Differences among primary care physicians' adherence to 2009 acog guidelines for cervical cancer screening

Jennifer Corbelli, Sonya Borrero, Rachel Bonnema, Megan McNamara, Kevin Kraemer, Doris Rubio, Irina Karpov, Melissa McNeil

Research output: Contribution to journalArticle

21 Citations (Scopus)

Abstract

Background: In 2009, the American Congress of Obstetrics and Gynecology (ACOG) guidelines for cervical cancer screening changed significantly, to recommend less frequent screening than prior guidelines. The extent to which physicians in different specialties implemented these guidelines in the years following publication is unknown. Methods: Cross-sectional survey completed by 316 physicians in internal medicine, family medicine, and gynecology. Survey items assessed respondents' cervical cancer screening practices in women of different ages and medical histories. We used descriptive statistics to generate response distribution for survey items, and logistic regression models to compare responses among specialties. Results: Our response rate was 55% (316/575). Thirty-four percent of respondents' screening practices were inconsistent with ACOG guidelines for women under age 21, and 49% were inconsistent with guidelines for women over age 30. Internists (50%) were less likely than family medicine (89%, p<0.001) and gynecology (80%, p=0.02) physicians to delay pap testing until age 21. Internists (41%) were less likely than both family medicine (60%, p=0.009) and gynecology (68%, p=0.03) physicians to follow guidelines for women over age 30 (p=0.003). Overall 22% percent of physicians followed guidelines for women ages 21-29 years, with no significant differences between specialties. Differences remained significant in multivariable models. Conclusions: Despite consensus among national organizations as to optimal regimens for cervical cancer screening, a significant proportion of providers, especially in internal medicine, do not adhere to ACOG's 2009 guidelines. The lack of comprehensive guideline implementation suggests that adherence to new 2012 guidelines, which advocate for less frequent screening, will likely be suboptimal and discrepant by specialty.

Original languageEnglish (US)
Pages (from-to)397-403
Number of pages7
JournalJournal of Women's Health
Volume23
Issue number5
DOIs
StatePublished - May 1 2014

Fingerprint

Primary Care Physicians
Early Detection of Cancer
Uterine Cervical Neoplasms
Guidelines
Gynecology
Physicians
Medicine
Internal Medicine
Obstetrics
Logistic Models
Publications
Consensus
Cross-Sectional Studies
Organizations
Surveys and Questionnaires

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Corbelli, J., Borrero, S., Bonnema, R., McNamara, M., Kraemer, K., Rubio, D., ... McNeil, M. (2014). Differences among primary care physicians' adherence to 2009 acog guidelines for cervical cancer screening. Journal of Women's Health, 23(5), 397-403. https://doi.org/10.1089/jwh.2013.4475

Differences among primary care physicians' adherence to 2009 acog guidelines for cervical cancer screening. / Corbelli, Jennifer; Borrero, Sonya; Bonnema, Rachel; McNamara, Megan; Kraemer, Kevin; Rubio, Doris; Karpov, Irina; McNeil, Melissa.

In: Journal of Women's Health, Vol. 23, No. 5, 01.05.2014, p. 397-403.

Research output: Contribution to journalArticle

Corbelli, J, Borrero, S, Bonnema, R, McNamara, M, Kraemer, K, Rubio, D, Karpov, I & McNeil, M 2014, 'Differences among primary care physicians' adherence to 2009 acog guidelines for cervical cancer screening', Journal of Women's Health, vol. 23, no. 5, pp. 397-403. https://doi.org/10.1089/jwh.2013.4475
Corbelli, Jennifer ; Borrero, Sonya ; Bonnema, Rachel ; McNamara, Megan ; Kraemer, Kevin ; Rubio, Doris ; Karpov, Irina ; McNeil, Melissa. / Differences among primary care physicians' adherence to 2009 acog guidelines for cervical cancer screening. In: Journal of Women's Health. 2014 ; Vol. 23, No. 5. pp. 397-403.
@article{84aa8fb91eb843fc91f6864512421cbd,
title = "Differences among primary care physicians' adherence to 2009 acog guidelines for cervical cancer screening",
abstract = "Background: In 2009, the American Congress of Obstetrics and Gynecology (ACOG) guidelines for cervical cancer screening changed significantly, to recommend less frequent screening than prior guidelines. The extent to which physicians in different specialties implemented these guidelines in the years following publication is unknown. Methods: Cross-sectional survey completed by 316 physicians in internal medicine, family medicine, and gynecology. Survey items assessed respondents' cervical cancer screening practices in women of different ages and medical histories. We used descriptive statistics to generate response distribution for survey items, and logistic regression models to compare responses among specialties. Results: Our response rate was 55{\%} (316/575). Thirty-four percent of respondents' screening practices were inconsistent with ACOG guidelines for women under age 21, and 49{\%} were inconsistent with guidelines for women over age 30. Internists (50{\%}) were less likely than family medicine (89{\%}, p<0.001) and gynecology (80{\%}, p=0.02) physicians to delay pap testing until age 21. Internists (41{\%}) were less likely than both family medicine (60{\%}, p=0.009) and gynecology (68{\%}, p=0.03) physicians to follow guidelines for women over age 30 (p=0.003). Overall 22{\%} percent of physicians followed guidelines for women ages 21-29 years, with no significant differences between specialties. Differences remained significant in multivariable models. Conclusions: Despite consensus among national organizations as to optimal regimens for cervical cancer screening, a significant proportion of providers, especially in internal medicine, do not adhere to ACOG's 2009 guidelines. The lack of comprehensive guideline implementation suggests that adherence to new 2012 guidelines, which advocate for less frequent screening, will likely be suboptimal and discrepant by specialty.",
author = "Jennifer Corbelli and Sonya Borrero and Rachel Bonnema and Megan McNamara and Kevin Kraemer and Doris Rubio and Irina Karpov and Melissa McNeil",
year = "2014",
month = "5",
day = "1",
doi = "10.1089/jwh.2013.4475",
language = "English (US)",
volume = "23",
pages = "397--403",
journal = "Journal of women's health (2002)",
issn = "1540-9996",
publisher = "Mary Ann Liebert Inc.",
number = "5",

}

TY - JOUR

T1 - Differences among primary care physicians' adherence to 2009 acog guidelines for cervical cancer screening

AU - Corbelli, Jennifer

AU - Borrero, Sonya

AU - Bonnema, Rachel

AU - McNamara, Megan

AU - Kraemer, Kevin

AU - Rubio, Doris

AU - Karpov, Irina

AU - McNeil, Melissa

PY - 2014/5/1

Y1 - 2014/5/1

N2 - Background: In 2009, the American Congress of Obstetrics and Gynecology (ACOG) guidelines for cervical cancer screening changed significantly, to recommend less frequent screening than prior guidelines. The extent to which physicians in different specialties implemented these guidelines in the years following publication is unknown. Methods: Cross-sectional survey completed by 316 physicians in internal medicine, family medicine, and gynecology. Survey items assessed respondents' cervical cancer screening practices in women of different ages and medical histories. We used descriptive statistics to generate response distribution for survey items, and logistic regression models to compare responses among specialties. Results: Our response rate was 55% (316/575). Thirty-four percent of respondents' screening practices were inconsistent with ACOG guidelines for women under age 21, and 49% were inconsistent with guidelines for women over age 30. Internists (50%) were less likely than family medicine (89%, p<0.001) and gynecology (80%, p=0.02) physicians to delay pap testing until age 21. Internists (41%) were less likely than both family medicine (60%, p=0.009) and gynecology (68%, p=0.03) physicians to follow guidelines for women over age 30 (p=0.003). Overall 22% percent of physicians followed guidelines for women ages 21-29 years, with no significant differences between specialties. Differences remained significant in multivariable models. Conclusions: Despite consensus among national organizations as to optimal regimens for cervical cancer screening, a significant proportion of providers, especially in internal medicine, do not adhere to ACOG's 2009 guidelines. The lack of comprehensive guideline implementation suggests that adherence to new 2012 guidelines, which advocate for less frequent screening, will likely be suboptimal and discrepant by specialty.

AB - Background: In 2009, the American Congress of Obstetrics and Gynecology (ACOG) guidelines for cervical cancer screening changed significantly, to recommend less frequent screening than prior guidelines. The extent to which physicians in different specialties implemented these guidelines in the years following publication is unknown. Methods: Cross-sectional survey completed by 316 physicians in internal medicine, family medicine, and gynecology. Survey items assessed respondents' cervical cancer screening practices in women of different ages and medical histories. We used descriptive statistics to generate response distribution for survey items, and logistic regression models to compare responses among specialties. Results: Our response rate was 55% (316/575). Thirty-four percent of respondents' screening practices were inconsistent with ACOG guidelines for women under age 21, and 49% were inconsistent with guidelines for women over age 30. Internists (50%) were less likely than family medicine (89%, p<0.001) and gynecology (80%, p=0.02) physicians to delay pap testing until age 21. Internists (41%) were less likely than both family medicine (60%, p=0.009) and gynecology (68%, p=0.03) physicians to follow guidelines for women over age 30 (p=0.003). Overall 22% percent of physicians followed guidelines for women ages 21-29 years, with no significant differences between specialties. Differences remained significant in multivariable models. Conclusions: Despite consensus among national organizations as to optimal regimens for cervical cancer screening, a significant proportion of providers, especially in internal medicine, do not adhere to ACOG's 2009 guidelines. The lack of comprehensive guideline implementation suggests that adherence to new 2012 guidelines, which advocate for less frequent screening, will likely be suboptimal and discrepant by specialty.

UR - http://www.scopus.com/inward/record.url?scp=84899981397&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84899981397&partnerID=8YFLogxK

U2 - 10.1089/jwh.2013.4475

DO - 10.1089/jwh.2013.4475

M3 - Article

C2 - 24380500

AN - SCOPUS:84899981397

VL - 23

SP - 397

EP - 403

JO - Journal of women's health (2002)

JF - Journal of women's health (2002)

SN - 1540-9996

IS - 5

ER -