Too Much of a Good Thing? Physician Practices and Patient Willingness for Less Frequent Pap Test Screening Intervals
Too Much of a Good Thing? Physician Practices and Patient Willingness for Less Frequent Pap Test Screening Intervals
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DOI：
10.1097/mlr.0b013e3181ca4015
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发表时间：
2010-03-01
期刊：
影响因子：
3
通讯作者：
Coughlin, Steven S.
中科院分区：
文献类型：
--
作者：
Meissner, Helen I.;Tiro, Jasmin A.;Coughlin, Steven S.
背景：最近的指南建议更长的巴氏试验间隔。然而，医生和患者可能不会采用这些recommendations.Objectives：识别（1）医生和实践的特点与建议较低频率的间隔，和（2）与妇女的意愿，坚持3年的间隔相关的特点。研究设计：我们使用了2个国家的调查：（1）2006/2007年全国初级保健医生宫颈癌筛查情况调查（N = 1114），以及（2）2005年健康信息趋势调查，了解妇女接受较长巴氏检查间隔的情况（N = 2206）.测量和方法：使用临床小插曲测量关于巴氏检查间隔的医生建议，所述临床小插曲涉及35岁的无新性伴侣和连续3次阴性巴氏检查的患者;与自变量的关联用逻辑回归进行评估。在平行模型中，我们评估了妇女愿意遵循3年巴氏试验intervention.Results：少数医生（32%）采用，但超过一半的妇女愿意采用3年巴氏试验间隔。在调整后的模型中，与筛查频率较低相关的医生因素是：服务于较高比例的医疗补助患者，白色，非西班牙裔种族，医学院毕业后的年数较少，以及美国预防服务工作组在医生临床实践中非常有影响力。妇女更愿意遵循3年的间隔，如果他们是老年人，但不太愿意，如果他们有个人或家庭的经验，癌症或遵循每年巴氏试验schedule.Conclusions：许多妇女接受3年的间隔巴氏试验，虽然大多数初级保健医生继续建议较短的间隔。
Background: Recent guidelines recommend longer Pap test intervals. However, physicians and patients may not be adopting these recommendations.Objectives: Identify (1) physician and practice characteristics associated with recommending a less frequent interval, and (2) characteristics associated with women's willingness to adhere to a 3-year interval.Research Design: We used 2 national surveys: (1) a 2006/2007 National Survey of Primary Care Physicians for physician cervical cancer screening practices (N = 1114), and (2) the 2005 Health Information Trends Survey for women's acceptance of longer Pap intervals (N = 2206).Measures and Methods: Physician recommendation regarding Pap intervals was measured using a clinical vignette involving a 35-year-old with no new sexual partners and 3 consecutive negative Pap tests; associations with independent variables were evaluated with logistic regression. In parallel models, we evaluated women's willingness to follow a 3-year Pap test interval.Results: A minority of physicians (32%) have adopted-but more than half of women are willing to adopt-3-year Pap test intervals. In adjusted models, physician factors associated with less frequent screening were: serving a higher proportion of Medicaid patients, white, non-Hispanic race, fewer years since medical school graduation, and US Preventive Services Task Force being very influential in physician clinical practice. Women were more willing to follow a 3-year interval if they were older, but less willing if they had personal or family experiences with cancer or followed an annual Pap test schedule.Conclusions: Many women are accepting of a 3-year interval for Pap tests, although most primary care physicians continue to recommend shorter intervals.