title: Missed connections: Unintended consequences of updated cervical cancer screening guidelines on screening rates for sexually transmitted infections.
abstract: OBJECTIVE
  To examine the effects of the updated 2012 cervical cancer screening guidelines on the rates of sexually transmitted infection (STI) screening in primary care.
  
  
  METHODS
  Retrospective chart review.
  
  
  METHODS
  Five academic family practice units at St Michael's Hospital in Toronto, Ont.
  
  
  METHODS
  Female patients, aged 19 to 25, who had at least 1 visit with a physician at 1 of the 5 academic family practice units during a 12-month period before (May 1, 2011, to April 30, 2012) or after (November 1, 2012, to October 31, 2013) the release of the updated guidelines.
  
  
  METHODS
  Number of women who received Papanicolaou tests or underwent STI screening; rates of STI screening performed during a Pap test or a periodic health examination; screening rates for HIV, syphilis, and hepatitis C; and the methods used for STI screening before and after the release of the updated guidelines. Results Before the release of the 2012 guidelines, 42 of 100 women had Pap tests and 40 of 100 women underwent STI screening. After the release of the guidelines, 17 of 100 women had Pap tests and 20 of 100 women received STI screening. Female patients were less likely to undergo STI screening under the 2012 guidelines compared with the 2005 guidelines (odds ratio 0.38, 95% CI 0.19 to 0.74; P = .003).
  
  
  CONCLUSIONS
  Implementation of the 2012 cervical cancer screening guidelines was associated with lower rates of STI screening in the primary care setting. Primary care physicians should screen at-risk women for STIs at any clinically appropriate encounter and consider using noninvasive self-sampling methods.
authors.forename: Tali
authors.initials: T
authors.lastname: Bogler
authors.forename: Allison
authors.initials: A
authors.lastname: Farber
authors.forename: Nathan
authors.initials: N
authors.lastname: Stall
authors.forename: Sheila
authors.initials: S
authors.lastname: Wijayasinghe
authors.forename: Morgan
authors.initials: M
authors.lastname: Slater
authors.forename: Charlie
authors.initials: C
authors.lastname: Guiang
authors.forename: Richard H
authors.initials: RH
authors.lastname: Glazier
mesh_terms: D000328:Adult; D055088:Early Detection of Cancer / Q000379:methods*; D005194:Family Practice; D005260:Female; D006801:Humans; D008403:Mass Screening / Q000706:statistics & numerical data*; D009864:Ontario; D065006:Papanicolaou Test; D058007:Physicians, Primary Care / Q000193:education; D017410:Practice Guidelines as Topic / Q000592:standards*; D012189:Retrospective Studies; D012749:Sexually Transmitted Diseases / Q000175:diagnosis*; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis*; D014626:Vaginal Smears; D055815:Young Adult