Primary care physicians' awareness and adherence to cervical cancer screening guidelines in Texas

Background. Cervical cancer screening guidelines were created to help healthcare professionals in appropriate screening utilizing the PAP test. However, significant variation in cervical cancer screening among primary care physicians has been noted. Knowledge of the awareness of and adherence to cervical cancer screening guidelines by primary care physicians will help determine how best to disseminate and educate these physicians regarding the guidelines in hopes of reducing unnecessary screening and improving screening for under screened populations. Methods. A cross-sectional, mailed survey involving Family Medicine (FP), Community Internal Medicine (CIM), and Obstetrics/Gynecology (013) physicians practicing in a large University-affiliated, multi-specialty group practice associated with an 186,000-member HMO in Central Texas (n = 177) was conducted in 2001-2002. Results. Most physicians performed PAP testing (50.4%). PAP screening was noted to vary significantly by specialty (P < 0.0001). All OBs were aware of at least one published guideline, compared to 96% of FPs and 91% of CIMs (P < 0.05). A wide variation was reported regarding adherence to published guidelines. In addition, there was significant intraspecialty variation regarding adherence to the physicians' own specialty's guidelines. Conclusions. While most physicians in the primary care setting perform PAP tests and are aware of published guidelines for PAP screening, adherence to the published guidelines varies considerably even in the same clinical setting. (c) 2005 Published by Elsevier Inc.