Pap Tests: Why are Older Women Without a Cervix Still Getting Them? Interview with
Deanna Kepka, PhD, MPH  
Assistant Professor
College of Nursing & Huntsman Cancer Institute
University of Utah What are the main findings of the study?

Dr. Kepka: Nearly two-thirds, 64.8% (95% CI: 62.2% – 67.3%) of women reporting a hysterectomy also reported a recent Pap test since their hysterectomy and more than half,  58.4% (95% CI: 55.3% – 61.4%)  of women age 65 years and older without a hysterectomy reported a Pap test in the past three years.  Together, this represents approximately 14 million in the United States. Were any of the findings unexpected?

Dr. Kepka: The rates of overuse of Pap testing have been slow to decline over the past decade. What should clinicians and patients take away from your report?

Dr. Kepka: We need to increase familiarity with guidelines and work harder to follow them. This will reduce the unnecessary use of valuable medical resources. Patients should inform their clinicians of their support of these guidelines and state that if they are not at high risk, they do not want these tests anymore.  Improvement in medical records will help clinicians decide if a  Pap test is necessary or not for an older woman or a woman who has undergone a hysterectomy. What recommendations do you have for future research as a result of this study?

Dr. Kepka: We need to learn more about why clinicians are not following guidelines for Pap testing among older women and women without a cervix.  We would also like to look at the costs associated with overuse of Pap testing in the United States.   Lastly, we would like to look at the impact of improved electronic medical records on the assessment of a patient’s medical history and risk for cervical cancer.


Overuse of Papanicolaou Testing Among Older Women and Among Women Without a Cervix

Mona Saraiya, MD, MPH; Zahava Berkowitz, MSc, MSPH; K. Robin Yabroff, PhD, MBA; Louise Wideroff, PhD; Sarah Kobrin, PhD, MPH; Vicki Benard, PhD

Arch Intern Med. 2010;170(11):977-986. doi:10.1001/archinternmed.2010.134.

Last Updated on November 26, 2013 by Marie Benz MD FAAD