Management choice and adherence to follow-up after colposcopy in women with cervical intraepithelial neoplasia 1.
OBJECTIVE
To determine women's preference when given a choice of management between cryotherapy and cytology surveillance and to compare subsequent adherence to serial cytologic follow-up after being diagnosed with cervical intraepithelial neoplasia grade 1 (CIN1).


METHODS
Two hundred nineteen low-income women with biopsy-proven CIN1 seen in a reproductive health clinic from August 1995 through December 1999 were offered cryotherapy or cytology surveillance, followed by cytologic testing every 4 months until three consecutive results were normal. Endpoints of the study were: successful completion of follow-up; transferred or referred out of clinic; or lost to follow-up.


RESULTS
Ninety-four women (42.9%) chose cryotherapy, compared with 125 women (57.1%) who chose cytology surveillance (P < .05). Cryotherapy patients were more likely to return for at least one visit (their treatment visit) after colposcopy compared with cytology surveillance patients (P < .001). In contrast to their initial return for treatment of 98.9%, cryotherapy patients were less likely to return for their first follow-up cytology visit compared to surveillance-only patients (68.1% and 83.2%, respectively, P < .01). Thirty-seven percent of the total group successfully completed follow-up at the clinic, 30.1% transferred or were referred, and 32.9% were lost to follow-up.


CONCLUSIONS
Successful completion of a commonly recommended protocol for serial cytology follow-up was low. Management choice affected initial adherence but not adherence to long-term follow-up.
Hartz
L E
LE
Reproductive Health Clinic, Division of Health and Human Services, Municipality of Anchorage, Anchorage, Alaska, USA. lhartz@alaska.com
Fenaughty
A M
AM
D000293:Adolescent; D000328:Adult; D003127:Colposcopy; D017679:Cryotherapy; D005260:Female; D006801:Humans; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D011446:Prospective Studies; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis / Q000473:pathology / Q000628:therapy*; D014626:Vaginal Smears; D002578:Uterine Cervical Dysplasia / Q000175:diagnosis / Q000473:pathology / Q000628:therapy*