Discontent and Confusion: Primary Care Providers' Opinions and Understanding of Current Cervical Cancer Screening Recommendations

Background: Current evidence-based cervical cancer testing guidelines recommend that screening of low-risk women ceases after age 65. Despite this, research suggests that continued testing by primary care providers remains common and represents unnecessary patient discomfort, cost, and consumption of valuable primary care resources. Objective: To understand why primary care providers might knowingly ignore consensus evidence-based screening guidelines for cervical cancer in low-risk women of this age-group and to identify barriers to adherence with best practice recommendations. Methods: A survey tool to identify barriers to adherence with current guidelines for cervical cancer screening in low-risk women older than age 65 was mailed to 4929 randomly selected primary care providers throughout California. Providers were asked to indicate the predominant reason(s) they might knowingly continue cervical cancer screening in women older than 65 years, despite evidence-based recommendations to the contrary. Results: Qualified surveys were received from 1259 (25.5%) of those surveyed, representing primary care providers of all types, practicing in areas of vastly different demographics. Despite published reassurance to the contrary, many providers retain fear that discontinuation of testing in low-risk women after age 65 may result in missed invasive cervical cancer. Even among health-care providers who agree that cessation of screening is safe, other circumstances prompt their recommendation to continue cervical screening. Conclusion: Although the data from this study suggest areas of policy intervention to lessen unnecessary cervical cancer screening, the broader implication is that advancement of evidence-based medicine will be of little value in improving the quality and cost of health care if barriers to guideline adherence are poorly understood and addressed.

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Abstract PO-267: Does primary care providers' implicit and explicit bias impact cervical cancer screening recommendations for lesbian women?

10.1158/1538-7755.disp20-po-267 ◽

2020 ◽

Author(s):

Mollie E. Aleshire ◽

Amanda Fallin-Bennett ◽

Mary Kay Rayens ◽

Keisa Fallin-Bennett ◽

Jennifer Hatcher

Keyword(s):

Primary Care ◽

Cervical Cancer ◽

Cancer Screening ◽

Cervical Cancer Screening ◽

Primary Care Providers ◽

Lesbian Women ◽

Care Providers ◽

Explicit Bias ◽

Implicit And Explicit

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Strategies to reach marginalized women for cervical cancer screening: A qualitative study of stakeholder perspectives

Current Oncology ◽

10.3747/co.25.3851 ◽

2018 ◽

Vol 25 (1) ◽

pp. 8 ◽

Cited By ~ 3

Author(s):

B. Wood ◽

A. Lofters ◽

M. Vahabi

Keyword(s):

Cervical Cancer ◽

Cancer Screening ◽

Qualitative Study ◽

Cervical Cancer Screening ◽

Health Care Providers ◽

Cervical Screening ◽

Primary Care Providers ◽

Care Providers ◽

Structured Interviews ◽

Primary Screening

Background Self-sampling for human papillomavirus (hpv) has the potential to reach marginalized populations that are underserved for cervical cancer screening. However, before implementing an alternative screening strategy such as self-sampling for under- and never-screened women, the key processes, facilitators, and barriers to reform need to be understood.Methods A descriptive qualitative study was conducted that involved semi-structured interviews with Canadian and international cancer screening health care providers and policy-makers. Respondents were purposively selected from a list of thirty stakeholders generated through an environmental scan. The interviews were transcribed verbatim and analyzed using directed content analysis.Results Nineteen stakeholders participated in the interviews. Most respondents thought that self-sampling was an appropriate cervical screening alternative for hard-to-reach populations, as it addressed barriers to cervical screening related to various social determinants of health. All respondents emphasized that transitioning to hpv primary screening would catalyze a policy shift towards self-sampling. Clinician respondents were less enthusiastic about self-sampling strategies since that discouraged women’s appointments with primary care providers, because cervical screening offered an opportunity to discuss other preventive health topics. There also was little consensus between respondents on whether the state of evidence was satisfactory to integrate a self-sampling option into policy, or whether more Canadian research was needed.Conclusion Canadian cervical cancer screening stakeholders should collaborate to identify the knowledge gaps that researchers should address and leverage the existing literature to implement tailored, patient-centred alternative cervical screening strategies. The transition to hpv primary screening would be a key first step in the broad implementation of hpv self-sampling in Canada.

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Knowledge and Practice of Cervical Cancer Screening among Women in Orlu Local Government Area, Imo State, Nigeria.

10.33798/ajmas2019/00266 ◽

2019 ◽

Vol 1 (1) ◽

pp. 55-65

Author(s):

Jude Egwurugwu ◽

S.D. Ejikunle ◽

E.I. Dike ◽

M.C. Ohamaeme ◽

Jude Egwurugwu ◽

...

Keyword(s):

Cervical Cancer ◽

Cancer Screening ◽

Local Government ◽

Cervical Cancer Screening ◽

Cervical Screening ◽

Local Government Area ◽

Care Providers ◽

Imo State ◽

Study Results ◽

Knowledge And Practice

Background: Cervical cancer is the 2nd commonest cancer among women worldwide and the most common cancer among women in developing countries like Nigeria. Though preventable by screening for premalignant and early cervical lesions, this is predicated on the knowledge and practice of a cervical screening. Objective: To assess the knowledge and practice of cervical cancer screening among women in Orlu, Local Government Area(LGA) Imo State, Nigeria. Materials & Methods: A community based cross-sectional study with the use of 502 interviewer – administered questionnaires was conducted among women in Orlu LGA of Imo State. All the women in the communities attending the annual August Meeting who consented were recruited for this study. Results: The study showed that the mean age of the respondents was 42±2.8years. Furthermore, 82.3% of respondents attained postsecondary school educational level, 61.8% & 21.1% were multiparous and grand multiparous respectively. Also, 80.5% of respondents have heard about cervical cancer screening. Majority (67.5%) of these respondents heard it from health care providers. There was a positive statistically significant relationship between educational status and the likelihood of having knowledge of cervical cancer screening, (p< 0.01). The level of practice of cervical cancer screening was very low among the respondents(13.5%).Though majority of the respondents have high level of educational attainment this did not reflect their practice of cervical cancer screening. Conclusion: There was high knowledge of cervical cancer and cervical screening modalities among women in Orlu but their practice of cervical cancer screening was very low. There is an urgent need to educate and encourage women on the benefits of cervical cancer screening. Key words: cervical cancer, knowledge, Practice, Orlu women, Screening.

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Unintended Consequences: The Impact of Cervical Cancer Screening Guidelines on Rates of STI Screening in Primary Care

Journal of Obstetrics and Gynaecology Canada ◽

10.1016/j.jogc.2020.10.011 ◽

2020 ◽

Author(s):

Rebecca Zur ◽

Margaret Casson ◽

Jacqueline Bellaire ◽

Mark Yudin

Keyword(s):

Primary Care ◽

Cervical Cancer ◽

Cancer Screening ◽

Cervical Cancer Screening ◽

Unintended Consequences ◽

Screening Guidelines ◽

The Impact

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“They Should Be Asking Us”: A Qualitative Decisional Needs Assessment for Women Considering Cervical Cancer Screening

Global Qualitative Nursing Research ◽

10.1177/2333393618783632 ◽

2018 ◽

Vol 5 ◽

pp. 233339361878363 ◽

Cited By ~ 4

Author(s):

Brianne Wood ◽

Virginia L. Russell ◽

Ziad El-Khatib ◽

Susan McFaul ◽

Monica Taljaard ◽

...

Keyword(s):

Health Care ◽

Cervical Cancer ◽

Decision Making ◽

Cancer Screening ◽

Shared Decision Making ◽

Cervical Cancer Screening ◽

Cervical Screening ◽

Hpv Testing ◽

Shared Decision ◽

Care Providers

In this study, we examine from multiple perspectives, women’s shared decision-making needs when considering cervical screening options: Pap testing, in-clinic human papillomavirus (HPV) testing, self-collected HPV testing, or no screening. The Ottawa Decision Support Framework guided the development of the interview schedule. We conducted semi-structured interviews with seven screen-eligible women and five health care professionals (three health care providers and two health system managers). Women did not perceive that cervical screening involves a “decision,” which limited their knowledge of options, risks, and benefits. Women and health professionals emphasized how a trusted primary care provider can support women making a choice among cervical screening modalities. Having all cervical screening options recommended and funded was perceived as an important step to facilitate shared decision making. Supporting women in making preference-based decisions in cervical cancer screening may increase screening among those who do not undergo screening regularly and decrease uptake in women who are over-screened.

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