Quality of follow-up of women with high grade squamous intra-epithelial lesion (HGSIL) cervical smears: results from a population-based organised screening programme.
OBJECTIVE
After a HGSIL cervical smear, to appraise the diagnostic and treatment modalities by comparing with national recommendations.


METHODS
A clinical audit concerning 444 women with a HGSIL cervical smear, within the first 3 years of the programme.


RESULTS
Among the 413 women followed-up (98%), the colposcopy rate reached 71% at 3 months and 81% at 1 year. It was lower for women who had a history of other abnormal Pap smears than for those with no gynaecological symptoms or past history (66% versus 87%, P = 0.02), it was higher when the cytology report showed a CIN III than when a CIN II was reported (84% versus 78%, P = 9 x 10(-4). After the colposcopy, 23 women (7%) were lost to follow-up. Among the 76 women without a colposcopy, 17 (22%) did not have any histological examinations during their follow-up.


CONCLUSIONS
Measures to improve women's follow-up compliance and ensure appropriate physician behaviours are necessary to achieve better quality in this screening programme.
Monnet
Elisabeth
E
Department of Public Health, Faculty of Medicine and Pharmacy, Besancon Cedex 25030, France. elisabeth.monnet@ufc-chu.univ-fcomte.fr
Marquant
Arielle
A
Genin
Pascal
P
Mauny
Fréderic
F
Carbillet
Jean-Pierre
JP
D000328:Adult; D003127:Colposcopy / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008875:Middle Aged; D065006:Papanicolaou Test; D010349:Patient Compliance; D014626:Vaginal Smears; D002578:Uterine Cervical Dysplasia / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy