Clinicians recommend unnecessary cervical cancer screening

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Many clinicians overscreen women for cervical cancer, according to a study published in the journal Archives of Internal Medicine (2010 Jun;170(11):977-986).

According to background information provided in the paper, while annual Pap testing has helped decrease the burden of cervical cancer in the United States, the U.S. Preventive Services Task Force cites evidence that screening annually does not improve outcomes when compared with screening every 3 years.

 The findings are from a study led by Mona Saraiya, MD, MPH, of the Centers for Disease Control and Prevention, which surveyed 1,212 primary care physicians, of whom 950 performed Pap tests and had ever recommended the HPV test for their patients. The clinicians, who included general practitioners, family practitioners, obstetrician-gynecologists, and general internists, were asked to report their screening recommendations in response to clinical vignettes.

Results of the study found that for a 35-year-old woman with no new sex partners in the past 5 years and three normal Pap test results, 31.8% of clinicians reported they would recommend the next Pap test in 3 years and 31.7% would recommend the next Pap test in 1 year. However, for a 35-year-old woman with one normal Pap test and a normal HPV test, 19% of clinicians would extend the screening interval to 3 years, whereas 60.1% would recommend annual testing.

“Many physicians reported overscreening women by using both the HPV and Pap test annually,” the authors concluded. “Until measures are in place to reinforce extended screening intervals among women with negative HPV and normal Pap test results, there is no advantage gained with HPV co-testing, and it is more expensive.”

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