Improving the Utilization of Human Papillomavirus and Cervical Cytology Co-testing for Cervical Cancer Screening in an Obstetrics and Gynecology Resident Clinic.
Human Papillomavirus (HPV) testing in combination with cervical cytology (HPV co-testing) has been recommended for cervical cancer screening for women 30 to 65 years of age. In several studies, HPV co-testing increased sensitivity for detecting high grade dysplasia and resulted in cost-savings. This retrospective cohort study assessed the prevalence of HPV co-testing in an obstetrics and gynecology resident clinic before and after a brief educational intervention which was designed to reinforce current cervical cancer screening recommendations. The intervention consisted of a short presentation that was given to all residents and medical assistants in October 2011. The proportion of women age 30-65 years of age who had cervical cancer screening with HPV co-testing as compared to cervical cytology alone was compared before and after the intervention using chi-square tests. The goal of the intervention was to increase the percentage of patients receiving co-testing from 0.5% to 7.8%. Each arm (pre- and post-intervention) required 130 subjects to achieve 80% power with a significance of P = .05. No significant differences in demographics including age, insurance type, and cytology were noted. HPV co-testing increased from 0% to 55% (P < .001). Of the 72 subjects who had co-testing, 58 (80%) will not need cervical cancer screening for another 5 years. HPV co-testing represents an underutilized cervical cancer screening modality for women 30 years and older. This brief educational intervention, adaptable to any clinical setting, significatnly increased co-testing at the clinical site.
University of Hawai'i John A. Burns School of Medicine, Department of Obstetrics, Gynecology and Women's Health, Honolulu, HI.
Kurt
K
Yoshino
University of Hawai'i John A. Burns School of Medicine, Department of Obstetrics, Gynecology and Women's Health, Honolulu, HI.
Maxine
M
Karimoto
University of Hawai'i John A. Burns School of Medicine, Department of Obstetrics, Gynecology and Women's Health, Honolulu, HI.
Christina
C
Marzo
University of Hawai'i John A. Burns School of Medicine, Department of Obstetrics, Gynecology and Women's Health, Honolulu, HI.
Bliss
B
Kaneshiro
University of Hawai'i John A. Burns School of Medicine, Department of Obstetrics, Gynecology and Women's Health, Honolulu, HI.
Mark
M
Hiraoka
D000328:Adult; D000368:Aged; D002584:Cervix Uteri / Q000473:pathology*; D015331:Cohort Studies; D055088:Early Detection of Cancer / Q000379:methods*; D005260:Female; D006801:Humans; D008875:Middle Aged; D027383:Papillomaviridae / Q000302:isolation & purification*; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis*