Predicting nonattendance for colposcopy clinic follow-up after referral for an abnormal Pap smear

This is retrospective cohort study of women who were recommended for further assessment or treatment after their first visit to a gynaecologist for an abnormal Pap smear. The sample included women who first attended a private outpatient colposcopy service in Canberra between 1 January 1989 and 30 April 1990. Only women who had never previously seen a gynaecologist for an abnormal Pap smear were included in the sample. The nonattendance rate was 2.2 women per 100 women-months (n = 493). Cox proportional hazards modelling was used to examine the relationships between sociodemographic and clinic variables and nonattendance. After adjusting for age and the degree of abnormality on presenting smear, women without private health insurance and women who had had treatment were less likely to continue attending. The current focus on identifying barriers to screening services needs to be broadened to consider attendance at all points along the screening pathway.