MedicalResearch.com Interview with:
Fangjian Guo, MD, PhD
Department of Obstetrics & Gynecology
Center for Interdisciplinary Research in Women’s Health
The University of Texas Medical Branch
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: National guidelines consistently recommend against cervical cancer screening among women with a history of a total hysterectomy for a benign condition. These women are unlikely to develop high-grade cervical lesions. The goal of our study was to assess whether these guidelines are being followed. We examined the use of Pap testing among US adult women with a history of total hysterectomy for a benign condition and the roles of health care providers and patients in the initiation of Pap test use.
We found that in 2013, 32% of women who have had a hysterectomy received an unnecessary recommendation for cervical cancer screening from a health care provider in the past year; 22.1% of women with hysterectomy received unnecessary Pap testing. Although the majority of Pap tests were performed at a clinician’s recommendation, approximately one fourth were initiated by patients without clinician recommendations. According to standard 2010 US Census population figures, about 4.9 million unnecessary Pap tests are performed annually among women who have had a total hysterectomy for a benign condition. At approximately $30 per test, $150 million in direct medical costs could be saved annually if screening guidelines were followed for these women.
MedicalResearch.com: What should readers take away from your report?
Response: Provider recommendations for Pap testing are common among US adult women who have undergone hysterectomies. More than 60% of unnecessary screens are recommended by providers. Eliminating unnecessary screens for women who have had total hysterectomy for a benign conditions could save $150 million in medical costs each year. Health care providers should advise women who have had a total hysterectomy for a benign condition on appropriate use of screening services.
MedicalResearch.com: What recommendations do you have for future research as a result of this study?
Response: Future studies should focus on innovative approaches that enhance communication between clinicians and patients to facilitate decision-making processes that are patient centered and evidence based.
MedicalResearch.com: Is there anything else you would like to add?
Response: Electronic alerts within order entry systems may be adopted to improve compliance with practice guidelines for ordering Pap tests and to help reduce unnecessary screening.
MedicalResearch.com: Thank you for your contribution to the MedicalResearch.com community.
Fangjian Guo and Yong-Fang Kuo. (2016). Roles of Health Care Providers and Patients in Initiation of Unnecessary Papanicolaou Testing After Total Hysterectomy. American Journal of Public Health. e-View Ahead of Print.
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