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

Meissner HI, Tiro JA, Yabroff KR, Haggstrom DA, Coughlin SS. Too much of a good thing? Physician practices and patient willingness for less frequent pap test screening intervals. Medical care. 2010 Mar 1; 48(3):249-59.

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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.





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