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JOURNAL ARTICLE

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

Helen I Meissner, Jasmin A Tiro, K Robin Yabroff, David A Haggstrom, Steven S Coughlin
Medical Care 2010, 48 (3): 249-59
20182268

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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