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

Background

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.

Methods

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.

Results

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.

Conclusions

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.