title: Follow-up of women with inadequate Pap smears: a prospective cohort study.
abstract: OBJECTIVE
  Inadequate Pap smears do not provide satisfactory cell samples for evaluation, thus making it more difficult to detect cervical cytological abnormalities. The objective of this study was to determine the cytological and histological follow-up results from women with inadequate smear reports in primary healthcare centers in Santiago, Chile 2010-2011.
  
  
  METHODS
  Prospective cohort study at primary healthcare clinics in Santiago, Chile.
  
  
  METHODS
  The population was taken from the "Cito-Expert" database of 2010. The data were then organized according to the cytological and histological follow-up results of 2,547 women with inadequate cervical cytological reports over the 12-month period. The samples were assigned to groups based on the cause of inadequacy (smears with endocervical cells alone; insufficient, hemorrhagic, inflammatory or poorly fixed samples; insufficient and hemorrhagic samples; or insufficient and inflammatory specimens). The data were analyzed using the "conditional probability tree diagram" and descriptive statistics.
  
  
  RESULTS
  Half of the women (n = 1,285) met the requirements of the Ministry of Health for repeating these inadequate smears, and 1,104 of these women had normal cytological results (85.9%). The detection rate for cervical lesions according to group ranged from 0% (smears with endocervical cells alone or insufficient and hemorrhagic specimens) to 4.1% (poor fixation).
  
  
  CONCLUSIONS
  The large proportion of normal results justifies revision of the current clinical guidelines. The results showed that it is not necessary to repeat the Pap test early on, with the exception of inadequate hemorrhagic and inflammatory cytological results.
authors: School of Nursing, Universidad Andres Bello, Santiago, Chile.
authors: Fanny
authors: F
authors: López-Alegría
authors: Department of Obstetrics and Gynecology, University of Caxias do Sul, Brazil.
authors: Dino Roberto Soares De
authors: DR
authors: Lorenzi
authors: MT. Medical Technologist, Cytology Laboratory, Complejo Asistencial Barros Luco, Santiago, Chile.
authors: Orlando Quezada
authors: OQ
authors: Poblete
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002677:Chile; D004847:Epithelial Cells / Q000166:cytology* / Q000473:pathology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007249:Inflammation / Q000175:diagnosis; D059012:Lost to Follow-Up; D008875:Middle Aged; D010043:Outcome and Process Assessment, Health Care / Q000458:organization & administration*; D065006:Papanicolaou Test / Q000379:methods* / Q000592:standards / Q000706:statistics & numerical data; D017410:Practice Guidelines as Topic; D011446:Prospective Studies; D013048:Specimen Handling; D065310:Squamous Intraepithelial Lesions of the Cervix / Q000175:diagnosis; D014626:Vaginal Smears / Q000379:methods* / Q000592:standards / Q000706:statistics & numerical data; D055815:Young Adult
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