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Ob-Gyns Stray From Guidelines for Cervical Cancer Prevention
HPV vaccination is widely offered but underused; many docs continue annual Paps

THURSDAY, July 11 (HealthDay News) -- A survey of obstetrician-gynecologists has identified barriers to the adoption of human papillomavirus (HPV) vaccination and screening measures for cervical cancer, according to research published online July 9 in the American Journal of Preventive Medicine.

Rebecca B. Perkins, M.D., of Boston University, and colleagues conducted a survey of a national sample of members of the American Congress of Obstetricians and Gynecologists. A 15-item questionnaire was used to assess sociodemographic characteristics, clinical practices, and perceived barriers to HPV vaccination and cervical cancer screening guidelines.

The researchers note that 366 obstetrician-gynecologists responded. Although most (92 percent) respondents offered HPV vaccination to eligible patients, only 27 percent reported that most of the appropriate candidates received the vaccination. Common barriers to HPV vaccination included parent and patient refusals. About half of respondents followed guidelines for cervical cancer screening, initiating routine screening at age 21, discontinuing screening at age 70 or following hysterectomy, and offering Pap and HPV co-testing. Many physicians continued to recommend annual Pap smears for women. Physicians thought patients were not comfortable with extended intervals of screening and feared patients would not attend annual exams unless Paps were offered. Compared with those in group practices, solo practitioners were less likely to follow vaccination and screening guidelines.

"In the current survey and others, providers stated that the largest barrier to HPV vaccination was patients and parents declining to receive the vaccine," Perkins said in a statement. "However, studies indicate that most patients support HPV vaccination, and that a strong physician recommendation is the most important determinant of vaccine uptake in young women."

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