Practice Bulletins are evidence-based documents that summarize current Number , May ) (Interim Update); Cervical Cancer Screening and. The incidence of cervical cancer in the United States has decreased more than 50% in the past 30 years because of widespread screening with cervical cytology . COMMITTEE ON PRACTICE BULLETINS—Gynecology Practice Screening and Prevention (Replaces Practice Bulletin Number , Full text of Practice Bulletin #, an interim update of #, is available to ACOG.
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Cervical Cancer Screening Intervals, to Moving Beyond Annual Testing.
Clinical guidelines recommend that women 30 years and older with a negative test result for oncogenic human papillomavirus HPV and with a concurrent normal Papanicolaou test result co-testing not be tested again for at least 3 years.
Each vignette included Papanicolaou test results in the prior 5 years and current HPV and Papanicolaou test results.
Using the screening recommendations applicable at the time of the surveys, 1 we defined responses for timing of the next Papanicolaou test as consistent with guidelines; sooner than recommended; and later than recommended Table pracrice and Table 2. Potential differences in guideline-consistent recommendations between years were compared with t test statistic. Guideline adherence was low overall, especially in vignettes portraying women with normal test results vignettes 1, 2, and 3.
ACOG Practice Bulletin Number 131: Screening for cervical cancer.
After normal co-testing results vignettes 2 and 3most respondents Adherence improved cancrr the recommendation was to repeat screening in 1 year because of abnormal results vignettes 4 and 5. In vignette 4, percentages increased from However, without a known Papanicolaou test history vignette 5guideline adherence was low, ranging from From toprimary care providers consistently reported that they would recommend Papanicolaou testing sooner than recommended by guidelines, especially after normal co-testing results.
A novel benefit of co-testing is the ability to nmber screening intervals immediately among women who have no prior screening or whose screening history is unavailable if both test results are normal, yet the lowest fot to guidelines was for the cefvical of a woman with unknown Papanicolaou test history and negative co-test results 3.
The highest adherence to guidelines occurred when the recommended interval was less than 3 years, suggesting that clinicians are willing to adhere to guidelines if more vigilant testing is recommended.
The ability to obtain prior screening results and the use of electronic medical records or systems changes, such as office reminders or reimbursement packages, may help achieve adherence to recommended intervals.
However, estimates were weighted to physician population and accounted for survey nonresponse. Uncertain concordance of practitioner response to hypothetical vignette with actual practice might also be of concern. Vignettes, however, have been shown to be inexpensive pracyice useful tools for measuring quality of care by physicians.
Future analyses will monitor adherence to newer guidelines that recommend extending screening intervals to 5 years among women with normal co-testing results, a strategy designed to screenkng a reasonable balance between benefits and harms. Study concept and design: Berkowitz, Saraiya, and Sawaya.
Analysis and interpretation of data: Drafting of the manuscript: Critical revision of the manuscript for important intellectual content: The finding and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.
American Cancer Society guideline for the early detection of cervical neoplasia and cancer. CA Cancer J Clin. Cervical cancer screening with both human papillomavirus and Papanicolaou testing vs Papanicolaou testing alone: Common abnormal results of Pap and human papillomavirus contesting. Centers for Disease Control and Prevention. About the ambulatory health care surveys: Accessed December 12, Cervical cancer risk for women undergoing concurrent testing for human papillomavirus and cervical cytology: Comparison of vignettes, standardized patients, and chart abstraction: Am J Clin Pathol.
Committee on Practice Bulletins—Gynecology.
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ACOG Practice Bulletin Number Screening for cervical cancer. – Semantic Scholar
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Women’s Health Care Physicians
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