title: Cervical cancer screening continues to limit provision of contraception.
abstract: OBJECTIVE
  Balancing needs for contraception and cervical cancer screening is challenging for clinicians. We assessed US obstetrician/gynecologists' practices regarding requirement of Pap testing before prescribing oral contraceptive or emergency contraceptive pills.
  
  
  METHODS
  Questionnaires structured as clinical vignettes describing women desiring contraception with different risks of cervical dysplasia were mailed to a national sample of 355 obstetrician/gynecologists.
  
  
  RESULTS
  A minority (3%) of the 185 obstetrician/gynecologists who responded would refill 12 months of oral contraceptives without requiring Pap testing. However, most would provide a limited supply of oral contraceptives until Pap testing could be performed. A substantial proportion (11-16%) would refuse to prescribe emergency contraception to women who they felt required Pap testing. Younger physicians, those practicing in academic settings and those who follow American Cancer Society guidelines were more willing to prescribe contraceptives without Pap testing.
  
  
  CONCLUSIONS
  Cervical cancer screening continues to limit prescription of routine and emergency contraception by many US obstetrician/gynecologists.
authors.affiliation: General Internal Medicine Section, Department of Medicine, University of California, San Francisco (UCSF), San Francisco, CA 94121, USA. schwarz@medicine.ucsf.edu
authors.forename: Eleanor Bimla
authors.initials: EB
authors.lastname: Schwarz
authors.forename: Mona
authors.initials: M
authors.lastname: Saint
authors.forename: Ginny
authors.initials: G
authors.lastname: Gildengorin
authors.forename: Tracy A
authors.initials: TA
authors.lastname: Weitz
authors.forename: Felicia H
authors.initials: FH
authors.lastname: Stewart
authors.forename: George F
authors.initials: GF
authors.lastname: Sawaya
mesh_terms: D003267:Contraception / Q000706:statistics & numerical data; D003271:Contraceptive Agents, Female; D003276:Contraceptives, Oral; D003281:Contraceptives, Postcoital; D011307:Drug Prescriptions; D005260:Female; D006801:Humans; D008875:Middle Aged; D010820:Physicians / Q000941:ethics; D010818:Practice Patterns, Physicians'; D011795:Surveys and Questionnaires; D002578:Uterine Cervical Dysplasia; D002583:Uterine Cervical Neoplasms / Q000517:prevention & control; D014626:Vaginal Smears
chemical_list: D003271:Contraceptive Agents, Female; D003276:Contraceptives, Oral; D003281:Contraceptives, Postcoital