MONDAY, Nov. 11 (HealthDay News) -- There is considerable practice variation in the ordering of human papillomavirus (HPV) testing among family medicine practitioners performing a Papanicolaou smear, according to a study published in the November-December issue of the Journal of the American Board of Family Medicine.
Marisyl D. de la Cruz, M.D., from the University of Michigan in Ann Arbor, and colleagues determined the HPV orders completed by clinicians performing Papanicolaou smears (January 2008 to April 2011) using audits of 833 cytology request forms for low-risk women from five Michigan family medicine clinics.
The researchers found that the cytology requests were completed by faculty (75 percent), residents/fellows (20 percent), and nurse practitioner/physician assistants (NP/PAs; 5 percent). On 39 percent of request forms, HPV testing was ordered for any cytology result, with 48, 38, and 10 percent, respectively, ordered by residents/fellows, faculty, and NP/PAs. Across all clinics and provider statuses, female providers were twice as likely to order HPV testing for any cytology result, compared with male providers (P < 0.001). Among clinics, there were significant differences in HPV test ordering. After adjustment for faculty provider sex, annual cytology requests increased 46 percent between 2008 and 2011, including HPV testing for any cytology result.
"Overall, our study shows that there are significant differences in practices of ordering HPV testing for normal cytology results based on provider sex, provider status, and provider clinic," the authors conclude.
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