Doctors Overprescribing the Pap Test

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The ACS also recommended that a woman with three normal tests could stop screening at age 70 if she'd had no abnormal tests within 10 years. And, any woman with a life-limiting condition could stop Pap tests, according to the ACS. The task force recommended stopping screening at age 65 if past tests had been normal. ACOG felt there wasn't enough evidence to recommend a specific age to stop screening.

For the current study, Yabroff and her colleagues surveyed more than 1,200 primary care physicians, including 471 general or family practice doctors, 310 internal medicine physicians and 333 ob/gyns.

The physicians ranged in age from under 40 to over 60, and nearly two-thirds were male, according to the study. Most practiced in an urban location.

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The researchers presented the physicians with questions about their screening practices, alongside four clinical vignettes describing a woman's age, along with her sexual and screening history. They then asked the doctors whether or not they would recommend screening for that woman. And, because of the differences in screening recommendations, the researchers created a composite measure to assess screening practices, according to Yabroff.

Some of the results:

• About a third (32 percent) of physicians recommended a yearly Pap test for an 18-year-old with no sexual experience.
• About 23 percent of doctors recommended an annual or biennial screen for a 66-year-old woman with advanced, inoperable lung cancer and three prior (consecutive) normal Pap results.
• More than half (54.4 percent) recommended testing between every one to three years for a 71-year-old woman with three prior normal test results.
• More than 44 percent of physicians recommended the Pap test every one to three years for a woman who had previously had her cervix removed for benign reasons.

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