NDLI: Cervical Cancer Screening With Both Human Papillomavirus and Papanicolaou Testing vs Papanicolaou Testing Alone: What Screening Intervals Are Physicians Recommending?

Content Provider	JAMA Network
Author	Saraiya, Mona Berkowitz, Zahava Yabroff, K. Robin Wideroff, Louise Kobrin, Sarah Benard, Vicki
Copyright Year	2010
Abstract	Background: Guidelines recommend screening for cervical cancer among women 30 years or older 3 years after a normal Papanicolaou test (hereinafter referred to as Pap test) result or a combined normal screening result (normal Pap/negative human papillomavirus [ HPV] test results). We assessed reported recommendations by US primary care physicians ( PCPs) on screening intervals that incorporate HPV cotesting compared with Pap testing alone. Methods: From September 1, 2006, through May 31, 2007, we conducted a mailed survey of a representative sample of 1212 PCPs, of whom 950 performed Pap tests and recommended the HPV test for screening or management. The main outcome measure included self-reported data on timing of screening intervals for women with normal results using clinical vignettes. Results: Among Pap test providers who recommend HPV testing, 31.8% reported that they would conduct the next Pap test in 3 years for a 35-year-old woman with 3 normal Pap test results. For a 35-year-old woman with a normal Pap test result and a negative HPV test finding, only 19.0% would conduct the next Pap test in 3 years. Most remaining physicians would conduct the Pap test more frequently. Most PCPs did not recommend a second HPV test or recommended the next HPV test at the same frequency as the Pap test. Physician specialty was strongly associated with guideline-consistent recommendations for the next Pap or HPV test. Conclusions: A lower proportion of PCPs recommend extending screening intervals to 3 years with an HPV cotest than those screening with the Pap test alone. Implementation of effective interventions and strategies that improve physician adherence to recommendations will be important for efficient screening practices.
Ending Page	986
Starting Page	977
Page Count	10
File Format	PDF HTM / HTML
ISSN	00039926
DOI	10.1001/archinternmed.2010.134
Issue Number	11
Journal	Archives of Internal Medicine
Volume Number	170
Language	English
Publisher	American Medical Association
Publisher Date	2010-06-14
Access Restriction	Open
Subject Keyword	human papillomavirus vaginal smears screening human papillomavirus test cervical cancer screening guidelines
Content Type	Text
Resource Type	Article
Subject	Internal Medicine

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