Bruder K L, Downes K L, Malo T L, Giuliano A R, Salmon D A, Vadaparampil S T
Department of Obstetrics and Gynecology, College of Medicine, University of South Florida, Tampa, FL, USA.
J Pediatr Adolesc Gynecol. 2012 Dec;25(6):384-9. doi: 10.1016/j.jpag.2012.07.004. Epub 2012 Oct 22.
We evaluated factors associated with physicians' intentions to perform Pap smears in human papillomavirus-vaccinated women.
Physicians were mailed a survey asking about intentions to change cervical cancer screening based on patients' human papillomavirus vaccination status.
A national sample of 1,738 Family Physicians, Internal Medicine Physicians, Pediatricians, and Obstetricians and Gynecologists was selected from the American Medical Association Physician Masterfile. Completed surveys were received from 1,118 physicians, of which 791 were included in the analyses.
Bivariate analyses compared physician, practice, and patient characteristics by intention change screening frequency. Significant variables were included in a multivariable logistic regression model.
Overall, 81.8% (n = 647) of physicians reported not planning to change Pap smear frequency for vaccinated women. Internal Medicine physicians were significantly more likely than Obstetrician/Gynecologists to report intentions to change frequency for vaccinated patients. Other factors significantly associated with the intention to change frequency were self-identification as a late adopter of new vaccines, a solo practice, and practicing primarily in a clinic or hospital-based setting.
Although it appears most clinicians understand that human papillomavirus vaccination should not alter current screening practices, there is a need to develop and evaluate interventions for physicians who are likely to change their screening pattern based on human papillomavirus vaccination receipt.
我们评估了与医生对人乳头瘤病毒(HPV)疫苗接种女性进行巴氏涂片检查意愿相关的因素。
向医生邮寄一份调查问卷,询问他们基于患者的HPV疫苗接种状况改变宫颈癌筛查的意愿。
从美国医学协会医生主文件中选取了1738名家庭医生、内科医生、儿科医生以及妇产科医生作为全国样本。共收到1118名医生完成的调查问卷,其中791份纳入分析。
双变量分析按意愿改变筛查频率比较医生、执业情况和患者特征。显著变量纳入多变量逻辑回归模型。
总体而言,81.8%(n = 647)的医生报告不打算改变对已接种疫苗女性的巴氏涂片检查频率。内科医生比妇产科医生更有可能报告有改变对已接种疫苗患者检查频率的意愿。与改变频率意愿显著相关的其他因素包括自认为是新疫苗的晚期采用者、个体执业以及主要在诊所或医院环境中执业。
尽管大多数临床医生似乎明白HPV疫苗接种不应改变当前的筛查做法,但对于可能根据HPV疫苗接种情况改变筛查模式的医生,仍有必要制定和评估干预措施。