Practice patterns in cervical cancer screening and human papillomavirus testing.

Area of Science:

• Gynecology
• Oncology
• Public Health

Background:

• Since 2006, human papillomavirus (HPV) DNA testing plus Papanicolaou (Pap) testing (cotesting) has been recommended for cervical cancer screening in women aged 30 and older.
• Limited data exist on the clinical practice adoption of this recommended cotesting strategy.

Purpose of the Study:

• To analyze trends in the monthly percentage of Pap tests ordered as cotests in a clinical laboratory setting over a 2.5-year period.
• To identify changes in the average monthly proportion of cotests using joinpoint regression analysis.

Main Methods:

• Retrospective analysis of laboratory testing data from January 2008 to June 2010.
• Joinpoint regression analysis to determine statistically significant changes in cotesting trends.

Main Results:

• Cotesting in patients aged 30 years and older increased from 15.9% in January 2008 to 39.4% in June 2010.
• In patients aged 18 to 29 years, cotesting initially increased but then trended downward, ending at 7.7% in June 2010.
• The study observed increased adoption of age-appropriate cotesting alongside persistent age-inappropriate cotesting.

Conclusions:

• Clinical practice shows increasing adherence to age-recommended cotesting guidelines for cervical cancer screening.
• Continued vigilance is needed to address and reduce the persistence of age-inappropriate cotesting in younger age groups.