Clinicians often stray from cervical cancer prevention guidelines

Getting the cervix in view
Getting the cervix in view

HealthDay News -- A survey of obstetrician-gynecologists has identified barriers to the adoption of human papillomavirus (HPV) vaccination and appropriate screening measures for cervical cancer

Rebecca B. Perkins, MD, of Boston University, and colleagues, administered a 15-item questionnaire to assess sociodemographic characteristics, clinical practices and perceived barriers to HPV vaccination and cervical cancer screening guidelines to a national sample of 366 American Congress of Obstetricians and Gynecologists (ACOG) members. The findings were published online in the American Journal of Preventive Medicine.

Although most (92%) respondents offered HPV vaccination to eligible patients, only 27% reported that most of the appropriate candidates received the vaccination. Common barriers to HPV vaccination included parent and patient refusals.

About half of respondents followed guidelines for cervical cancer screening, initiating routine screening at age 21, discontinuing screening at age 70 or following hysterectomy, and offering Pap and HPV co-testing.

However, many respondents continued to recommend annual Pap smears for women -- 74% indicated they still recommended annual pap smears for patients aged 21 to 29 years, and 53% said they still recommended the test for those aged 30 years or younger.

Physicians thought patients were not comfortable with extended intervals of screening and feared patients would not attend annual exams unless Paps were offered. Compared with those in group practices, solo practitioners were less likely to follow vaccination and screening guidelines.

"In the current survey and others, providers stated that the largest barrier to HPV vaccination was patients and parents declining to receive the vaccine," Perkins said in a statement. "However, studies indicate that most patients support HPV vaccination, and that a strong physician recommendation is the most important determinant of vaccine uptake in young women."


References

  1. Perkins RB et al. Am J Prev Med. 2013;45(2):175-181.
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