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Many Doctors May Overscreen With Annual Pap and HPV Tests

And fewer in primary care recommend going to three-year interval with combo than Pap test alone

TUESDAY, June 15 (HealthDay News) -- Despite cervical cancer screening recommendations that low-risk women be screened every three years after age 30, most primary care providers report that they would advise more frequent testing, and primary care providers are less likely to recommend extending screening intervals to three years with a human papillomavirus (HPV) test used with a Pap test than with the Pap test alone, according to research published in the June 14 issue of the Archives of Internal Medicine.

Mona Saraiya, M.D., of the U.S. Centers for Disease Control and Prevention in Atlanta, and colleagues analyzed data from a survey of 950 primary care providers, including family practitioners, general internists, and obstetrician-gynecologists, who provided Pap tests and ever recommended HPV testing for screening or management. The survey offered vignettes of women with normal results and asked for participants' screening intervals.

The researchers found that 31.8 percent recommended conducting the next Pap test in three years in a 35-year-old with three normal Pap results. In a 35-year-old with a normal Pap result and negative HPV test, only 19 percent would perform the next Pap in three years. Most others would do it more frequently. Participants' specialty was strongly associated with guideline-consistent recommendations for the next Pap or HPV test, with Ob-Gyns more likely to recommend extending to triennial screening (27.4 percent) than family doctors or internists (11.9 and 17.4 percent, respectively).

"We observed that primary care providers' recommended extension of the screening interval to three years is actually lower when HPV co-testing is considered. In addition, many physicians reported overscreening women by using both the HPV and Pap tests annually. Until measures are in place to reinforce extended screening intervals among women with negative HPV and normal Pap test results, there is no advantage gained with HPV co-testing, and it is more expensive," the authors conclude.

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