Cervical cancer screening among women ≥70years of age in the United States-A referral problem or patient choice

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Objective: Clinical guidelines recommend that women with a history of adequate screening and not otherwise at high risk may discontinue cervical cancer screening after 65. years of age. However, screening remains common among US women over 65. years old. This study was conducted to examine whether overutilization was attributable to provider's recommendation or patient choice. Method: This cross-sectional study used data from 1752 female participants (70. + years) from the 2013 National Health Interview Survey (NHIS). We quantitatively assessed the proportions of provider-recommended and patient self-initiated Pap smears. Results: Among female respondents, 40.8% had a Pap smear within the past 3. years, 19.4% had a Pap smear in the last year, and 39.7% reported receiving a recommendation for a Pap smear from their provider in the past year. Among women who received a recommendation to obtain a Pap smear, 39.8% did so within the past 12. months compared to 5.9% of women who did not receive a recommendation (adjusted odds ratio 10.5, 95% confidence interval 7.39-15.0). About 70% of women who visited an obstetrician/gynecologist and reported receiving a recommendation to have a Pap smear did so in the past year, while 32.3% of women who visited an obstetrician/gynecologist but did not receive a recommendation obtained one. Conclusion: Pap smears were common among women ≥. 70. years of age. Health care providers may need additional education on current guidelines regarding indications for Pap smears in this age group to help reduce screening of patients who may not benefit.

Original languageEnglish (US)
Pages (from-to)427-432
Number of pages6
JournalPreventive Medicine
Volume81
DOIs
StatePublished - Dec 1 2015

Fingerprint

Papanicolaou Test
Early Detection of Cancer
Uterine Cervical Neoplasms
Referral and Consultation
Guidelines
Health Surveys
Health Personnel
Age Groups
Cross-Sectional Studies
Odds Ratio
Confidence Intervals
Interviews
Education

Keywords

  • Cancer screening
  • Cervical cancer
  • Overutilization of health services
  • Pap smear

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Epidemiology

Cite this

@article{26cecb1f2aad40a2a34e8f32e5330aed,
title = "Cervical cancer screening among women ≥70years of age in the United States-A referral problem or patient choice",
abstract = "Objective: Clinical guidelines recommend that women with a history of adequate screening and not otherwise at high risk may discontinue cervical cancer screening after 65. years of age. However, screening remains common among US women over 65. years old. This study was conducted to examine whether overutilization was attributable to provider's recommendation or patient choice. Method: This cross-sectional study used data from 1752 female participants (70. + years) from the 2013 National Health Interview Survey (NHIS). We quantitatively assessed the proportions of provider-recommended and patient self-initiated Pap smears. Results: Among female respondents, 40.8{\%} had a Pap smear within the past 3. years, 19.4{\%} had a Pap smear in the last year, and 39.7{\%} reported receiving a recommendation for a Pap smear from their provider in the past year. Among women who received a recommendation to obtain a Pap smear, 39.8{\%} did so within the past 12. months compared to 5.9{\%} of women who did not receive a recommendation (adjusted odds ratio 10.5, 95{\%} confidence interval 7.39-15.0). About 70{\%} of women who visited an obstetrician/gynecologist and reported receiving a recommendation to have a Pap smear did so in the past year, while 32.3{\%} of women who visited an obstetrician/gynecologist but did not receive a recommendation obtained one. Conclusion: Pap smears were common among women ≥. 70. years of age. Health care providers may need additional education on current guidelines regarding indications for Pap smears in this age group to help reduce screening of patients who may not benefit.",
keywords = "Cancer screening, Cervical cancer, Overutilization of health services, Pap smear",
author = "Fangjian Guo and Jacqueline Hirth and Abbey Berenson",
year = "2015",
month = "12",
day = "1",
doi = "10.1016/j.ypmed.2015.10.005",
language = "English (US)",
volume = "81",
pages = "427--432",
journal = "Preventive Medicine",
issn = "0091-7435",
publisher = "Academic Press Inc.",

}

TY - JOUR

T1 - Cervical cancer screening among women ≥70years of age in the United States-A referral problem or patient choice

AU - Guo, Fangjian

AU - Hirth, Jacqueline

AU - Berenson, Abbey

PY - 2015/12/1

Y1 - 2015/12/1

N2 - Objective: Clinical guidelines recommend that women with a history of adequate screening and not otherwise at high risk may discontinue cervical cancer screening after 65. years of age. However, screening remains common among US women over 65. years old. This study was conducted to examine whether overutilization was attributable to provider's recommendation or patient choice. Method: This cross-sectional study used data from 1752 female participants (70. + years) from the 2013 National Health Interview Survey (NHIS). We quantitatively assessed the proportions of provider-recommended and patient self-initiated Pap smears. Results: Among female respondents, 40.8% had a Pap smear within the past 3. years, 19.4% had a Pap smear in the last year, and 39.7% reported receiving a recommendation for a Pap smear from their provider in the past year. Among women who received a recommendation to obtain a Pap smear, 39.8% did so within the past 12. months compared to 5.9% of women who did not receive a recommendation (adjusted odds ratio 10.5, 95% confidence interval 7.39-15.0). About 70% of women who visited an obstetrician/gynecologist and reported receiving a recommendation to have a Pap smear did so in the past year, while 32.3% of women who visited an obstetrician/gynecologist but did not receive a recommendation obtained one. Conclusion: Pap smears were common among women ≥. 70. years of age. Health care providers may need additional education on current guidelines regarding indications for Pap smears in this age group to help reduce screening of patients who may not benefit.

AB - Objective: Clinical guidelines recommend that women with a history of adequate screening and not otherwise at high risk may discontinue cervical cancer screening after 65. years of age. However, screening remains common among US women over 65. years old. This study was conducted to examine whether overutilization was attributable to provider's recommendation or patient choice. Method: This cross-sectional study used data from 1752 female participants (70. + years) from the 2013 National Health Interview Survey (NHIS). We quantitatively assessed the proportions of provider-recommended and patient self-initiated Pap smears. Results: Among female respondents, 40.8% had a Pap smear within the past 3. years, 19.4% had a Pap smear in the last year, and 39.7% reported receiving a recommendation for a Pap smear from their provider in the past year. Among women who received a recommendation to obtain a Pap smear, 39.8% did so within the past 12. months compared to 5.9% of women who did not receive a recommendation (adjusted odds ratio 10.5, 95% confidence interval 7.39-15.0). About 70% of women who visited an obstetrician/gynecologist and reported receiving a recommendation to have a Pap smear did so in the past year, while 32.3% of women who visited an obstetrician/gynecologist but did not receive a recommendation obtained one. Conclusion: Pap smears were common among women ≥. 70. years of age. Health care providers may need additional education on current guidelines regarding indications for Pap smears in this age group to help reduce screening of patients who may not benefit.

KW - Cancer screening

KW - Cervical cancer

KW - Overutilization of health services

KW - Pap smear

UR - http://www.scopus.com/inward/record.url?scp=84946740141&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84946740141&partnerID=8YFLogxK

U2 - 10.1016/j.ypmed.2015.10.005

DO - 10.1016/j.ypmed.2015.10.005

M3 - Article

C2 - 26500084

AN - SCOPUS:84946740141

VL - 81

SP - 427

EP - 432

JO - Preventive Medicine

JF - Preventive Medicine

SN - 0091-7435

ER -