UNITED STATES: Many Doctors Overuse Pap Testing: Survey

Important note: Information in this article was accurate in 2009. The state of the art may have changed since the publication date.

UNITED STATES: Many Doctors Overuse Pap Testing: Survey

Reuters Health (11.02.09) - Friday, November 06, 2009

Guidelines for Pap screening were substantially revised earlier this decade in response to research showing that low- risk women age 30 and older did not need annual testing. However, a new study suggests that many US primary care doctors recommend Pap screening more often than guidelines suggest.

Researchers surveyed a nationally representative sample of physicians during 2006-07, asking what their Pap testing recommendations would be for four patient vignettes. Of 1,212 participants responding, just 22.3 percent made recommendations fully consistent with major professional organizations' guidelines, including the American Cancer Society (ACS) and the American College of Obstetricians and Gynecologists (ACOG). The proportion making guideline- consistent recommendations was 27.5 percent among internists, 21.1 percent among family and general practitioners, and 16.4 percent among obstetricians and gynecologists.

Half of respondents would not recommend Pap testing for a hypothetical 18-year-old woman with no sexual experience, which is in line with guidelines. The other half recommended testing at least every three years. ACS, ACOG, and the US Preventive Services Task Force generally counsel that women begin Pap testing at age 21 or within three years of sexual debut, whichever is earlier; then screen yearly to age 30; and thereafter screen every two to three years if results for three consecutive tests are normal.

More than 40 percent said they would advise Pap testing for a 66-year old woman with lung cancer, and some recommended annual testing, despite the fact that the guidelines say Pap testing would not be indicated for this patient.

Low-risk women ages 65-70 can stop Pap screening, the recommendations say. In addition, according to ACS guidance, women who have had a total hysterectomy for a noncancerous condition or who have a serious disease limiting life expectancy can stop Pap screening.

The researchers said doctors' reasons for disregarding the guidelines could include disagreement with them, confusion about the recent changes, concerns over potential malpractice suits or financial incentives for testing more often.

The full report, "Specialty Differences in Primary Care Physician Reports of Papanicolaou Test Screening Practices: A National Survey, 2006 to 2007," was published in Annals of Internal Medicine (2009;151(9):602-611).
091106
AD091913

Copyright © 2009 - Information, Inc., Bethesda, MD. The CDC National Center for HIV, STD and TB Prevention provides the following information as a public service only. Providing synopses of key scientific articles and lay media reports on HIV/AIDS, other sexually transmitted diseases and tuberculosis does not constitute CDC endorsement. This daily update also includes information from CDC and other government agencies, such as background on Morbidity and Mortality Weekly Report (MMWR) articles, fact sheets, press releases and announcements. Reproduction of this text is encouraged; however, copies may not be sold, and the CDC HIV/STD/TB Prevention News Update should be cited as the source of the information. Contact the sources of the articles abstracted below for full texts of the articles.

AEGiS is a 501(c)3, not-for-profit, tax-exempt, educational corporation. AEGiS is made possible through unrestricted funding from the Elton John AIDS Foundation, National Library of Medicine, AIDS Walk of Orange County, and donations from users like you.

Always watch for outdated information. This article first appeared in 2009. This material is designed to support, not replace, the relationship that exists between you and your doctor.

AEGiS presents published material, reprinted with permission and neither endorses nor opposes any material. All information contained on this website, including information relating to health conditions, products, and treatments, is for informational purposes only. It is often presented in summary or aggregate form. It is not meant to be a substitute for the advice provided by your own physician or other medical professionals. Always discuss treatment options with a doctor who specializes in treating HIV.

Copyright ©1980, 2009. AEGiS. All materials appearing on AEGiS are protected by copyright as a collective work or compilation under U.S. copyright and other laws and are the property of AEGiS, or the party credited as the provider of the content.