Roland Katherine B, Greek April, Hawkins Nikki A, Lin Lavinia, Benard Vicki B
Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Division of Cancer Prevention and Control, Epidemiology and Applied Research Branch, Atlanta, GA, USA.
Battelle, Health & Analytics, Seattle, WA, USA.
Prev Med Rep. 2015;2:444-447. doi: 10.1016/j.pmedr.2015.05.008.
Among providers who serve low-income and uninsured women, resistance to extending the cervical cancer screening interval following normal Pap and co-test results has been documented. Our objective was to examine provider characteristics and beliefs associated with guideline-consistent screening interval recommendations.
We collected cross-sectional survey data between 2009 and 2010 from 82 primary care providers in six Federally Qualified Health Centers in Illinois, USA. The relationships between characteristics, beliefs, and screening interval recommendations (1 year vs. 3 years) were tested with Pearson chi-square, negative binomial and ordered logistic regression.
Compared to providers who recommended annual intervals after a normal co-test, providers who recommended a guideline-consistent (i.e., 3 years) screening interval were significantly more likely to report the goodness, ease, and benefit of their recommendation and perceived encouragement for a 3-year interval from professional organizations and journals (p < .05). Providers who recommended a 3-year interval were also less likely to report that longer intervals increase patient risk for cervical cancer (p < .05). Interval recommendations were not associated with provider specialty, gender, or years in practice.
Messages that promote the benefits of longer screening intervals after a normal co-test, the natural history of human papillomavirus and cervical cancer, and low risk of developing cancer with a longer interval may be useful to promote evidence-based screening in this population of Federally Qualified Health Center providers. Dissemination of targeted messages through professional journals and specialty organizations should be considered.
在为低收入和未参保女性提供服务的医疗服务提供者中,有记录表明他们对在巴氏涂片检查和联合检测结果正常后延长宫颈癌筛查间隔存在抵触情绪。我们的目标是研究与符合指南的筛查间隔建议相关的医疗服务提供者特征和信念。
我们在2009年至2010年期间收集了美国伊利诺伊州6家联邦合格健康中心的82名初级保健提供者的横断面调查数据。使用Pearson卡方检验、负二项回归和有序逻辑回归来检验特征、信念与筛查间隔建议(1年与3年)之间的关系。
与在联合检测正常后建议每年进行筛查的医疗服务提供者相比,建议符合指南(即3年)筛查间隔的医疗服务提供者更有可能报告其建议的益处、便利性和优势,以及认为专业组织和期刊对3年间隔的鼓励(p < 0.05)。建议3年间隔的医疗服务提供者也不太可能报告较长间隔会增加患者患宫颈癌的风险(p < 0.05)。间隔建议与医疗服务提供者的专业、性别或从业年限无关。
宣传联合检测正常后较长筛查间隔的益处、人乳头瘤病毒和宫颈癌自然史以及较长间隔患癌风险较低的信息,可能有助于在这一联邦合格健康中心医疗服务提供者群体中推广基于证据的筛查。应考虑通过专业期刊和专业组织传播有针对性的信息。