Physicians' intentions to change pap smear frequency following human papillomavirus vaccination

Abstract

Study objective: We evaluated factors associated with physicians' intentions to perform Pap smears in human papillomavirus-vaccinated women.

Design: Physicians were mailed a survey asking about intentions to change cervical cancer screening based on patients' human papillomavirus vaccination status.

Participants: A national sample of 1,738 Family Physicians, Internal Medicine Physicians, Pediatricians, and Obstetricians and Gynecologists was selected from the American Medical Association Physician Masterfile. Completed surveys were received from 1,118 physicians, of which 791 were included in the analyses.

Main outcome measures: Bivariate analyses compared physician, practice, and patient characteristics by intention change screening frequency. Significant variables were included in a multivariable logistic regression model.

Results: Overall, 81.8% (n = 647) of physicians reported not planning to change Pap smear frequency for vaccinated women. Internal Medicine physicians were significantly more likely than Obstetrician/Gynecologists to report intentions to change frequency for vaccinated patients. Other factors significantly associated with the intention to change frequency were self-identification as a late adopter of new vaccines, a solo practice, and practicing primarily in a clinic or hospital-based setting.

Conclusions: Although it appears most clinicians understand that human papillomavirus vaccination should not alter current screening practices, there is a need to develop and evaluate interventions for physicians who are likely to change their screening pattern based on human papillomavirus vaccination receipt.

Figure 1. Questions Used to Determine Knowledge of HPV and HPV Vaccination

Q1. Most HPV infections resolve without medical intervention. True Q2. Treatment of cervical dysplasia/cancer permanently eliminates the causative infection. False Q3. Genital warts are caused by the same HPV types that cause cervical cancer. False Q4. Almost all cervical cancers are caused by HPV infection. True Q5. The FDA approved the quadrivalent HPV vaccine for use in females ages 9-26. True Q6. Females who have been diagnosed with HPV infection should not be given the HPV vaccine. False