Change in frequency of Pap smears and HPV testing among insured teenage females who received a well woman exam, 2008-2010

Introduction: In December 2009, the American College of Obstetrics and Gynecology (ACOG) recommended that Pap smears and HPV tests should not be administered in females < 21 years old because detection of cervical dysplasia and human papilloma virus (HPV) is more harmful than beneficial in these groups. This study examined whether reductions in Pap smears and HPV testing among teenagers occurred after these ACOG guidelines were issued. Methods: A retrospective study using insurance claims data examined the proportion of females between 12-20 years who received a well woman exam and who also received a Pap smear or HPV test between 2008 and 2010. The frequencies of cervical dysplasia and diagnosis of high risk HPV were also examined. Results: A total of 179,324 privately insured females were identified who met the age criteria and had at least one well woman exam between 2008 and 2010. The proportion of teenagers that received a pap smear dropped from over 70% in December of 2009 to 57% in December of 2010. HPV tests were more common among patients with a Pap smear than among those who did not receive a Pap smear. HPV testing did not decrease after December 2009. Conclusions: Physicians need to respond more quickly to guidelines from ACOG to reduce unnecessary screening procedures. Further research needs to be conducted to examine compliance since similar guidelines were adopted by the US Preventive Services Task Force in March of 2012.