Adherence to Cervical Cancer Screening Guidelines Among Women Aged 66-68 Years in a Large Community-Based Practice

Area of Science:

• Gynecology
• Public Health
• Preventive Medicine

Background:

• National guidelines recommend stopping cervical cancer screening after age 65 for women with adequate prior screening.
• Adherence to these screening cessation guidelines is crucial for optimizing healthcare resources and patient care.

Purpose of the Study:

• To examine adherence to 2012 cervical cancer screening cessation guidelines in women aged 66-68 years.
• To identify factors associated with continued screening in women who had reached the recommended screening exit age.

Main Methods:

• Retrospective cohort study of 14,778 women aged 66-68 years at Kaiser Permanente Southern California.
• Prior screening adequacy assessed from age 56-65 using electronic medical records.
• Logistic regression used to analyze patient- and physician-level correlates of guideline adherence.

Main Results:

• 24% of women lacked adequate prior screening by age 65.
• Among those without adequate prior screening, screening uptake after age 65 varied significantly (3%-71%), influenced by recent abnormal results.
• 10% of women with adequate prior screening continued screening after age 65; frequent visits and male PCPs were associated factors.

Conclusions:

• A substantial number of women do not meet criteria for screening cessation at age 65.
• Understanding barriers to guideline adherence and clinical decision-making is essential for refining cervical cancer screening strategies.
• Further research is needed to improve adherence to evidence-based screening guidelines.