To compare guideline adherence rates of HPV co-testing for cervical cancer screening among Family Medicine and Obstetrics and Gynecology (OB/GYN) physicians.METHODS:
In this retrospective cohort study, we identified women who presented to the University of California Davis Medical Center outpatient clinics between September 2013 and January 2014 for a routine gynecologic visit. Women were included in this study if they were age 21–65 years, had cervical cytology performed at that visit, and had their prior cervical cytology completed in the same health system. We analyzed adherence to 2013 recommended guidelines for all providers and also compared adherence between Family Medicine and OB/GYN.RESULTS:
One thousand two hundred sixty-seven women were included in this study (Ob/Gyn=276, Family Medicine=991). Of women who were eligible for preferred HPV co-testing based on age, only 62.47% of Family Medicine and 71.97% of OB/GYN practitioners actually performed co-testing (P<.01). Over time, the overall proportion of patients co-tested did increase during the study period (P=.06). Only 7% of all patients had documentation of having received the HPV vaccine (9.28% in Family Medicine and 2.09% in OB/GYN, P<.001).CONCLUSION:
HPV co-testing has not been universally adopted as the method of screening for cervical cancer for women over the age of 30 years despite guidelines indicating co-testing as the preferred screening method. Our study also demonstrates inadequate assessment of HPV vaccination history. Dissemination of information regarding updated cervical cancer screening guidelines should emphasize the role of HPV, and the importance of vaccination and preference for co-testing among women ≥30 years.