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Related Experiment Videos

Why do we continue to take unnecessary smears?

C B Woodman1, J Richardson, M Spence

  • 1Centre for Cancer Epidemiology, Christie Hospital NHS Trust, University of Manchester.

The British Journal of General Practice : the Journal of the Royal College of General Practitioners
|February 25, 1998
PubMed
Summary
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Many general practices perform extra cervical smear tests beyond screening program guidelines. Common reasons include abnormal bleeding, genital warts, and multiple sexual partners, which are often unnecessary.

Area of Science:

  • Gynecology
  • Public Health
  • Primary Care Medicine

Background:

  • Cervical cancer screening programs aim to detect precancerous changes.
  • Primary care physicians in Manchester Health Authority conduct more cervical smear tests than recommended.
  • Understanding the reasons for these deviations is crucial for optimizing screening efficiency.

Purpose of the Study:

  • To investigate the indications for additional cervical smear tests performed in primary care.
  • To identify the frequency of specific clinical reasons cited by general practitioners and family planning doctors.
  • To evaluate the validity of these indications against established screening guidelines.

Main Methods:

  • A questionnaire survey was distributed to all general practices and family planning doctors in Manchester Health Authority.

Related Experiment Videos

  • An 82% response rate was achieved, providing a robust dataset.
  • Data analysis focused on the most frequently cited reasons for performing extra smear tests.

    • Main Results:

    • Postcoital bleeding (88%), postmenopausal bleeding (84%), and genital warts (87%) were the most common reasons for additional smears.
    • Intermenstrual bleeding (55%) and multiple sexual partners (52%) were also significant factors.
    • 46% of responders believed women should have repeat tests within one year of their first test.

    Conclusions:

    • Many additional cervical smear tests are performed for indications not supported by current screening program guidelines.
    • Physician-driven factors, such as perceived patient risk and interpretation of symptoms, contribute to over-screening.
    • Education and guideline reinforcement are needed to align primary care practices with evidence-based cervical cancer screening recommendations.