Opting out of cervical cancer screening: physicians who do not perform pap tests.

BACKGROUND Some primary care physicians choose not to provide cervical cancer screening. PURPOSE To investigate the characteristics and screening beliefs of family practitioners and internists who treat adult women in outpatient settings but perform no routine Pap tests. METHODS A survey of U.S. primary care physicians (N=892) was conducted and analyzed in 2012. RESULTS Participants who performed no Pap tests during a typical month (17.2% of family practitioners and 44.3% of internists) generally reported that they referred patients to gynecologists for cervical cancer screening. The most significant predictor of Pap test non-provision was agreement that patients are best served by having Pap tests performed by gynecologists (AOR=8.80, 95% CI=5.58, 13.88, p<0.001). CONCLUSIONS The perception that patients benefit from cervical cancer screening administered by gynecologists may deter screening in primary care settings, resulting in missed opportunities to offer screening to women who are never or rarely screened.