title: Long-term adherence to follow-up after treatment of cervical intraepithelial neoplasia: nationwide population-based study.
abstract: OBJECTIVE
  To measure adherence to annual follow-up among women treated for cervical intraepithelial neoplasia.
  
  
  METHODS
  Prospective, population-based, register study.
  
  
  METHODS
  Denmark, 1996-2007.
  
  
  METHODS
  All women treated for cervical intraepithelial neoplasia with conization.
  
  
  METHODS
  Treated women were routinely recommended to have follow-up with annual smears for at least 5 years.
  
  
  METHODS
  Using individually linked nationwide register data on conizations and follow-up tests (smears and biopsies), we calculated the cumulative proportion of treated women undergoing the recommended follow-up. We measured this cumulative proportion conservatively in 15-month intervals for 5 years.
  
  
  RESULTS
  Adherence to annual follow-up among 45,984 treated women decreased gradually. In total, 90% of these women obtained at least one smear in the first post-treatment year, but only 40% obtained the recommended tests for 5 years. Five-year adherence was substantially better outside the capital area, for example, the odds ratio for women from Jutland compared with women from the capital area was 1.70 (95% confidence interval 1.60-1.82).
  
  
  CONCLUSIONS
  Adherence to follow-up after conization was poor in Denmark. Our findings suggest that because of this poor adherence, recommendations for long-term annual follow-up after treatment of cervical intraepithelial neoplasia may not be highly effective. Shorter follow-up schedules using highly sensitive tests appear attractive.
authors: Department of Public Health, University of Copenhagen, Copenhagen, Denmark.
authors: Sidsel S
authors: SS
authors: Barken
authors: Elsebeth
authors: E
authors: Lynge
authors: Erik S
authors: ES
authors: Andersen
authors: Matejka
authors: M
authors: Rebolj
mesh_terms: D000328:Adult; D002584:Cervix Uteri / Q000601:surgery; D019092:Conization; D003718:Denmark; D055088:Early Detection of Cancer / Q000706:statistics & numerical data*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016015:Logistic Models; D008875:Middle Aged; D016017:Odds Ratio; D010349:Patient Compliance / Q000706:statistics & numerical data*; D011446:Prospective Studies; D012042:Registries; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis* / Q000601:surgery; D014626:Vaginal Smears / Q000706:statistics & numerical data*; D002578:Uterine Cervical Dysplasia / Q000175:diagnosis* / Q000601:surgery