The use of the Pap smear in Mississippi

Mississippi physicians participating in this survey generally followed the recommended guidelines for frequency of Pap smear screening in the general population and for high risk groups. While the participating physicians considered the presence of some sexually transmitted diseases to increase the risk of developing cervical cancer, many did not consider other STD's to place a patient at increased risk. Smoking was another risk factor that many physicians overlooked. Many Mississippi physicians also did not consider a Pap smear lacking endocervical cells inadequate. All physicians performing Pap smears need to be aware of the risk factors for the development of cervical cancer. There is a continuing controversy concerning the significance of certain Pap smear findings, the timing of colposcopic intervention, and the management of abnormal findings on these tests. Clinical decisions should be based on the newer concepts of degrees of dysplasia, cytological and descriptive findings, and the potential for rapid progression of lesions. Management of the abnormal Pap smear is the topic of another article in this issue of the Journal.