Current practice patterns in cervical cancer screening in Indiana

Patient knowledge and attitudes toward cervical cancer screening after the 2012 screening guidelines

“…reported that patient expectations drove provider deviation from guideline adherence [5,6]. Our findings that patients expressed discomfort with deviating from annual screening and that screening should not be stopped past age 65 suggest that these concerns are valid.…”

“…A similar study in the Pacific Northwest noted that 48% of the provider participants were not following or planning to follow the 2012 guidelines [6]. Both these studies found that providers were concerned about meeting their patients' expectations to have annual or frequent screenings (52.7% and 66.1%, respectively) as reasons for not complying with the current standard of care [5,6]. Additionally, studies of factors influencing patients' attitudes and compliance with cervical cancer screening prior to the new guidelines include ethnicity, socioeconomic status, insurance status, age, education and profession [7][8][9][10][11][12].…”

“…A 2013 vignette-based survey of gynecology providers in Indiana revealed discordance between their cervical cancer screening practices and 2012 screening guidelines, with only 16.2% of providers completely adhering to the current guidelines [5]. A similar study in the Pacific Northwest noted that 48% of the provider participants were not following or planning to follow the 2012 guidelines [6].…”

Provider beliefs associated with cervical cancer screening interval recommendations: A pilot study in Federally Qualified Health Centers

“…These data identify specific beliefs associated with providers guideline-consistent screening interval recommendations, including beliefs about the goodness, ease, and benefit of extending screening intervals with a normal co-test result, and that extending the interval will not put the patient at increased risk of developing cancer or pre-cancer. Disseminating the positive beliefs found to be associated with 3-year intervals through professional specialty organizations and professional journals could be effective for promoting guideline-consistent interval recommendations among this population, as was found in a survey of Indiana primary care providers King et al, 2014 . Notably, nonmodifiable provider characteristics such as specialty, age, and gender were not associated with interval recommendations in this analysis.…”

“…Despite successful integration of cervical cancer screening into women's routine care, some uninsured and low-income women are screened less often than recommended and suffer disproportionate cervical cancer morbidity, mortality, and late-stage diagnosis ( Benard et al, 2008 , Fedewa et al, 2012 , Spence et al, 2007 ). Conversely, too-frequent cervical cancer screening has also been documented in both the medically underserved and general population ( Corbelli et al, 2014 , King et al, 2014 , Perkins et al, 2013 , Roland et al, 2011 , Teoh et al, 2015 , Verrilli et al, 2014 , Yabroff et al, 2009 ). Plausible explanations include opportunistic clinical service provision ( Habbema et al, 2012 ), provider specialty ( Corbelli et al, 2014 , Yabroff et al, 2009 ), practice setting ( Yabroff et al, 2009 ) and size ( Perkins et al, 2013 ), provider concern for losing the patient to follow-up ( King et al, 2014 , Perkins et al, 2013 , Verrilli et al, 2014 ), patient expectations ( King et al, 2014 , Perkins et al, 2013 , Teoh et al, 2015 , Verrilli et al, 2014 ), and provider knowledge ( Teoh et al, 2015 ).…”