Cervical Cancer Screening With Both Human Papillomavirus and Papanicolaou Testing vs Papanicolaou Testing Alone

Saraiya, Mona; Berkowitz, Zahava; Yabroff, K. Robin; Wideroff, Louise; Kobrin, Sarah C.; Benard, Vicki B.

doi:10.1001/archinternmed.2010.134

Cited by 100 publications

(100 citation statements)

References 40 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…20 As in prior studies, most providers in our survey valued multiple guidelines. 20 To date, surveys of the cancer screening practices of primary care providers have focused on physicians; [13][14][15]19 our sample included nurse practitioners, certified nurse midwives, and physician assistants, who are becoming more central to the provision of primary care as models of team-based care are disseminated. 21 We examined a broader set of practice characteristics and found that providers who practiced in hospital-based settings were less likely to recommend screening in excess of both guidelines.…”

Section: Discussionmentioning

confidence: 99%

“…13,14,19 Provider characteristics and experience were measured by age, gender, specialty, medical school affiliation (as a proxy for working in a setting where there was teaching of medical students and residents, as teaching responsibilities may be associated with greater familiarity with guidelines and evidence-based practice), and number of office visits during a typical week. We also asked providers about the characteristics of their main practice site, including practice location (e.g., non-hospital-based, hospital-based, or community health center), achievement of National Committee for Quality Assurance (NCQA) recognition as a medical home, and the number of full-or part-time physicians in the practice.…”

Section: Survey Content and Measuresmentioning

confidence: 99%

“…Prior to the revisions, a national survey conducted in 2007 showed that the majority of U.S. primary care physicians routinely recommended screening mammography for women in their 40s, and over 90 % recommended annual screening mammography for women ages 50 and older. 13,14 This survey also documented primary care physicians' preferences for annual Pap testing for most women. Although more recent national data are not available, a 2012 survey of physicians from the University of Pittsburgh found that gynecologists were more likely than internists or family physicians to offer annual versus biennial mammography testing.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Provider Attitudes and Screening Practices Following Changes in Breast and Cervical Cancer Screening Guidelines

et al. 2015

View full text Add to dashboard Cite

BACKGROUND: Changes to national guidelines for breast and cervical cancer screening have created confusion and controversy for women and their primary care providers. OBJECTIVE: To characterize women's primary health care provider attitudes towards screening and changes in practice in response to recent revisions in guidelines for breast and cervical cancer screening. DESIGN, SETTING, PARTICIPANTS: In 2014, we distributed a confidential web and mail survey to 668 women's health care providers affiliated with the four clinical care networks participating in the three PROSPR (Populationbased Research Optimizing Screening through Personalized Regimens) consortium breast cancer research centers (385 respondents; response rate 57.6 %). MAIN MEASURES:We assessed self-reported attitudes toward breast and cervical cancer screening, as well as practice changes in response to the most recent revisions of the U.S. Preventive Services Task Force (USPSTF) recommendations. KEY RESULTS: The majority of providers believed that mammography screening was effective for reducing cancer mortality among women ages 40-74 years, and that Papanicolaou (Pap) testing was very effective for women ages 21-64 years. While the USPSTF breast and cervical cancer screening recommendations were widely perceived by the respondents as influential, 75.7 and 41.2 % of providers (for mammography and cervical cancer screening, respectively) reported screening practices in excess of those recommended by USPSTF. Provider-reported barriers to concordance with guideline recommendations included: patient concerns (74 and 36 % for breast and cervical, respectively), provider disagreement with the recommendations (50 and 14 %), health system measurement of a provider's screening practices that use conflicting measurement criteria (40 and 21 %), concern about malpractice risk (33 and 11 %), and lack of time to discuss the benefits and harms with their patients (17 and 8 %). CONCLUSIONS: Primary care providers do not consistently follow recent USPSTF breast and cervical cancer screening recommendations, despite noting that these guidelines are influential.KEY WORDS: breast cancer screening; cervical cancer screening; provider practice patterns; primary care; clinical practice guidelines.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Survey Content and Measuresmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Provider Attitudes and Screening Practices Following Changes in Breast and Cervical Cancer Screening Guidelines

et al. 2015

View full text Add to dashboard Cite

show abstract

“…[22][23][24] Provider characteristics assessed were age, gender, provider type (MD/DO or PA/NP practicing family medicine, general internal medicine, or OB/GYN), medical school affiliation, and number of office visits during a typical week. We asked providers about the characteristics of their main practice site including achievement of NCQA recognition as a PCMH, practice type (e.g., non-hospital-based office, hospital-based office, or community health center), and the number of full-or part-time physicians.…”

Section: Survey Content and Measuresmentioning

confidence: 99%

Inadequate Systems to Support Breast and Cervical Cancer Screening in Primary Care Practice

et al. 2016

View full text Add to dashboard Cite

BACKGROUND: Despite substantial resources devoted to cancer screening nationally, the availability of clinical practice-based systems to support screening guidelines is not known. OBJECTIVE: To characterize the prevalence and correlates of practice-based systems to support breast and cervical cancer screening, with a focus on the patientcentered medical home (PCMH). DESIGN: Web and mail survey of primary care providers conducted in 2014. The survey assessed provider (gender, training) and facility (size, specialty training, physician report of National Committee for Quality Assurance (NCQA) PCMH recognition, and practice affiliation) characteristics. A hierarchical multivariate analysis clustered by clinical practice was conducted to evaluate characteristics associated with the adoption of practice-based systems and technology to support guideline-adherent screening. PARTICIPANTS: Primary care physicians in family medicine, general internal medicine, and obstetrics and gynecology, and nurse practitioners or physician assistants from four clinical care networks affiliated with PROSPR (Population-based Research Optimizing Screening through Personalized Regimens) consortium research centers. MAIN MEASURES: The prevalence of routine breast cancer risk assessment, electronic health record (EHR) decision support, comparative performance reports, and panel reports of patients due for routine screening and follow-up. KEY RESULTS: There were 385 participants (57.6 % of eligible). Forty-seven percent (47.0 %) of providers reported NCQA recognition as a PCMH. Less than half reported EHR decision support for breast (48.8 %) or cervical cancer (46.2 %) screening. A minority received comparative performance reports for breast (26.2 %) or cervical (19.7 %) cancer screening, automated reports of patients overdue for breast (18.7 %) or cervical (16.4 %) cancer screening, or follow-up of abnormal breast (18.1 %) or cervical (17.6 %) cancer screening tests. In multivariate analysis, reported NCQA recognition as a PCMH was associated with greater use of comparative performance reports of guidelineadherent breast (OR 3.23,

show abstract

“…There have been several other publications using these national survey data, 19,20 including one by Yabroff et al, 11 examining the overall findings of physician practices for cervical cancer screening. That study found that although most Pap test providers reported that screening guidelines were very influential, few had guideline-consistent recommendations for starting and stopping Pap screening across multiple vignettes.…”

Section: Discussionmentioning

confidence: 99%

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

Benard

Saraiya²,

Soman³

et al. 2011

Journal of Women's Health

View full text Add to dashboard Cite

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.

show abstract

Cervical Cancer Screening With Both Human Papillomavirus and Papanicolaou Testing vs Papanicolaou Testing Alone

Cited by 100 publications

References 40 publications

Provider Attitudes and Screening Practices Following Changes in Breast and Cervical Cancer Screening Guidelines

Provider Attitudes and Screening Practices Following Changes in Breast and Cervical Cancer Screening Guidelines

Inadequate Systems to Support Breast and Cervical Cancer Screening in Primary Care Practice

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

Contact Info

Product

Resources

About