Human papillomavirus and Papanicolaou tests screening interval recommendations in the United States.

OBJECTIVE Guidelines recommend when the human papillomavirus (HPV) and Papanicolaou tests are used together (HPV co-test) for routine cervical cancer screening, screening intervals can be extended to 3 years. We assessed HPV test practices and Papanicolaou test screening interval recommendations of US providers. STUDY DESIGN Using a multistage probability design, we analyzed nationally representative data that were collected in 2006 through the Centers for Disease Control and Prevention's National Ambulatory Medical Care Survey and National Hospital Ambulatory Medical Care Survey. RESULTS Approximately 51% of providers ordered the HPV co-test; however, clinical vignettes found that <15% of providers who ordered the HPV test recommend the next Papanicolaou test in 3 years for women with concurrent normal HPV co-test results and a documented normal screening history. CONCLUSION Overall, annual cervical cancer screening continues to be a common recommendation, regardless of whether a screening history has been established or an HPV test has been ordered.

[1]  ACOG Practice Bulletin no. 109: Cervical cytology screening. , 2009, Obstetrics and gynecology.

[2]  David A Haggstrom,et al.  Specialty Differences in Primary Care Physician Reports of Papanicolaou Test Screening Practices: A National Survey, 2006 to 2007 , 2009, Annals of Internal Medicine.

[3]  J. Niloff,et al.  Cancer of the uterine cervix. , 1996, The New England journal of medicine.

[4]  J. Peto,et al.  Human papillomavirus is a necessary cause of invasive cervical cancer worldwide , 1999, The Journal of pathology.

[5]  Z. Berkowitz,et al.  Content analysis of continuing medical education for cervical cancer screening. , 2010, Journal of women's health.

[6]  D. Bertenthal,et al.  An evaluation of vignettes for predicting variation in the quality of preventive care , 2004, Journal of general internal medicine.

[7]  H. Lawson,et al.  Report from the CDC. Pap test intervals used by physicians serving low-income women through the National Breast and Cervical Cancer Early Detection Program. , 2005, Journal of women's health.

[8]  ACOG committee opinion No. 431: routine pelvic examination and cervical cytology screening. , 2009, Obstetrics and gynecology.

[9]  J. T. Cox.  The clinician's view: role of human papillomavirus testing in the American Society for Colposcopy and Cervical Pathology Guidelines for the management of abnormal cervical cytology and cervical cancer precursors. , 2009, Archives of pathology & laboratory medicine.

[10]  Jeff Luck,et al.  Measuring the Quality of Physician Practice by Using Clinical Vignettes: A Prospective Validation Study , 2004, Annals of Internal Medicine.

[11]  D. Solomon,et al.  Cervical Cancer Screening Rates in the United States and the Potential Impact of Implementation of Screening Guidelines , 2007, CA: a cancer journal for clinicians.

[12]  T. Wright,et al.  2006 Consensus Guidelines for the Management of Women With Abnormal Cervical Screening Tests , 2007, Journal of lower genital tract disease.

[13]  Zahava Berkowitz,et al.  Cervical cancer screening with both human papillomavirus and Papanicolaou testing vs Papanicolaou testing alone: what screening intervals are physicians recommending? , 2010, Archives of internal medicine.

[14]  J. T. Cox,et al.  Interim Guidance for the Use of Human Papillomavirus DNA Testing as an Adjunct to Cervical Cytology for Screening , 2004, Obstetrics and gynecology.

[15]  Diane Solomon,et al.  American Cancer Society Guideline for the Early Detection of Cervical Neoplasia and Cancer , 2003, Journal of lower genital tract disease.

[16]  G. Sawaya.  Rightsizing cervical cancer screening: comment on "Cervical cancer screening with both human papillomavirus and Papanicolaou testing vs Papanicolaou testing alone". , 2010, Archives of internal medicine.

[17]  O. Brawley,et al.  Cancer screening in the United States, 2009: A review of current American Cancer Society guidelines and issues in cancer screening , 2009, CA: a cancer journal for clinicians.

[18]  J. Kaldor,et al.  The causal link between human papillomavirus and invasive cervical cancer: A population‐based case‐control study in colombia and spain , 1992, International journal of cancer.

[19]  Mark A. Sutton,et al.  Too much of a good thing , 2001, Nature.

[20]  J. T. Cox,et al.  Human Papillomavirus Testing in Primary Cervical Screening and Abnormal Papanicolaou Management , 2006, Obstetrical & gynecological survey.

[21]  G. Gildengorin,et al.  Current cervical neoplasia screening practices of obstetrician/gynecologists in the US. , 2005, American journal of obstetrics and gynecology.

[22]  S. J. Henley,et al.  Surveillance of screening-detected cancers (colon and rectum, breast, and cervix) - United States, 2004-2006. , 2010, Morbidity and mortality weekly report. Surveillance summaries.

[23]  J W Peabody,et al.  Comparison of vignettes, standardized patients, and chart abstraction: a prospective validation study of 3 methods for measuring quality. , 2000, JAMA.

[24]  Michael D. Reis,et al.  Primary care physicians' awareness and adherence to cervical cancer screening guidelines in Texas. , 2006, Preventive medicine.

[25]  C J L M Meijer,et al.  The causal relation between human papillomavirus and cervical cancer. , 2002, Journal of clinical pathology.

[26]  Jasmin A. Tiro,et al.  Too Much of a Good Thing? Physician Practices and Patient Willingness for Less Frequent Pap Test Screening Intervals , 2010, Medical care.

[27]  Diane Solomon,et al.  Risk assessment to guide the prevention of cervical cancer. , 2007, American journal of obstetrics and gynecology.

[28]  M. Sherman,et al.  Comparison of HPV-based assays with Papanicolaou smears for cervical cancer screening in Morelos State, Mexico , 2003, Cancer Causes & Control.