Primary care provider practices and beliefs related to cervical cancer screening with the HPV test in Federally Qualified Health Centers

Prev Med. 2013 Nov;57(5):419-25. doi: 10.1016/j.ypmed.2013.04.012. Epub 2013 Apr 28.

Abstract

Objective: Cervical cancer screening using the human papillomavirus (HPV) test and Pap test together (co-testing) is an option for average-risk women ≥ 30 years of age. With normal co-test results, screening intervals can be extended. The study objective is to assess primary care provider practices, beliefs, facilitators and barriers to using the co-test and extending screening intervals among low-income women.

Method: Data were collected from 98 providers in 15 Federally Qualified Health Center (FQHC) clinics in Illinois between August 2009 and March 2010 using a cross-sectional survey.

Results: 39% of providers reported using the co-test, and 25% would recommend a three-year screening interval for women with normal co-test results. Providers perceived greater encouragement for co-testing than for extending screening intervals with a normal co-test result. Barriers to extending screening intervals included concerns about patients not returning annually for other screening tests (77%), patient concerns about missing cancer (62%), and liability (52%).

Conclusion: Among FQHC providers in Illinois, few administered the co-test for screening and recommended appropriate intervals, possibly due to concerns over loss to follow-up and liability. Education regarding harms of too-frequent screening and false positives may be necessary to balance barriers to extending screening intervals.

Keywords: Cervical cancer screening; HPV testing; Screening guidelines.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Attitude of Health Personnel*
  • Cross-Sectional Studies
  • Culture*
  • Early Detection of Cancer / statistics & numerical data*
  • Female
  • Health Knowledge, Attitudes, Practice
  • Health Services Misuse / statistics & numerical data
  • Health Services Research
  • Hospitals, Federal / statistics & numerical data
  • Humans
  • Illinois
  • Papillomavirus Infections / prevention & control*
  • Practice Patterns, Physicians' / statistics & numerical data
  • Primary Health Care / statistics & numerical data*
  • United States
  • Uterine Cervical Neoplasms / prevention & control*
  • Utilization Review
  • Vaginal Smears / statistics & numerical data*