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Research General gynecology| Volume 209, ISSUE 3, P200.e1-200.e7, September 01, 2013

Compliance with cervical cancer screening and human papillomavirus testing guidelines among insured young women

Published:June 03, 2013DOI:https://doi.org/10.1016/j.ajog.2013.05.058
Compliance with cervical cancer screening and human papillomavirus testing guidelines among insured young women
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      Objective

      In December 2009, the American Congress of Obstetricians and Gynecologists (ACOG) recommended that women under 21 years old should not receive cervical cancer screening (Papanicolaou tests) or human papillomavirus (HPV) tests. This study examined whether clinicians stopped administering Papanicolaou and HPV tests among women younger than 21 years of age after new ACOG guidelines were issued.

      Study Design

      This study was a retrospective secondary data analysis of administrative claims data that included insurance enrollees from across the United States that examined the frequency of Papanicolaou tests and HPV tests among 178,898 nonimmunocompromised females 12-20 years old who had a paid claim for a well-woman visit in 2008, 2009, or 2010. Young women with well-woman examinations in each observed year were examined longitudinally to determine whether past diagnoses of cervical cell abnormalities accounted for Papanicolaou testing in 2010.

      Results

      The proportion of women younger than 21 years old that received a Papanicolaou test as part of her well-woman exam dropped from 77% in 2008 and 2009 to 57% by December of 2010, whereas HPV testing remained stable across time. A diagnosis of cervical cell abnormalities in 2009 was associated with Papanicolaou testing in 2010. However, a previous Papanicolaou test was more strongly associated with a Papanicolaou test in 2010.

      Conclusion

      These data show that some physicians are adjusting their practices among young women according to ACOG guidelines, but Papanicolaou and HPV testing among insured women younger than 21 years of age still remains unnecessarily high.

      Key words

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      Article Info

      Publication History

      Published online: June 03, 2013
      Accepted: May 28, 2013
      Received in revised form: May 1, 2013
      Received: January 31, 2013

      Footnotes

      The views expressed herein are solely those of the authors and do not necessarily represent the official views of the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) or the National Institutes of Health.

      Federal support for this study was provided by the NICHD as follows: Dr Hirth is currently supported by the Office of Research on Women's Health ( NICHD grant K12HD052023 ; principal investigator: A.B.B.) and was supported at the time of initial submission by the NICHD through an institutional training grant ( National Research Service Award T32HD055163 ; principal investigator: A.B.B.). Dr Berenson was supported by a midcareer investigator award in patient-oriented research (grant K24HD043659 ; principal investigator: A.B.B.). This study also was supported by the Institute for Translational Sciences at the University of Texas Medical Branch, which is partially funded by a Clinical and Translational Science Award ( UL1RR029876 ) from the National Center for Research Resources , National Institutes of Health .

      The authors report no conflict of interest.

      Reprints not available from the authors.

      Cite this article as: Hirth JM, Tan A, Wilkinson GS, et al. Compliance with cervical cancer screening and human papillomavirus testing guidelines among insured young women. Am J Obstet Gynecol 2013;209:200.e1-7.

      Identification

      DOI: https://doi.org/10.1016/j.ajog.2013.05.058

      Copyright

      © 2013 Mosby, Inc. Published by Elsevier Inc. All rights reserved.

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