting overuse.
Physician self-reported practices may not accurately reflect actual patient care.
Targeted interventions addressing physician and practice factors are necessary to improve adherence to screening guidelines.

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