title: Too much of a good thing? Physician practices and patient willingness for less frequent pap test screening intervals.
abstract: BACKGROUND
  Recent guidelines recommend longer Pap test intervals. However, physicians and patients may not be adopting these recommendations.
  
  
  OBJECTIVE
  Identify (1) physician and practice characteristics associated with recommending a less frequent interval, and (2) characteristics associated with women's willingness to adhere to a 3-year interval.
  
  
  METHODS
  We used 2 national surveys: (1) a 2006/2007 National Survey of Primary Care Physicians for physician cervical cancer screening practices (N = 1114), and (2) the 2005 Health Information Trends Survey for women's acceptance of longer Pap intervals (N = 2206). MEASURES AND METHODS: Physician recommendation regarding Pap intervals was measured using a clinical vignette involving a 35-year-old with no new sexual partners and 3 consecutive negative Pap tests; associations with independent variables were evaluated with logistic regression. In parallel models, we evaluated women's willingness to follow a 3-year Pap test interval.
  
  
  RESULTS
  A minority of physicians (32%) have adopted-but more than half of women are willing to adopt-3-year Pap test intervals. In adjusted models, physician factors associated with less frequent screening were: serving a higher proportion of Medicaid patients, white, non-Hispanic race, fewer years since medical school graduation, and US Preventive Services Task Force being very influential in physician clinical practice. Women were more willing to follow a 3-year interval if they were older, but less willing if they had personal or family experiences with cancer or followed an annual Pap test schedule.
  
  
  CONCLUSIONS
  Many women are accepting of a 3-year interval for Pap tests, although most primary care physicians continue to recommend shorter intervals.
authors.affiliation: Office of Behavioral and Social Sciences Research, National Institutes of Health, 31 Center Dr, Building 31/Room B1C19, Bethesda, MD 20892-2027, USA. meissneh@od.nih.gov
authors.forename: Helen I
authors.initials: HI
authors.lastname: Meissner
authors.forename: Jasmin A
authors.initials: JA
authors.lastname: Tiro
authors.forename: K Robin
authors.initials: KR
authors.lastname: Yabroff
authors.forename: David A
authors.initials: DA
authors.lastname: Haggstrom
authors.forename: Steven S
authors.initials: SS
authors.lastname: Coughlin
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D001291:Attitude of Health Personnel; D001294:Attitude to Health; D019317:Evidence-Based Medicine / Q000706:statistics & numerical data; D005260:Female; D019983:Guideline Adherence / Q000706:statistics & numerical data*; D006297:Health Services Accessibility / Q000706:statistics & numerical data; D006801:Humans; D008403:Mass Screening / Q000706:statistics & numerical data; D008484:Medicaid / Q000706:statistics & numerical data; D008511:Medicine / Q000706:statistics & numerical data; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors; D014481:United States; D014626:Vaginal Smears / Q000523:psychology* / Q000706:statistics & numerical data*