Cancer Screening Practices Among Physicians in the National Breast and Cervical Cancer Early Detection Program

Abstract

Background: The National Breast and Cervical Cancer Early Detection Program (NBCCEDP) provides lowincome, uninsured women with screening and diagnostic services for breast and cervical cancer. Our study was conducted to describe the demographic and practice characteristics of participating and nonparticipating physicians, as well as their beliefs, adoption of new screening technologies, and recommendations for breast and cervical cancer screening. Methods: From a 2006-2007 nationally representative survey, we identified 1,111 practicing primary care physicians who provide breast and cervical cancer screenings and assessed their recommendations using clinical vignettes related to screening initiation, frequency, and cessation. Responses of physicians participating in the NBCCEDP were compared with those from nonparticipating physicians. Results: Of the physicians surveyed, 15% reported participation in the NBCCEDP, 65% were not participants, and 20% were not sure or did not respond to this question. Program physicians were significantly more likely to practice in multispecialty settings, in a rural location, and in a hospital or clinic setting and had more patients who were female and insured by Medicaid or uninsured compared with nonprogram physicians. Beliefs about the effectiveness of screening tools or procedures in reducing breast or cervical cancer mortality were similar by program participation. Adoption of new technologies, including digital mammography and human papillomavirus (HPV) testing, and making guideline-consistent recommendations for screening initiation, frequency, and cessation did not differ significantly by program participation. Conclusions: Although there may be differences in physician characteristics and practice settings, the beliefs and screening practices for both breast and cervical cancer are similar between program and nonprogram providers.

Provider management of equivocal cervical cancer screening results among underserved women, 2009–2011: follow-up of atypical squamous cells of undetermined significance

“…Benard et al [14] found that providers were following women in the NBCCEDP with low-grade abnormalities according to national guidelines for the study period. Additionally, national provider surveys have found that providers serving women in the NBCCEDP had similar results on screening and management beliefs and practices compared to providers who do not serve women in the NBCCEDP [15]. …”

Current Cervical Cancer Screening Knowledge, Awareness, and Practices Among U.S. Affiliated Pacific Island Providers: Opportunities and Challenges

“…Awareness of VIA was considerably lower in NBCCEDPfunded jurisdictions, and few believed it was an acceptable screening method. In general, NBCCEDP policies on cervical cancer screening generally follow U.S. Preventive Services Task Force guidelines, which do not address use of VIA [4,31]. In LMICs, using primary HPV screening rather than cytology presents numerous advantages and is a feasible strategy [32,33].…”

Primary care providers human papillomavirus vaccine recommendations for the medically underserved: A pilot study in U.S. Federally Qualified Health Centers

“…The provider survey was developed specifically for this study, and is based upon national primary care provider surveys [16,17]. The survey was pilot tested with seven primary care providers in the Atlanta, GA area to estimate respondent burden, format, appropriateness and relevance of survey questions.…”