Quality of follow-up of women with high grade squamous intra-epithelial lesion (HGSIL) cervical smears: results from a population-based organised screening programme

• Published in: European Journal of Obstetrics & Gynecology and Reproductive Biology 2004-04, Vol.113 (2), p.234-239
• Main Authors: Monnet, Elisabeth, Marquant, Arielle, Genin, Pascal, Mauny, Fréderic, Carbillet, Jean-Pierre
• Format: Article
• Language: English
• Subjects: Adult; Biological and medical sciences; Cervical cancer screening; Cervical Intraepithelial Neoplasia; Cervical Intraepithelial Neoplasia - diagnosis; Cervical Intraepithelial Neoplasia - pathology; Cervical Intraepithelial Neoplasia - therapy; Clinical audit; Colposcopy; Colposcopy - statistics & numerical data; Female; Follow-up; Gynecology. Andrology. Obstetrics; HGSIL; Humans; Life Sciences; Medical sciences; Middle Aged; Papanicolaou Test; Patient Compliance; Santé publique et épidémiologie; Vaginal Smears
• ISSN: 0301-2115; 1872-7654; 2590-1613
• DOI: 10.1016/j.ejogrb.2003.09.043

Objective: After a HGSIL cervical smear, to appraise the diagnostic and treatment modalities by comparing with national recommendations. Study design: A clinical audit concerning 444 women with a HGSIL cervical smear, within the first 3 years of the programme. Results: Among the 413 women followed-up (98%), the colposcopy rate reached 71% at 3 months and 81% at 1 year. It was lower for women who had a history of other abnormal Pap smears than for those with no gynaecological symptoms or past history (66% versus 87%, P=0.02), it was higher when the cytology report showed a CIN III than when a CIN II was reported (84% versus 78%, P=9×10 −4). After the colposcopy, 23 women (7%) were lost to follow-up. Among the 76 women without a colposcopy, 17 (22%) did not have any histological examinations during their follow-up. Conclusion: Measures to improve women’s follow-up compliance and ensure appropriate physician behaviours are necessary to achieve better quality in this screening programme.