Too much of a good thing? Physician practices and patient willingness for less frequent pap test screening intervals

Med Care. 2010 Mar;48(3):249-59. doi: 10.1097/MLR.0b013e3181ca4015.

Abstract

Background: Recent guidelines recommend longer Pap test intervals. However, physicians and patients may not be adopting these recommendations.

Objectives: 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.

Research design: 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.

Results: 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.

Conclusions: Many women are accepting of a 3-year interval for Pap tests, although most primary care physicians continue to recommend shorter intervals.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Attitude of Health Personnel
  • Attitude to Health
  • Evidence-Based Medicine / statistics & numerical data
  • Female
  • Guideline Adherence / statistics & numerical data*
  • Health Services Accessibility / statistics & numerical data
  • Humans
  • Mass Screening / statistics & numerical data
  • Medicaid / statistics & numerical data
  • Medicine / statistics & numerical data
  • Middle Aged
  • Practice Guidelines as Topic*
  • Practice Patterns, Physicians' / statistics & numerical data*
  • Socioeconomic Factors
  • United States
  • Vaginal Smears / psychology*
  • Vaginal Smears / statistics & numerical data*