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Factors Associated With Guideline-Concordant Cervical Cancer Screening Exit: A Mixed Methods Study

  • 0Boston Medical Center, Boston, Massachusetts.
Women's Health Issues : Official Publication of the Jacobs Institute of Women's Health +

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September 9, 2025

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September 9, 2025

View abstract on PubMed

Summary

This summary is machine-generated.

Many clinicians lack knowledge of cervical cancer screening exit criteria, leading to inadequate screening in older women. Simplifying guidelines is recommended to improve adherence and patient care.

Area Of Science

  • Gynecology
  • Public Health
  • Preventive Medicine

Background

  • Over 20% of cervical cancers occur in women over 65.
  • Current guidelines recommend screening cessation at 65 for average-risk individuals meeting specific criteria.
  • Many women aged 64-66 in the US are not screened according to guidelines.

Purpose Of The Study

  • To explore clinician knowledge of cervical cancer screening exit criteria.
  • To identify factors, facilitators, and barriers related to guideline-concordant screening cessation.

Main Methods

  • A mixed-methods study involving national surveys (n=1,251) and qualitative interviews (n=55) of clinicians.
  • Guideline concordance was defined by awareness of hysterectomy, Pap test, and HPV test criteria, and exclusion of those with prior precancer treatment.

Main Results

  • Only 35% of clinicians correctly identified all screening exit criteria.
  • Awareness was higher for hysterectomy ( >70%) and prior negative screening ( >70%) criteria.
  • Factors associated with correct responses included male gender, OB/GYN specialty, and academic/hospital practice settings.

Conclusions

  • Clinicians exhibit knowledge gaps and practical difficulties in applying cervical cancer screening exit criteria.
  • Increasing life expectancy and decreasing hysterectomy rates will increase the number of older women at risk.
  • Simplifying exit criteria may improve adherence and reduce screening disparities.

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