Too Much of a Good Thing? Physician Practices and Patient Willingness for Less Frequent Pap Test Screening Intervals

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Medical care (Impact Factor: 3.23). 03/2010; 48(3):249-59. DOI: 10.1097/MLR.0b013e3181ca4015
Source: PubMed


Recent guidelines recommend longer Pap test intervals. However, physicians and patients may not be adopting these recommendations.
Identify (1) physician and practice characteristics associated with recommending a less frequent interval, and (2) characteristics associated with women's willingness to adhere to a 3-year interval.
We used 2 national surveys: (1) a 2006/2007 National Survey of Primary Care Physicians for physician cervical cancer screening practices (N = 1114), and (2) the 2005 Health Information Trends Survey for women's acceptance of longer Pap intervals (N = 2206). MEASURES AND METHODS: Physician recommendation regarding Pap intervals was measured using a clinical vignette involving a 35-year-old with no new sexual partners and 3 consecutive negative Pap tests; associations with independent variables were evaluated with logistic regression. In parallel models, we evaluated women's willingness to follow a 3-year Pap test interval.
A minority of physicians (32%) have adopted-but more than half of women are willing to adopt-3-year Pap test intervals. In adjusted models, physician factors associated with less frequent screening were: serving a higher proportion of Medicaid patients, white, non-Hispanic race, fewer years since medical school graduation, and US Preventive Services Task Force being very influential in physician clinical practice. Women were more willing to follow a 3-year interval if they were older, but less willing if they had personal or family experiences with cancer or followed an annual Pap test schedule.
Many women are accepting of a 3-year interval for Pap tests, although most primary care physicians continue to recommend shorter intervals.

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Available from: Jasmin A Tiro, Jul 23, 2014
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    • "No published data were found about compliance to the recommended interval after HPV. Previous studies found an association between intervals shorter than recommended and high socio-economic status women (109, 110). Consequently, if over-screening increases, the phenomenon will probably be less relevant for deprived women. "
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