Many Doctors Ignore Guidelines, Order Annual Pap Test
Survey Suggests Doctors May Be Overscreening for Cervical Cancer
Yearly Pap Tests Still Popular continued...
As to why there is a disconnect, Roland and colleagues can only speculate because the study did not look at reasons behind these screening decisions.
"There might be resistance because of patient preference for annual screening, a fear of litigation or lack of awareness of the guidelines," she says. There may also be financial incentives for doctors and labs to run these tests more frequently than the guidelines recommend, she says.
Study co-researcher Mona Saraiya, MD, of the CDC's division of cancer prevention and control, says, "Patients are playing a really key role in affecting provider behaviors, so they can say if they want to be screened with the Pap test or new HPV-co test."
Mark H. Einstein, MD, a gynecologic oncologist at Montefiore Medical Center in New York City, explains some of the dangers associated with over-screening for cervical cancer. "There is quite a bit of over-screening in women in the U.S., which ultimately leads to over-management and over-treatment," he says.
"Providers may be aware of guidelines, but to a large degree, they are not completely following them," Einstein says. "Explaining to a patient that they don't need annual testing and why it is detrimental can be a tricky conversation."
The women who are most likely to get cervical cancer haven't had screening in five years, he says.