A Comparison of the Evaluation and Treatment of Cervical Dysplasia by Gynecologists and Nurse Practitioners

Abstract

Cervical dysplasia, a precursor to cervical cancer, affects approximately 6% to 10% of women in the United States. Although cervical dysplasia traditionally is diagnosed and treated by gynecologists, nurse practitioners with special education and expertise in the evaluation and treatment of the condition have begun providing care to many women in rural and other medically underserved areas where there is limited access to specialized physicians. This study compared cervical dysplasia evaluation and treatment techniques of 11 gynecologists and 6 nurse practitioners using abstracted patient records. The MDs showed a greater variation in performance than nurse practitioner colposcopists (NPCs) when evaluated on 10 criteria. NPC practices fell within the range of MDs, and when they were statistically different, NPCs practices were more consistent with generally accepted medical practice. These data suggest that NPCs were more likely to adhere to a consistent set of practices. It can be concluded that NPCs are viable alternative providers in the evaluation and treatment of cervical dysplasia.