[Adverse incidents in a cervical cancer screening programme].
BACKGROUND
In about 10% of routine vaginal smears, pathologists recommend a repeat smear. The purpose of this paper is to describe the extent to which this recommendation is followed, reasons why this is not always the case, and possible ways of improvement.


METHODS
Data on follow-up rates were extracted from the cervical cancer screening database in Aarhus County. Through facilitator visits information was obtained about the routine procedures for informing women about the test results, reasons for lack of follow-up and suggestions for improvement of the follow-up rate.


RESULTS
One third of the recommended follow-up smears were not taken. Patients from single-handed practices were less likely to have a follow-up smear than those registered with group practices. The follow-up rate was independent of the organisation of the procedures for informing the women about the test results. Reasons at practice level for lack of follow-up included failure to convey the test results, unclear information to the women and lack of procedures to identify those who did not have the recommended test taken. To improve the follow-up rate, the general practitioners who were interviewed suggested a number of procedures to identify the women who did not receive the recommended follow-up smear.


CONCLUSIONS
The follow-up rate is not acceptable, and a systematic follow-up procedure is necessary to ensure that the recommended follow-up tests are carried out. This is most efficiently done at a central level.
Bro
Flemming
F
Aarhus Universitet, Forskningsenheden for Almen Praksis, Regionshospitalet Randers, Patologisk Institut. fbro@alm.au.dk
Svanholm
Hans
H
Støvring
Henrik
H
Frandsen
Charlotte
C