title: Primary care provider practices and beliefs related to cervical cancer screening with the HPV test in Federally Qualified Health Centers.
abstract: OBJECTIVE
  Cervical cancer screening using the human papillomavirus (HPV) test and Pap test together (co-testing) is an option for average-risk women ≥ 30 years of age. With normal co-test results, screening intervals can be extended. The study objective is to assess primary care provider practices, beliefs, facilitators and barriers to using the co-test and extending screening intervals among low-income women.
  
  
  METHODS
  Data were collected from 98 providers in 15 Federally Qualified Health Center (FQHC) clinics in Illinois between August 2009 and March 2010 using a cross-sectional survey.
  
  
  RESULTS
  39% of providers reported using the co-test, and 25% would recommend a three-year screening interval for women with normal co-test results. Providers perceived greater encouragement for co-testing than for extending screening intervals with a normal co-test result. Barriers to extending screening intervals included concerns about patients not returning annually for other screening tests (77%), patient concerns about missing cancer (62%), and liability (52%).
  
  
  CONCLUSIONS
  Among FQHC providers in Illinois, few administered the co-test for screening and recommended appropriate intervals, possibly due to concerns over loss to follow-up and liability. Education regarding harms of too-frequent screening and false positives may be necessary to balance barriers to extending screening intervals.
authors.affiliation: Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Division of Cancer Prevention and Control, Epidemiology and Applied Research Branch, 4770 Buford Hwy NE, MS K-55, Atlanta, GA 30341, USA. Electronic address: kroland@cdc.gov.
authors.forename: K B
authors.initials: KB
authors.lastname: Roland
authors.forename: V B
authors.initials: VB
authors.lastname: Benard
authors.forename: A
authors.initials: A
authors.lastname: Greek
authors.forename: N A
authors.initials: NA
authors.lastname: Hawkins
authors.forename: D
authors.initials: D
authors.lastname: Manninen
authors.forename: M
authors.initials: M
authors.lastname: Saraiya
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D003430:Cross-Sectional Studies; D003469:Culture; D055088:Early Detection of Cancer / Q000706:statistics & numerical data*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006300:Health Services Misuse / Q000706:statistics & numerical data; D006302:Health Services Research; D006768:Hospitals, Federal / Q000706:statistics & numerical data; D006801:Humans; D007087:Illinois; D030361:Papillomavirus Infections / Q000517:prevention & control*; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data; D011320:Primary Health Care / Q000706:statistics & numerical data*; D014481:United States; D002583:Uterine Cervical Neoplasms / Q000517:prevention & control*; D014600:Utilization Review; D014626:Vaginal Smears / Q000706:statistics & numerical data*
keywords: Cervical cancer screening; HPV testing; Screening guidelines