Physician recommendation for Papanicolaou testing among U.S. women, 2000

Steven Scott Coughlin, Erica S. Breslau, Trevor Thompson, Vicki B. Benard

Research output: Contribution to journalReview article

49 Citations (Scopus)

Abstract

Objective: Many women in the U.S. undergo routine cervical cancer screening, but some women have rarely or never had a Papanicolaou (Pap) test. Studies of other cancer screening tests (for example, mammograms) have shown that physician recommendation to get a screening test is one of the strongest predictors of cancer screening. Methods: In this study, we examined whether women in the U.S. had received a physician recommendation to get a Pap test using data from the 2000 National Health Interview Survey. Reported reasons for not receiving a Pap test were also explored. Results: Among women aged ≥18 years who had no history of hysterectomy, 83.3% [95% confidence interval (CI), 82.4-84.1%] of the 13,636 women in this sample had had a Pap test in the last 3 years. Among 2,310 women who had not had a recent Pap test, reported reasons for not receiving a Pap test included: "No reason/never thought about it" (48.0%; 95% CI, 45.5-50.7), "Doctor didn't order it" (10.3%; 95% CI, 8.7-12.0), "Didn't need it/didn't know I needed this type of test" (8.1%; 95% CI, 6.7-9.6), "Haven't had any problems" (9.0%; 95% CI, 7.6-10.5), "Put it off" (7.4%; 95% CI, 6.2-8.7), "Too expensive/no insurance" (8.7%; 95% CI, 7.3-10.2), "Too painful, unpleasant, embarrassing" (3.5%; 95% CI, 2.5-4.6), and "Don't have doctor" (1.7%; 95% CI, 1.2-2.4). Among women who had had a doctor visit in the last year but who had not had a recent Pap test, about 86.7% (95% CI, 84.5-88.6) reported that their doctor had not recommended a Pap test in the last year. African-American women were as likely as White women to have received a doctor recommendation to get a Pap test. Hispanic women were as likely as non-Hispanic women to have received a doctor recommendation to get a Pap test. In multivariate analysis, factors positively associated with doctor recommendation to get a Pap test included being aged 30 to 64 years, having been born in the U.S., and having seen a specialist or general doctor in the past year. Conclusion: These findings suggest that lack of a physician recommendation contributes to underuse of Pap screening by many eligible women. Given research that shows the effectiveness of physician recommendations in improving use, increased physician recommendations could contribute significantly to increased Pap screening use in the U.S.

Original languageEnglish (US)
Pages (from-to)1143-1148
Number of pages6
JournalCancer Epidemiology Biomarkers and Prevention
Volume14
Issue number5
DOIs
StatePublished - May 1 2005
Externally publishedYes

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Papanicolaou Test
Physicians
Confidence Intervals
Early Detection of Cancer
Health Surveys
Insurance
Hysterectomy
Hispanic Americans
Uterine Cervical Neoplasms
African Americans
Multivariate Analysis

ASJC Scopus subject areas

  • Epidemiology
  • Oncology

Cite this

Physician recommendation for Papanicolaou testing among U.S. women, 2000. / Coughlin, Steven Scott; Breslau, Erica S.; Thompson, Trevor; Benard, Vicki B.

In: Cancer Epidemiology Biomarkers and Prevention, Vol. 14, No. 5, 01.05.2005, p. 1143-1148.

Research output: Contribution to journalReview article

Coughlin, Steven Scott ; Breslau, Erica S. ; Thompson, Trevor ; Benard, Vicki B. / Physician recommendation for Papanicolaou testing among U.S. women, 2000. In: Cancer Epidemiology Biomarkers and Prevention. 2005 ; Vol. 14, No. 5. pp. 1143-1148.
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abstract = "Objective: Many women in the U.S. undergo routine cervical cancer screening, but some women have rarely or never had a Papanicolaou (Pap) test. Studies of other cancer screening tests (for example, mammograms) have shown that physician recommendation to get a screening test is one of the strongest predictors of cancer screening. Methods: In this study, we examined whether women in the U.S. had received a physician recommendation to get a Pap test using data from the 2000 National Health Interview Survey. Reported reasons for not receiving a Pap test were also explored. Results: Among women aged ≥18 years who had no history of hysterectomy, 83.3{\%} [95{\%} confidence interval (CI), 82.4-84.1{\%}] of the 13,636 women in this sample had had a Pap test in the last 3 years. Among 2,310 women who had not had a recent Pap test, reported reasons for not receiving a Pap test included: {"}No reason/never thought about it{"} (48.0{\%}; 95{\%} CI, 45.5-50.7), {"}Doctor didn't order it{"} (10.3{\%}; 95{\%} CI, 8.7-12.0), {"}Didn't need it/didn't know I needed this type of test{"} (8.1{\%}; 95{\%} CI, 6.7-9.6), {"}Haven't had any problems{"} (9.0{\%}; 95{\%} CI, 7.6-10.5), {"}Put it off{"} (7.4{\%}; 95{\%} CI, 6.2-8.7), {"}Too expensive/no insurance{"} (8.7{\%}; 95{\%} CI, 7.3-10.2), {"}Too painful, unpleasant, embarrassing{"} (3.5{\%}; 95{\%} CI, 2.5-4.6), and {"}Don't have doctor{"} (1.7{\%}; 95{\%} CI, 1.2-2.4). Among women who had had a doctor visit in the last year but who had not had a recent Pap test, about 86.7{\%} (95{\%} CI, 84.5-88.6) reported that their doctor had not recommended a Pap test in the last year. African-American women were as likely as White women to have received a doctor recommendation to get a Pap test. Hispanic women were as likely as non-Hispanic women to have received a doctor recommendation to get a Pap test. In multivariate analysis, factors positively associated with doctor recommendation to get a Pap test included being aged 30 to 64 years, having been born in the U.S., and having seen a specialist or general doctor in the past year. Conclusion: These findings suggest that lack of a physician recommendation contributes to underuse of Pap screening by many eligible women. Given research that shows the effectiveness of physician recommendations in improving use, increased physician recommendations could contribute significantly to increased Pap screening use in the U.S.",
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N2 - Objective: Many women in the U.S. undergo routine cervical cancer screening, but some women have rarely or never had a Papanicolaou (Pap) test. Studies of other cancer screening tests (for example, mammograms) have shown that physician recommendation to get a screening test is one of the strongest predictors of cancer screening. Methods: In this study, we examined whether women in the U.S. had received a physician recommendation to get a Pap test using data from the 2000 National Health Interview Survey. Reported reasons for not receiving a Pap test were also explored. Results: Among women aged ≥18 years who had no history of hysterectomy, 83.3% [95% confidence interval (CI), 82.4-84.1%] of the 13,636 women in this sample had had a Pap test in the last 3 years. Among 2,310 women who had not had a recent Pap test, reported reasons for not receiving a Pap test included: "No reason/never thought about it" (48.0%; 95% CI, 45.5-50.7), "Doctor didn't order it" (10.3%; 95% CI, 8.7-12.0), "Didn't need it/didn't know I needed this type of test" (8.1%; 95% CI, 6.7-9.6), "Haven't had any problems" (9.0%; 95% CI, 7.6-10.5), "Put it off" (7.4%; 95% CI, 6.2-8.7), "Too expensive/no insurance" (8.7%; 95% CI, 7.3-10.2), "Too painful, unpleasant, embarrassing" (3.5%; 95% CI, 2.5-4.6), and "Don't have doctor" (1.7%; 95% CI, 1.2-2.4). Among women who had had a doctor visit in the last year but who had not had a recent Pap test, about 86.7% (95% CI, 84.5-88.6) reported that their doctor had not recommended a Pap test in the last year. African-American women were as likely as White women to have received a doctor recommendation to get a Pap test. Hispanic women were as likely as non-Hispanic women to have received a doctor recommendation to get a Pap test. In multivariate analysis, factors positively associated with doctor recommendation to get a Pap test included being aged 30 to 64 years, having been born in the U.S., and having seen a specialist or general doctor in the past year. Conclusion: These findings suggest that lack of a physician recommendation contributes to underuse of Pap screening by many eligible women. Given research that shows the effectiveness of physician recommendations in improving use, increased physician recommendations could contribute significantly to increased Pap screening use in the U.S.

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