The Adequacy of Papanicolaou Smears as Performed by Family Physicians and Obstetrician-Gynecologists

Kevin Fiscella, Peter Franks

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

BACKGROUND. Little is known about the quality of Papanicolaou (Pap) smears performed by family physicians and obstetrician-gynecologists. METHODS. Using hospital archival records of Pap smears performed from 1995 to 1997, we compared the quality of Pap smear sampling and the rate of detection of significant cytologic abnormalities by family physicians and obstetrician-gynecologists. Using hierarchic logistic regression, we examined the relationship between physician specialty and Pap smear reports, controlling for patient age and socioeconomic position, multiple Pap smears performed by the same clinician, and physician attending status. RESULTS. A total of 34,916 Pap smears performed by 130 family physicians and 88 obstetrician-gynecologist residents and attending physicians were included in the analysis. There were no statistically significant differences by specialty in the rates of unsatisfactory reports (adjusted odds ratio [AOR] = 0.82; 95% confidence interval [Cl], 0.48 -1.38), satisfactory but limited reports (AOR = 1.16; 95% Cl, 0.93 -1.48), or detection rates of significant cytologic abnormalities (AOR = 0.83; 95% Cl, 0.66 -1.04). However, family physicians submitted more Pap smears with an absent endocervical component (AOR = 1.50; 95% Cl, 1.07-2.11). CONCLUSIONS. These findings show no significant differences by specialty in Pap smear quality as measured by rates of unsatisfactory and satisfactory but limited reports, or detection of cytologic abnormalities. The finding of higher rates of absent endocervical cells, if replicated by further study, may suggest the need for improved training of family physicians in sampling the endocervix.

Original languageEnglish (US)
Pages (from-to)294-298
Number of pages5
JournalJournal of Family Practice
Volume48
Issue number4
StatePublished - Apr 1999
Externally publishedYes

Fingerprint

Papanicolaou Test
Family Physicians
Odds Ratio
Physicians
Hospital Records
Logistic Models
Confidence Intervals

Keywords

  • Cytology
  • Gynecology
  • Papanicolaou smear
  • Physician, family

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

Cite this

The Adequacy of Papanicolaou Smears as Performed by Family Physicians and Obstetrician-Gynecologists. / Fiscella, Kevin; Franks, Peter.

In: Journal of Family Practice, Vol. 48, No. 4, 04.1999, p. 294-298.

Research output: Contribution to journalArticle

@article{8b8365a0af2042d993afb7eb5e15317f,
title = "The Adequacy of Papanicolaou Smears as Performed by Family Physicians and Obstetrician-Gynecologists",
abstract = "BACKGROUND. Little is known about the quality of Papanicolaou (Pap) smears performed by family physicians and obstetrician-gynecologists. METHODS. Using hospital archival records of Pap smears performed from 1995 to 1997, we compared the quality of Pap smear sampling and the rate of detection of significant cytologic abnormalities by family physicians and obstetrician-gynecologists. Using hierarchic logistic regression, we examined the relationship between physician specialty and Pap smear reports, controlling for patient age and socioeconomic position, multiple Pap smears performed by the same clinician, and physician attending status. RESULTS. A total of 34,916 Pap smears performed by 130 family physicians and 88 obstetrician-gynecologist residents and attending physicians were included in the analysis. There were no statistically significant differences by specialty in the rates of unsatisfactory reports (adjusted odds ratio [AOR] = 0.82; 95{\%} confidence interval [Cl], 0.48 -1.38), satisfactory but limited reports (AOR = 1.16; 95{\%} Cl, 0.93 -1.48), or detection rates of significant cytologic abnormalities (AOR = 0.83; 95{\%} Cl, 0.66 -1.04). However, family physicians submitted more Pap smears with an absent endocervical component (AOR = 1.50; 95{\%} Cl, 1.07-2.11). CONCLUSIONS. These findings show no significant differences by specialty in Pap smear quality as measured by rates of unsatisfactory and satisfactory but limited reports, or detection of cytologic abnormalities. The finding of higher rates of absent endocervical cells, if replicated by further study, may suggest the need for improved training of family physicians in sampling the endocervix.",
keywords = "Cytology, Gynecology, Papanicolaou smear, Physician, family",
author = "Kevin Fiscella and Peter Franks",
year = "1999",
month = "4",
language = "English (US)",
volume = "48",
pages = "294--298",
journal = "Journal of Family Practice",
issn = "0094-3509",
publisher = "Appleton-Century-Crofts",
number = "4",

}

TY - JOUR

T1 - The Adequacy of Papanicolaou Smears as Performed by Family Physicians and Obstetrician-Gynecologists

AU - Fiscella, Kevin

AU - Franks, Peter

PY - 1999/4

Y1 - 1999/4

N2 - BACKGROUND. Little is known about the quality of Papanicolaou (Pap) smears performed by family physicians and obstetrician-gynecologists. METHODS. Using hospital archival records of Pap smears performed from 1995 to 1997, we compared the quality of Pap smear sampling and the rate of detection of significant cytologic abnormalities by family physicians and obstetrician-gynecologists. Using hierarchic logistic regression, we examined the relationship between physician specialty and Pap smear reports, controlling for patient age and socioeconomic position, multiple Pap smears performed by the same clinician, and physician attending status. RESULTS. A total of 34,916 Pap smears performed by 130 family physicians and 88 obstetrician-gynecologist residents and attending physicians were included in the analysis. There were no statistically significant differences by specialty in the rates of unsatisfactory reports (adjusted odds ratio [AOR] = 0.82; 95% confidence interval [Cl], 0.48 -1.38), satisfactory but limited reports (AOR = 1.16; 95% Cl, 0.93 -1.48), or detection rates of significant cytologic abnormalities (AOR = 0.83; 95% Cl, 0.66 -1.04). However, family physicians submitted more Pap smears with an absent endocervical component (AOR = 1.50; 95% Cl, 1.07-2.11). CONCLUSIONS. These findings show no significant differences by specialty in Pap smear quality as measured by rates of unsatisfactory and satisfactory but limited reports, or detection of cytologic abnormalities. The finding of higher rates of absent endocervical cells, if replicated by further study, may suggest the need for improved training of family physicians in sampling the endocervix.

AB - BACKGROUND. Little is known about the quality of Papanicolaou (Pap) smears performed by family physicians and obstetrician-gynecologists. METHODS. Using hospital archival records of Pap smears performed from 1995 to 1997, we compared the quality of Pap smear sampling and the rate of detection of significant cytologic abnormalities by family physicians and obstetrician-gynecologists. Using hierarchic logistic regression, we examined the relationship between physician specialty and Pap smear reports, controlling for patient age and socioeconomic position, multiple Pap smears performed by the same clinician, and physician attending status. RESULTS. A total of 34,916 Pap smears performed by 130 family physicians and 88 obstetrician-gynecologist residents and attending physicians were included in the analysis. There were no statistically significant differences by specialty in the rates of unsatisfactory reports (adjusted odds ratio [AOR] = 0.82; 95% confidence interval [Cl], 0.48 -1.38), satisfactory but limited reports (AOR = 1.16; 95% Cl, 0.93 -1.48), or detection rates of significant cytologic abnormalities (AOR = 0.83; 95% Cl, 0.66 -1.04). However, family physicians submitted more Pap smears with an absent endocervical component (AOR = 1.50; 95% Cl, 1.07-2.11). CONCLUSIONS. These findings show no significant differences by specialty in Pap smear quality as measured by rates of unsatisfactory and satisfactory but limited reports, or detection of cytologic abnormalities. The finding of higher rates of absent endocervical cells, if replicated by further study, may suggest the need for improved training of family physicians in sampling the endocervix.

KW - Cytology

KW - Gynecology

KW - Papanicolaou smear

KW - Physician, family

UR - http://www.scopus.com/inward/record.url?scp=0033111723&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0033111723&partnerID=8YFLogxK

M3 - Article

VL - 48

SP - 294

EP - 298

JO - Journal of Family Practice

JF - Journal of Family Practice

SN - 0094-3509

IS - 4

ER -