Loss to follow-up of cervical smears without endocervical columnar cells is not disturbing.
OBJECTIVE
To investigate the six-month recommended follow-up after mass screening of Pap smears because of the absence of endocervical columnar cells (ECC-) or ECC+ smears with atypical squamous or glandular cells of undetermined origin (ASCUS/AGUS) or low-grade squamous or glandular intraepithelial lesions (LSIL/LGIL) in a Dutch mass screening cervical cancer programme.


METHODS
Data were extracted from computerised medical records of national representative Dutch general practices. We have studied the attendance at and the outcome of the subsequent Pap smears after a 6-month recommendation.


RESULTS
The six-month follow-up was linked to 8.7% of the Pap smears (n = 1,002); 77.6% were without endocervical columnar cells (ECC-). Clear differences were found between the follow-up of ECC+ and ECC- smears; after 36 weeks of follow-up of 43.5% the women had an ECC- smear and 66.9% had other conditions. For initial ECC- Pap smears, 84.1% had no abnormalities in the subsequent Pap smear; for initial ECC+ Pap smears, in about 64% of the cases no abnormalities were found (p < 0.0001).


CONCLUSIONS
Repeating ECC- smears has a low follow-up rate but also lacks evidence-based necessity. However, for the other 6-month recommended Pap smears, one in five women had still not responded within one year, so improvement is necessary.
Centre for Quality of Care Research (WOK), Radboud University Nijmegen Medical Centre, The Netherlands.
M A J B
MA
Tacken
J C C
JC
Braspenning
J
J
Mulder
R P M G
RP
Hermens
W L D M
WL
Nelen
D H
DH
de Bakker
R P T M
RP
Grol
D000328:Adult; D000368:Aged; D002584:Cervix Uteri / Q000166:cytology* / Q000473:pathology; D015331:Cohort Studies; D003581:Cytodiagnosis / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008403:Mass Screening / Q000592:standards* / Q000639:trends; D008875:Middle Aged; D020380:Needs Assessment; D065006:Papanicolaou Test; D010349:Patient Compliance / Q000706:statistics & numerical data; D012042:Registries; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D013997:Time Factors; D016312:Treatment Refusal / Q000706:statistics & numerical data; D002583:Uterine Cervical Neoplasms / Q000473:pathology*; D014626:Vaginal Smears / Q000592:standards* / Q000639:trends; D002578:Uterine Cervical Dysplasia / Q000473:pathology*