Too much of a good thing? Physician practices and patient willingness for less frequent pap test screening intervals

Helen I. Meissner, Jasmin A. Tiro, K. Robin Yabroff, David A. Haggstrom, Steven Scott Coughlin

Research output: Contribution to journalArticlepeer-review

47 Scopus citations


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 desing: 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.

Original languageEnglish (US)
Pages (from-to)249-259
Number of pages11
JournalMedical Care
Issue number3
StatePublished - Mar 1 2010


  • Behavior change
  • Cancer screening
  • Cervical cancer
  • Guidelines
  • Health service

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health


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