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Many U.S. Physicians Overuse Pap Testing

Only about one fifth of U.S. clinicians consistently follow guidelines for Pap testing, with many overusing such screening, according to a federally funded survey in Annals of Internal Medicine.

Some 1100 clinicians (internists, family practitioners, or obstetrician-gynecologists) were given a series of clinical vignettes that described women by age, sexual experience, and Pap testing history. Participants provided their screening recommendations for each scenario.

While over 80% said that at least one set of screening guidelines (e.g., U.S. Preventive Services Task Force) was "very influential" in their practices, only 22% recommended guideline-consistent care for every vignette. Obstetrician-gynecologists were less guideline-concordant than the other specialties.

Of note, one third of participants recommended annual Pap testing for an 18-year-old who hadn't had sexual intercourse, while almost half continued to recommend Pap testing for a women whose cervix had been removed for benign reasons.

LINK(S):

Annals of Internal Medicine article (Free abstract; full text requires subscription)

American Cancer Society guidelines on cervical cancer screening (Free)

American College of Obstetricians and Gynecologists guidelines (Free)

USPSTF guidelines (Free)

Published in Physician's First Watch November 3, 2009