196482 Analysis of time between gynecological office visits for routine preventive care after the introduction of HPV co-testing into standard cervical cancer screening practice

Monday, November 9, 2009

Meghan B. Gavaghan, MPH , Health Policy and Management, Boston University School of Public Health, Needham, MA
Susan Garfield, MSc, SM , Maternal and Child Health, Boston University School of Public Health, Wayland, MA

HPV testing with the Pap (“co-testing”) is a cervical cancer screening option available to clinicians since 2003. The impact of adopting co-testing to the frequency of subsequent office visits has not previously been evaluated. This study measures the average length of time between routine gynecological office visits after the adoption of co-testing in two practices.


A chart review was conducted on patients from two solo-physician practices that have been routinely co-testing for three or more years. Exclusion criteria included patients outside of the 30-65 year age range and patients with abnormal Pap or HPV testing results during the study period. Data were analyzed to determined the average length of time, in days, for visits before the initial co-test and then between subsequent visits. One-tailed t-tests were performed to analyze for significance.


The study examined 683 patient records and 3,143 total office visits. The average time between office visits prior to the initiation of co-testing was 458 days. The length of time between two subsequent office visits was 430 days (p < 0.002) and 376 days (p < 0.0001). These intervals were consistent between the two study offices and over different age groups within the population.


Routine use of co-testing did not increase the average time between gynecological office visits. Additional research should review the impact of co-testing to more office practices representing a diverse patient and provider population. Also, future research should address how clinicians can educate patients of the importance of an annual gynecological exam.

Learning Objectives:
1. Analyze the impact of co-testing for cervical cancer on patient visit frequency 2. Identify the average time between routine gynecological visits for two study offices

Keywords: Cervical Cancer, Preventive Medicine

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: MPH program at Boston University School of Public Health - completed May 2009
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.