Primary care physicians' awareness and adherence to cervical cancer screening guidelines in Texas.
BACKGROUND
Cervical cancer screening guidelines were created to help healthcare professionals in appropriate screening utilizing the PAP test. However, significant variation in cervical cancer screening among primary care physicians has been noted. Knowledge of the awareness of and adherence to cervical cancer screening guidelines by primary care physicians will help determine how best to disseminate and educate these physicians regarding the guidelines in hopes of reducing unnecessary screening and improving screening for under screened populations.


METHODS
A cross-sectional, mailed survey involving Family Medicine (FP), Community Internal Medicine (CIM), and Obstetrics/Gynecology (OB) physicians practicing in a large University-affiliated, multi-specialty group practice associated with an 186,000-member HMO in Central Texas (n = 177) was conducted in 2001-2002.


RESULTS
Most physicians performed PAP testing (50.4%). PAP screening was noted to vary significantly by specialty (P < 0.0001). All OBs were aware of at least one published guideline, compared to 96% of FPs and 91% of CIMs (P < 0.05). A wide variation was reported regarding adherence to published guidelines. In addition, there was significant intraspecialty variation regarding adherence to the physicians' own specialty's guidelines.


CONCLUSIONS
While most physicians in the primary care setting perform PAP tests and are aware of published guidelines for PAP screening, adherence to the published guidelines varies considerably even in the same clinical setting.
Holland-Barkis
Penelope
P
Department of Family and Community Medicine, Scott and White Memorial Hospital and Scott, Sherwood and Brindley Foundation, Texas A&M University System Health Science Center, College of Medicine, Temple, TX 76513, USA. pholland@swmail.sw.org
Forjuoh
Samuel N
SN
Couchman
Glen R
GR
Capen
Charles
C
Rascoe
Terry G
TG
Reis
Michael D
MD
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001364:Awareness; D003127:Colposcopy / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D005194:Family Practice / Q000592:standards; D005260:Female; D019983:Guideline Adherence / Q000706:statistics & numerical data*; D006176:Gynecology / Q000592:standards; D006279:Health Maintenance Organizations / Q000592:standards; D006801:Humans; D007388:Internal Medicine / Q000592:standards; D008297:Male; D008403:Mass Screening / Q000706:statistics & numerical data*; D008875:Middle Aged; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011320:Primary Health Care / Q000592:standards*; D013781:Texas; D002583:Uterine Cervical Neoplasms / Q000517:prevention & control*; D014626:Vaginal Smears / Q000706:statistics & numerical data*