title: Report from the CDC. Pap test intervals used by physicians serving low-income women through the National Breast and Cervical Cancer Early Detection Program.
abstract: The National Breast and Cervical Cancer Early Detection Program (NBCCEDP), administered by the Centers for Disease Control and Prevention (CDC), provides breast and cervical cancer screening to low-income women who are uninsured or underinsured. For women with three consecutive annual Pap tests with normal findings, the NBCCEDP supports extending the screening interval to every 3 years. Thirteen telephone focus groups were conducted with physician providers in 17 states and the District of Columbia to investigate familiarity with NBCCEDP's triennial Pap test policy, the Pap test intervals actually used, and the factors influencing screening interval selection. No participants were familiar with NBCCEDP's triennial Pap test policy, and none reported routinely extending the screening interval after three consecutive annual Pap tests with normal findings. Two patterns of screening interval use were reported: annual screeners continued performing yearly Pap tests, and selective extended screeners offered an extended interval to select patients. Annual and selective extended screeners reported that both unique and common factors influenced the screening intervals they used. The NBCCEDP has established its cancer screening priorities to focus limited resources on the goal of providing services to eligible women who have rarely or never been screened. Increased efforts are needed to educate physicians about the science supporting an extended Pap screening interval and overcome the barriers associated with its adoption.
authors.affiliation: Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, 4770 Buford Highway NE, Atlanta, GA 30341, USA.
authors.forename: Crystale Purvis
authors.initials: CP
authors.lastname: Cooper
authors.forename: Mona
authors.initials: M
authors.lastname: Saraiya
authors.forename: Teresa Abend
authors.initials: TA
authors.lastname: McLean
authors.forename: Judy
authors.initials: J
authors.lastname: Hannan
authors.forename: Jaime M
authors.initials: JM
authors.lastname: Liesmann
authors.forename: Shyanika Wijesinha
authors.initials: SW
authors.lastname: Rose
authors.forename: Herschel W
authors.initials: HW
authors.lastname: Lawson
mesh_terms: D000328:Adult; D000368:Aged; D001291:Attitude of Health Personnel; D001943:Breast Neoplasms / Q000175:diagnosis; D002487:Centers for Disease Control and Prevention, U.S.; D005260:Female; D017144:Focus Groups; D006293:Health Promotion / Q000706:statistics & numerical data; D006297:Health Services Accessibility / Q000191:economics / Q000592:standards*; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000191:economics / Q000592:standards*; D017057:Medically Uninsured / Q000706:statistics & numerical data; D008875:Middle Aged; D011203:Poverty; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000592:standards* / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires; D013997:Time Factors; D014481:United States / Q000453:epidemiology; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis* / Q000453:epidemiology / Q000517:prevention & control; D014626:Vaginal Smears / Q000191:economics / Q000592:standards*