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

Kevin Fiscella, Peter Franks

Research output: Contribution to journalArticlepeer-review

13 Scopus citations


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
Issue number4
StatePublished - Apr 1999
Externally publishedYes


  • Cytology
  • Gynecology
  • Papanicolaou smear
  • Physician, family

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health


Dive into the research topics of 'The Adequacy of Papanicolaou Smears as Performed by Family Physicians and Obstetrician-Gynecologists'. Together they form a unique fingerprint.

Cite this