Abnormal cervical cytology and health care use: a population-based register study.
OBJECTIVE
This study aimed to assess the long-term use of health care services in women with abnormal cytology results compared to women with normal cytology results.


METHODS
We did a nationwide population-based study, using women aged 23 to 59years participating in the national organized cervical cancer screening program. We included a study population of 40,153 women with abnormal cytology (exposed) and 752,627 women with normal cytology (non-exposed). We retrieved data from the Danish Civil Registration System, the Danish Pathology Data Bank, the National Health Service, the National Patient and the National Prescription Register. We calculated the frequencies of contacts to general practitioner (GP), to private psychiatrist and/or psychologist, admissions to hospitals and use of prescription drugs. These frequencies were calculated separately in the 5-year period "before" the cytology result and for the 5-year period "after" the result.


RESULTS
During the "before" period exposed women had more contacts to GPs, more contacts to psychologists/psychiatrist, and more hospital admissions than non-exposed women. In both exposed and non-exposed women, health care use increased from the "before" to the "after" period. This increase was significantly higher for exposed than non-exposed women regarding contacts to GP, admissions to hospitals, and drug use.


CONCLUSIONS
Women with abnormal cytology results constitute a selected group with a higher health care use than other women even before they have the abnormal cytology. This difference is further enhanced after the abnormal cytology result.
Dept. of Public Health, University of Copenhagen, Øster Farimagsgade 5, 1014 Copenhagen K, Denmark. Electronic address: marfr@sund.ku.dk.
Maria Eiholm
ME
Frederiksen
Dept. of Public Health, University of Copenhagen, Øster Farimagsgade 5, 1014 Copenhagen K, Denmark.
Miguel Vázquez-Prada
MV
Baillet
Dept. of Public Health, University of Copenhagen, Øster Farimagsgade 5, 1014 Copenhagen K, Denmark.
Pierre-Antoine
PA
Dugué
Dept. of Gynaecology and Obstetics, Odense University Hospital, Sdr. Boulevard 29, 5000 Odense C, Denmark.
Pernille Tine
PT
Jensen
Dept. of Pathology, Hvidovre University Hospital, Kettegård Alle 30, 2650 Hvidovre, Denmark.
Carsten
C
Rygaard
Clinical Pharmacology, University of Southern Denmark, J. B. Winsløws Vej 19, 2., 5000 Odense C, Denmark.
Jesper
J
Hallas
Dept. of Public Health, University of Copenhagen, Øster Farimagsgade 5, 1014 Copenhagen K, Denmark.
Elsebeth
E
Lynge
D000328:Adult; D002584:Cervix Uteri / Q000473:pathology*; D003695:Delivery of Health Care / Q000706:statistics & numerical data*; D003718:Denmark / Q000453:epidemiology; D005260:Female; D006801:Humans; D008875:Middle Aged; D065006:Papanicolaou Test; D012042:Registries; D002578:Uterine Cervical Dysplasia / Q000175:diagnosis* / Q000453:epidemiology / Q000473:pathology / Q000628:therapy*; D055815:Young Adult
Cervical cytology; Health care use; Screening