Pap testing: opinion and practice among young obstetrician-gynecologists

Since 1976, contradictory recommendations by a number of groups (including the American Cancer Society, the National Cancer Institute, a National Institutes of Health Consensus Development Conference, the Canadian Task Force on Cervical Cancer Screening Programs, and the American College of Obstetricians and Gynecologists) on the timing of Pap testing--including age to begin testing, appropriate frequency of testing, and age to discontinue testing--have been communicated to both physicians and consumers. The opinions and practices of a U.S. national sample of recently trained obstetrician-gynecologists, whose professional association continues to endorse annual Pap tests, were investigated and compared with key points from the various recommendations. The appropriateness of the recommendations themselves is not addressed. Findings show that respondents are aware of recommendations for less frequent Pap testing, but they believe that women should generally receive annual Pap tests and that regular Pap testing should not be discontinued among the elderly. While the intensity of Pap testing services varies by type of practice arrangement, such variation does not occur for opinions regarding Pap testing, with one exception: Those practicing in multispecialty groups (including health maintenance organizations) are more likely to endorse routine Pap testing for elderly women if they see elderly women in their practices. Thus, the physicians in this study are not adhering to recommendations for Pap testing on a less-than-annual basis or for discontinuance in the elderly.