Cervical Cytology Screening

Abstract

INTRODUCTION: To compare adherence to cervical cytology screening interval guidelines among Family Medicine and Obstetrics and Gynecology (OB/GYN) physicians. METHODS: In this retrospective cohort study, we identified women who presented to the University of California Davis Medical Center outpatient clinics between September 2013 and January 2014 for a routine gynecologic visit. Women were included in this study if they were age 21–65, had cervical cytology performed at that clinic visit, and had their prior cervical cytology completed in the same health system. We analyzed adherence to updated 2013 recommended guidelines among all providers and also compared adherence between Family Medicine and OB/GYN. RESULTS: Around 1,267 women were included in this study (276 in OB/GYN clinic and 991 in Family Medicine clinic). The Family Medicine and OB/GYN providers performed cervical cytology screening at appropriate intervals (50.76% vs 58.70%, P less than 0.05). When identified as inappropriate screening interval, the Family Medicine and OB/GYN providers screened less than six months before the appropriate time (10.60% vs 22.12%, P=.001), six months to one year too soon (27.44% vs 32.74%, P=.261), or more than a year too soon (61.95% vs 45.13%, P=.001). Overall, resident physicians performed better than attending physicians (71.84% vs 50.52%, P less than .0001). CONCLUSION: While overall rates of adherence to recommended cervical cancer screening intervals was poor, OB/GYN physicians followed guidelines more appropriately than Family Medicine physicians at this academic center, and residents better than attending physicians. Our findings suggest that focused education among women's healthcare providers may improve adherence to updated screening guidelines.