Schwarz Eleanor Bimla, Saint Mona, Gildengorin Ginny, Weitz Tracy A, Stewart Felicia H, Sawaya George F
General Internal Medicine Section, Department of Medicine, University of California, San Francisco (UCSF), San Francisco, CA 94121, USA.
Contraception. 2005 Sep;72(3):179-81. doi: 10.1016/j.contraception.2005.04.009.
Balancing needs for contraception and cervical cancer screening is challenging for clinicians. We assessed US obstetrician/gynecologists' practices regarding requirement of Pap testing before prescribing oral contraceptive or emergency contraceptive pills.
Questionnaires structured as clinical vignettes describing women desiring contraception with different risks of cervical dysplasia were mailed to a national sample of 355 obstetrician/gynecologists.
A minority (3%) of the 185 obstetrician/gynecologists who responded would refill 12 months of oral contraceptives without requiring Pap testing. However, most would provide a limited supply of oral contraceptives until Pap testing could be performed. A substantial proportion (11-16%) would refuse to prescribe emergency contraception to women who they felt required Pap testing. Younger physicians, those practicing in academic settings and those who follow American Cancer Society guidelines were more willing to prescribe contraceptives without Pap testing.
Cervical cancer screening continues to limit prescription of routine and emergency contraception by many US obstetrician/gynecologists.
对临床医生而言，平衡避孕需求和宫颈癌筛查需求颇具挑战性。我们评估了美国妇产科医生在开具口服避孕药或紧急避孕药之前进行巴氏试验的要求方面的做法。
将结构化的临床案例问卷邮寄给全国范围内抽取的355名妇产科医生，问卷描述了有不同宫颈发育异常风险的希望避孕的女性。
在185名回复问卷的妇产科医生中，少数人（3%）会在不要求进行巴氏试验的情况下续开12个月的口服避孕药。然而，大多数人会提供有限量的口服避孕药，直到能够进行巴氏试验。相当一部分人（11%-16%）会拒绝为他们认为需要进行巴氏试验的女性开具紧急避孕药。年轻医生、在学术环境中执业的医生以及遵循美国癌症协会指南的医生更愿意在不进行巴氏试验的情况下开具避孕药。
宫颈癌筛查仍然限制了许多美国妇产科医生开具常规和紧急避孕药。
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