Follow-up of abnormal gynecologic cytology: a college of American pathologists Q-probes study of 16132 cases from 306 laboratories.
OBJECTIVE
To measure the percentage of women with abnormal gynecologic cytology who have follow-up within 1 year and to identify patient and laboratory characteristics associated with higher percentages of follow-up.


METHODS
Retrospective identification of patients with abnormal cervicovaginal cytology and identification of the initial clinical follow-up activity during the 12 months following the cytologic diagnosis.


METHODS
Percentage of women receiving follow-up.


RESULTS
Three hundred six laboratories reported follow-up information on 16 132 patients with gynecologic cytology diagnoses of carcinoma, high-grade squamous intraepithelial lesion, low-grade squamous intraepithelial lesion, or glandular intraepithelial lesion. The following percentages of women received follow-up within 1 year: 85.6% of patients with cytologic diagnoses of carcinoma, 87.2% with diagnoses of high-grade squamous intraepithelial lesion, 82.7% with diagnoses of low-grade squamous intraepithelial lesion, and 84.9% with diagnoses of glandular intraepithelial lesion. Within 6 months, 82.2% of patients with cytologic diagnoses of carcinoma, 82.4% with diagnoses of high-grade squamous intraepithelial lesion, 71.9% with diagnoses of low-grade squamous intraepithelial lesion, and 74.7% with diagnoses of glandular intra-epithelial lesion received follow-up. Overall, 90. 8% of patients who received follow-up within the 1-year time frame of this study had their follow-up completed within 6 months. Specific follow-up activities and their frequencies are listed for each diagnostic category. Patients 30 years old or younger and pregnant patients had lower follow-up percentages.


CONCLUSIONS
With less than 83% of patients with high-grade squamous intraepithelial lesion or carcinoma cytology findings having available documentation of follow-up within 6 months, and less than 88% within 1 year, there is room for improvement in this area of health care. Monitoring and critical analysis of the follow-up process is a starting point for improvement.
Jones
B A
BA
Department of Pathology, St John Hospital and Medical Center, Detroit, Mich. 48236, USA.
Novis
D A
DA
D000328:Adult; D017677:Age Distribution; D000368:Aged; D001315:Australia / Q000453:epidemiology; D001530:Belgium / Q000453:epidemiology; D019985:Benchmarking / Q000706:statistics & numerical data* / Q000639:trends; D002170:Canada / Q000453:epidemiology; D002294:Carcinoma, Squamous Cell / Q000453:epidemiology / Q000473:pathology*; D003266:Continuity of Patient Care / Q000706:statistics & numerical data*; D005260:Female; D005500:Follow-Up Studies; D005833:Genital Neoplasms, Female / Q000453:epidemiology / Q000473:pathology*; D006801:Humans; D008875:Middle Aged; D010352:Patient Dropouts / Q000706:statistics & numerical data; D010359:Patient Readmission / Q000706:statistics & numerical data; D011230:Precancerous Conditions / Q000453:epidemiology / Q000473:pathology*; D012189:Retrospective Studies; D013785:Thailand / Q000453:epidemiology; D006113:United Kingdom / Q000453:epidemiology; D014481:United States / Q000453:epidemiology; D014626:Vaginal Smears / Q000706:statistics & numerical data*