Primary Care Physician Use of Pap Testing Examined

Study finds that testing unlikely consistent with major guidelines, with tendency toward overuse
By Eric Metcalf
HealthDay Reporter

TUESDAY, Nov. 3 (HealthDay News) -- Primary care physicians' recommendations for Papanicolaou (Pap) testing are less likely to be in line with cervical cancer screening guidelines, according to a cross-sectional survey published in the Nov. 3 issue of the Annals of Internal Medicine.

K. Robin Yabroff, Ph.D., of the National Cancer Institute in Bethesda, Md., and colleagues analyzed data from 1,212 primary care physicians who provided Pap screening recommendations for several vignettes featuring women with different ages, sexual history, and history of hysterectomy or negative Pap smears.

The researchers found that 91 percent of physicians reported providing Pap smears. Although most of these reported that screening guidelines were important in their clinical practice, only 22.3 percent were consistent with guidelines for stopping and starting Pap screenings in multiple vignettes. Internal medicine and family or general practice physicians were more likely to provide recommendations consistent with guidelines as compared to obstetricians and gynecology specialists (odds ratios, 1.98 and 1.45, respectively).

"In summary, we observed that primary care physicians' recommendations for Pap test screening are generally not consistent with major guidelines, and reflect overuse of screening," the authors conclude. "Development and dissemination of effective interventions that focus on potentially modifiable physician- and practice-level factors will be important for facilitating cervical cancer screening practices that are consistent with the most recent scientific evidence."

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