Access, Access, Access Cervical Cancer Screening and Management Practices Among Providers in the National Breast and Cervical Cancer Early Detection Program (NBCCEDP)

摘要

In this issue of Cancer, Saraiya et al. report the results of a 2004 survey among providers in 7 specialties who offered cervical cancer screening. They compared practices among providers who were participants in the National Breast and Cervical Cancer Early Detection Program (NBCCEDP) and their practices with those of providers not participating in the program. The authors found that program participants were more likely to be midlevel providers than nonprogram providers. They also found that program providers more likely served low-income and racial/ethnic minorities insured by Medicaid. Furthermore, they had significantly more patients with abnormal Pap test results than non-program providers (57% vs 40%). Participants were less likely to use liquid-based cytology (LBC) as their sole method for cytology, but were as likely to use human papil-lomavirus (HPV) testing to triage Papanicolaou (Pap) tests demonstrating atypical squamous cells of undetermined significance (ASC-US) as nonprogram providers. In general, program providers were within the guidelines of the American College of Obstetricians and Gynecologists (ACOG) and the American Cancer Society. However, there were some instances in which program providers used HPV testing inappropriately.