Adherence to 2019 ASCCP Cervical Cancer Screening Guidelines at a Community Health Network

Area of Science:

• Gynecology
• Public Health
• Oncology

Background:

• Cervical cancer screening (CCS) is crucial for early detection and prevention.
• Adherence to established guidelines, such as those from the American Society for Colposcopy and Cervical Pathology (ASCCP), is vital for effective screening.
• Variations in adherence can impact patient outcomes and healthcare resource utilization.

Purpose of the Study:

• To evaluate the adherence of cervical cancer screening practices to ASCCP guidelines.
• To identify specific areas of nonadherence within a hybrid community-academic institution.

Main Methods:

• A retrospective cohort study analyzed pap smears from October 2022 to December 2023.
• Data abstracted included test orders, intervals, and result management.
• Findings were classified as adherent or nonadherent to ASCCP guidelines.

Main Results:

• Out of 348 pap smears, 67% were nonadherent to ASCCP guidelines.
• Common nonadherence issues included incorrect HPV cotesting (31%), inappropriate intervals (55%), and improper management (18%).
• Management discrepancies were significantly linked to cytology results, provider type, and practice, but not age, BMI, or comorbidities.

Conclusions:

• The majority of cervical cancer screening in this cohort did not adhere to ASCCP guidelines.
• Underutilization of HPV cotesting, overscreening, and inadequate colposcopy referrals were primary reasons for nonadherence.
• There is substantial opportunity to improve CCS practices by aligning with current ASCCP recommendations.