An Assessment of Gynecological Cytology Screening Practices Among Health Care Providers Nationwide

Darwish-Yassine, May; Garvin, Ann D.; Johnston, Carolyn; Zoschnick, Lauren; Conners, Amy Lynn; Laing, Shannon; Wojcik, Christopher

doi:10.5858/arpa.2013-0620-oa

Cited by 11 publications

(6 citation statements)

References 42 publications

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“…Although there is indication that the most influential factors in clinicians' cervical cancer screening practices are screening guidelines, 158 in many health care settings, the current cervical cancer screening recommendations are not consistently followed, do not match women's preferences, or do not reflect efforts to educate women about new, recommended protocols 54 . A national survey of different provider groups (family physicians, nurse practitioners, obstetricians and gynecologists, and certified nurse‐midwives) revealed considerable disparities and variation between and among provider groups in the use of cervical cancer screening tests 159 . Despite recommendations against annual cervical cancer screening from major guideline developing groups, and many years since annual cytology screening was recommended, it is reported that annual cytology testing still is common 160,161 .…”

Section: Discussionmentioning

confidence: 99%

Cervical cancer screening for individuals at average risk: 2020 guideline update from the American Cancer Society

Fontham

Wolf

Church

et al. 2020

CA A Cancer J Clinicians

661

546

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The American Cancer Society (ACS) recommends that individuals with a cervix initiate cervical cancer screening at age 25 years and undergo primary human papillomavirus (HPV) testing every 5 years through age 65 years (preferred); if primary HPV testing is not available, then individuals aged 25 to 65 years should be screened with cotesting (HPV testing in combination with cytology) every 5 years or cytology alone every 3 years (acceptable) (strong recommendation). The ACS recommends that individuals aged >65 years who have no history of cervical intraepithelial neoplasia grade 2 or more severe disease within the past 25 years, and who have documented adequate negative prior screening in the prior 10 years, discontinue all cervical cancer screening (qualified recommendation). These new screening recommendations differ in 4 important respects compared with the 2012 recommendations: 1) The preferred screening strategy is primary HPV testing every 5 years, with cotesting and cytology alone acceptable where access to US Food and Drug Administration-approved primary HPV testing is not yet available; 2) the recommended age to start screening is 25 years rather than 21 years; 3) primary HPV testing, as well as cotesting or cytology alone when primary testing is not available, is recommended starting at age 25 years rather than age 30 years; and 4) the guideline is transitional, ie, options for screening with cotesting or cytology alone are provided but should be phased out once full access to primary HPV testing for cervical cancer screening is available without barriers. Evidence related to other relevant issues was reviewed, and no changes were made to recommendations for screening intervals, age or criteria for screening cessation, screening based on vaccination status, or screening after hysterectomy. Follow-up for individuals who screen positive for HPV and/or cytology should be in accordance with the 2019 American Society for Colposcopy and Cervical Pathology risk-based management consensus guidelines for abnormal cervical cancer screening tests and cancer precursors.

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Section: Discussionmentioning

confidence: 99%

Cervical cancer screening for individuals at average risk: 2020 guideline update from the American Cancer Society

Fontham

Wolf

Church

et al. 2020

CA A Cancer J Clinicians

661

546

View full text Add to dashboard Cite

show abstract

“…A potential mediator of the changes in both knowledge and practitioner recommendations may be the updates to cervical cancer screening guidelines that occurred over this period, 2,21 leaving both patients and practitioners uncertain of the timing and recommended intervals for screening. 22,23 Studies have suggested that changing guidelines may produce an increase in both overscreening and underscreening, 8,24 but those already at higher risk of cervical cancer may be most susceptible to underscreening. 25 Therefore, it was not unexpected to find many traditionally marginalized sociodemographic groups had the highest risk of overdue screening.…”

Section: Discussionmentioning

confidence: 99%

Assessment of US Preventive Services Task Force Guideline–Concordant Cervical Cancer Screening Rates and Reasons for Underscreening by Age, Race and Ethnicity, Sexual Orientation, Rurality, and Insurance, 2005 to 2019

et al. 2022

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IMPORTANCECervical cancer screening rates are suboptimal in the US. Population-based assessment of reasons for not receiving screening is needed, particularly among women from historically underserved demographic groups. OBJECTIVE To estimate changes in US Preventive Service Task Force guideline-concordant cervical cancer screening over time and assess the reasons women do not receive up-to-date screening by sociodemographic factors. DESIGN, SETTING, AND PARTICIPANTS This pooled population-based cross-sectional study used data from the US National Health Interview Survey from 2005 and 2019. A total of 20 557 women (weighted, 113.1 million women) aged 21 to 65 years without previous hysterectomy were included.

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“…9 Those findings correspond other studies that found physicianrelated factors also to be related to screening overuse. [20][21][22] Since the cervical cancer screening guideline has changed overtime, updated information regarding screening interval and indication should be provided to healthcare providers, and physicians should be aware of the drawbacks of overscreening. Specific indication, as well as the risks and benefits of screening should be discussed with each patient.…”

Section: Screening Overusementioning

confidence: 99%

Factors Associated with Cervical Cancer Screening Overuse and Underuse, and Attitude towards Human Papillomavirus Self-sampling among Hospital Staffs

Laowjan

Maichonklang²,

Permpool³

et al. 2023

Siriraj Med J

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Objective: To investigate the rates of and factors associated with cervical cancer screening overuse and underuse, and the attitude towards human papillomavirus (HPV) self-sampling among hospital staffs. Materials and Methods: This cross-sectional study included female hospital staff undergoing an annual health check-up. A questionnaire was used to collect sociodemographic characteristics, indication for cervical cancer screening, reasons for screening decision, and attitude toward HPV self-sampling. Screening overuse was defined as having cervical cancer screening without indication while screening underuse was having indication for screening but not receiving it. Results: Among the 600 included participants, 220 and 380 women decided to screen and not to screen for cervical cancer, respectively. The prevalence of screening overuse and underuse was 11.8% and 33.0%, respectively. Multivariate analysis revealed age was associated with screening underuse (aOR: 1.06, 95% CI: 1.04-1.09; p<0.001), whereas married status was associated with screening overuse (aOR: 3.73, 95% CI: 2.05-6.79; p<0.001). The common reasons for screening were “add-on to annual health check-up” (93.2%), “fear of cancer” (84.1%), and “family/organizational support” (54.5%). The common reasons for not screening were “feeling healthy” (73.7%), “fear of pain” (58.7%), and “embarrassment” (57.1%). Most women (65.1%) expressed interest in screening via HPV self-sampling. Conclusion: Overuse and underuse of cervical cancer screening were common. An accurate information regarding screening indication should be provided and indication restriction should be implemented to a health system to avoid screening overuse. In addition, an encouragement should be enhanced to the target population to attend the screening program.

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An Assessment of Gynecological Cytology Screening Practices Among Health Care Providers Nationwide

Cited by 11 publications

References 42 publications

Cervical cancer screening for individuals at average risk: 2020 guideline update from the American Cancer Society

Cervical cancer screening for individuals at average risk: 2020 guideline update from the American Cancer Society

Assessment of US Preventive Services Task Force Guideline–Concordant Cervical Cancer Screening Rates and Reasons for Underscreening by Age, Race and Ethnicity, Sexual Orientation, Rurality, and Insurance, 2005 to 2019

Factors Associated with Cervical Cancer Screening Overuse and Underuse, and Attitude towards Human Papillomavirus Self-sampling among Hospital Staffs

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