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CDC HIV/AIDS/Viral Hepatitis/STD/TB Prevention News Update
MICHIGAN: Human Papillomavirus (HPV) Testing for Normal Cervical Cytology in Low-Risk Women Aged 30-65 Years by Family Physicians
By Maria Syl D. de la Cruz; Alisa P. Young; Mack T. Ruffin IV
November 11, 2013
Journal of the American Board of Family Medicine Vol. 26; No. 6: P. 720-727 (11..2013)

An article in the Journal of the American Board of Family Medicine reported that a University of Michigan Health System study showed that low-risk women ages 30–65 were more likely to be tested for human papillomavirus (HPV), the virus that causes cervical cancer, if they had female family physicians. The Michigan study assessed orders for HPV tests for low-risk women who had normal Pap smears from family medicine clinicians in a community-based, academic-affiliated setting. The researchers audited 833 request forms for cytology in low-risk women who had completed a Pap smear from January 2008 to April 2011. Low-risk women were 30–65 years old, not pregnant and with no prior abnormal Pap smears, no prior colposcopy, no gynecology-oncology history, and no prior hysterectomy. Researchers collected data from five Michigan family medicine clinics. The physicians who performed the Pap smear completed the HPV testing orders; they included 622 faculty, 169 residents/fellows, and 43 nurse practitioner/physician assistants. Residents/fellows, faculty, and nurse practitioners/physician assistants ordered HPV testing for any cytology result on 324 forms. Researchers examined differences in HPV test ordering by patients’ age at Pap test and provider status and sex. Results showed that female providers were twice as likely as males to order HPV tests for any cytology result. Alisa Young, MD, clinical lecturer in the University of Michigan Department of Family Medicine and co-author of the study, noted that the results show that HPV testing varied based on training and could lead to inadequate or over-screening.