Adherence to cervical cancer screening guidelines by gynecologists in the Pacific Northwest

In 2012, US organizations released updated cervical cancer screening guidelines calling for less frequent screening. We surveyed practicing gynecologists in the Pacific Northwest region to understand their screening practices, gauge their uptake of the new guidelines, and identify reasons why they may not follow the new guidelines.

Gynecologists from Washington, Oregon, Montana, and Idaho were sent an online survey on behalf of their state's medical association. The survey consisted of 9 questions on sex, practice setting, community size, cervical cancer screening practices, and reasons for not following the 2012 guidelines.

Of 947 gynecologists, 123 (13.0%) completed the survey. Sixty-four respondents (52.0%) reported that they follow or plan to follow the new guidelines. Reasons cited for not following the new guidelines included concern over missed opportunities for women's health education (43 respondents or 72.9%), patients wanting more frequent screening (39 respondents or 66.1%), and concern about missing dysplasia or cancerous lesions (28 respondents or 47.5%). Although the new guidelines call for a 3-year interval between routine Pap tests or a 5-year interval between routine Pap/human papillomavirus cotests, 75 gynecologist respondents (61.0%) still recommended annual or biannual Pap screening for patients younger than 30 years, and 55 respondents (67.9%) recommended rescreening within 3 years for women 30 years and older with negative cotest results.

While over half of the gynecologist survey respondents reported adherence or planned adherence to the 2012 guidelines, over half also reported using screening schedules that are more frequent than recommended by new guidelines. Concerns highlighted by survey participants provide an opportunity for physician and patient education on the evidence supporting the new guidelines.