title: [ASC-US Pap Smear follow-up in a French department in 2077].
abstract: OBJECTIVE
  In the event of an ASC-US Pap smear, colposcopy, 6-month Pap smear or screening for oncogenic HPV are recommended as first-line testing options by the French National Authority for Health -HAS. The primary objective of this study was to determine the preferred option chosen by general practitioners and to assess their follow-up care.
  
  
  METHODS
  The Maine-et-Loire cancer screening database was used to extract 283 files of women, aged 25 to 65, in whom ASC-US Pap smear was performed by their general practitioners (GPs) in 2011.
  
  
  RESULTS
  265 women (93.6%) underwent their first test (C1]. GPs performed 64.5% of tests: 93% of which were Pap smears, 5.3% were HPV tests and 1.7% were Pap smears combined with HPV tests. 164 patients (58%) received comprehensive follow-up, i.e 2 tests after the first ASC-US pap smear or a therapeutic intervention after an abnormal Cl. 14 patients were lost to follow-up. Follow-up rate was 57.6% in the case of a normal C1 and 83.3% in the case of an abnormal C1. 79.2% of first tests were normal and a total of 16 high-grade lesions were diagnosed (5.7%).
  
  
  CONCLUSIONS
  The fact that liquid-based Pap smears were rarely used might explain why HPV testing is rarely prescribed. The rarity of ASC-US anomalies, the variable potential for progression and the possibility to choose between several follow-up options proved to be obstacles for GPs to apply guidelines. The poor coordination . between gynaecologists and GPs, the difficulties in planning follow-up and the lack of precision of test reports may limit the efficacy of monitoring.
authors.forename: Clara
authors.initials: C
authors.lastname: Giuria
authors.forename: Elise
authors.initials: E
authors.lastname: Guiheneuc
authors.forename: Flore
authors.initials: F
authors.lastname: Coimet
authors.forename: Eric
authors.initials: E
authors.lastname: Caillez
authors.forename: Céline
authors.initials: C
authors.lastname: Baron
mesh_terms: D000328:Adult; D000368:Aged; D065309:Atypical Squamous Cells of the Cervix / Q000473:pathology*; D003127:Colposcopy / Q000379:methods* / Q000706:statistics & numerical data; D016208:Databases, Factual; D005260:Female; D005500:Follow-Up Studies; D005602:France; D058005:General Practitioners / Q000706:statistics & numerical data; D006801:Humans; D059012:Lost to Follow-Up; D008875:Middle Aged; D065006:Papanicolaou Test / Q000379:methods* / Q000706:statistics & numerical data; D030361:Papillomavirus Infections / Q000175:diagnosis; D017410:Practice Guidelines as Topic; D012189:Retrospective Studies; D014626:Vaginal Smears / Q000379:methods* / Q000706:statistics & numerical data