title: Current practice patterns in cervical cancer screening in Indiana.
abstract: OBJECTIVE
  The purpose of this study is to describe current health care provider cervical cancer screening practice patterns for average-risk women in the state of Indiana in comparison to the 2012 guidelines as well as earlier guidelines. We also aim to describe what factors are associated with increased adherence to guidelines, and what factors may impede adherence.
  
  
  METHODS
  We conducted a vignette-based survey among a convenience sample of obstetricians, gynecologists, midwives, nurse practitioners, and physician assistants attending the Indiana American Congress of Obstetricians and Gynecologists Section meeting in January 2013.
  
  
  RESULTS
  Questionnaires were returned by 51% (112/218) of attendants. Of the 111 providers with completed surveys, 42 (38%) follow current guidelines. Of providers, 86% start screening at age 21 years. Of providers, 33% screen women aged 21-29 years every 3 years. Of providers, 33% follow recommendations for cotesting every 5 years for patients 30-65 years of age. The majority of providers follow guidelines to stop screening after a benign hysterectomy or age 65 years (75% and 51%, respectively).
  
  
  CONCLUSIONS
  The majority of providers follow the 2012 guidelines for the initiation and cessation of cervical screening; however, most providers screen more frequently than currently recommended for patients between ages 21-65 years.
authors.affiliation: Department of Obstetrics and Gynecology, Indiana University School of Medicine, Indianapolis, IN.
authors.forename: Nicole R
authors.initials: NR
authors.lastname: King
authors.affiliation: Department of Obstetrics and Gynecology, Indiana University School of Medicine, Indianapolis, IN.
authors.forename: Kelly M
authors.initials: KM
authors.lastname: Kasper
authors.affiliation: Department of Obstetrics and Gynecology, Indiana University School of Medicine, Indianapolis, IN.
authors.forename: Joanne K
authors.initials: JK
authors.lastname: Daggy
authors.affiliation: Department of Obstetrics and Gynecology, Indiana University School of Medicine, Indianapolis, IN.
authors.forename: Brownsyne
authors.initials: B
authors.lastname: Tucker Edmonds
mesh_terms: D000328:Adult; D000368:Aged; D055088:Early Detection of Cancer / Q000379:methods*; D005260:Female; D019983:Guideline Adherence / Q000706:statistics & numerical data*; D019538:Health Care Surveys; D006801:Humans; D007196:Indiana; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D009722:Nurse Practitioners / Q000706:statistics & numerical data; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis*; D014626:Vaginal Smears / Q000706:statistics & numerical data
keywords: Pap smears; cervical cancer screening; guideline adherence; practice patterns