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[Follow-up not according to guidelines after an abnormal cervix smear]
F A Kreuger1, H Beerman, H G Nijs
1Gemeentelijke Geneeskundige Dienst Rotterdam e.o., afd. Epidemiologie en Beleid, Rotterdam.
Objective:
To investigate whether the recommendations for the follow-up after a positive cervical smear test, made within the Dutch national screening programme on cervical cancer, are followed in practice.
Design:
Descriptive.
Setting:
The Rotterdam Municipal Health Services Area.
Method:
All cytological and clinical-histological findings on women who had a Pap smear of at least Pap class IIIA in the period 1989-1991, were collected from the Pathological Anatomical National Automised Archives (PALGA). Per smear test result, the cervix-cytological and histological examinations that took place after the screening programme were arranged in order of occurrence.
Results:
61% of the women with Pap class IIIA had been followed according to the recommendations, in 12% no follow-up had been done. Repeat cytology was often done much later than after three months as recommended. After Pap class IIIB, IV or V smear test outcome the recommendations were followed in respectively over half, about three-quarters, and all cases. In 9% of women with Pap class IIIB or IV, no follow-up was recorded in the PALGA data base.
Conclusion:
Often, the recommendations for follow-up after a positive smear were followed poorly. Further research into the problems in the follow-up route is necessary.