Pap smear screening in family physicians' offices in a rural area with a high cervical cancer rate.

BACKGROUND AND OBJECTIVES: Cervical cancer, when detected early by methods like the Pap test, is usually curable. Unfortunately, Pap smear screening is not universal, and mortality from cervical cancer still occurs. The objective of this study was to identify the extent to which female patients were not receiving annual Pap tests in nine family physicians' offices in the lower Rio Grande Valley region of Texas. METHODS: Patients age 18 or older were asked the date of their last Pap test. The answer was recorded on a chart sticker to help the physician identify patients in need of a Pap test. RESULTS: Of 5,526 women seen in the nine physicians' offices over a 3-month time period, 42% had not had a Pap smear within the previous 2 years. When offered a Pap test during this study, only 18% of patients refused. CONCLUSION: There appears to be a need for education of physicians and patients about the importance of Pap smear testing and a change in office routines that encourages incorporation of Pap testing into primary physicians' office practices.

Smoking cessation interventions by family physicians in Texas.

A survey of 1,292 family physicians in Texas indicates that most of them (99%) ask patients about their smoking behavior. Fewer physicians, however, participate in further activities recommended by the National Cancer Institute: arranging follow-up visits, providing self-help materials, prescribing nicotine gum, engaging patients in discussion, referring patients to a program for smoking cessation, and involving other office personnel in counseling. Almost 80% of the respondents cited such obstacles to their involvement in counseling/advising patients as patient attitudes or patient preferences for smoking. The survey was conducted to acquire baseline data on the involvement of family physicians in Texas in counseling their patients who smoke and the obstacles they meet in their efforts.