Do Women Comply with Recommendations for Pap Smears Following Colposcopy?
Do Women Comply with Recommendations for Pap Smears Following Colposcopy?
The objective of this study was to determine compliance with follow-up serial Papanicolaou smears after the completion of colposcopic examination and treatment as required in women with abnormal Papanicolaou smears. Following a retrospective chart review, data were selected from 103 charts of women who had undergone colposcopy. Patient compliance with the treatment plan was tracked for 18 months. Compliance was defined as having at least two cervical cancer screenings performed in the year and a half following colposcopy. Thirty-two percent of the study population complied with the plan of care. Eighty-six percent of those patients who had at least one Papanicolaou smear in the 18 months following colposcopy had no progression of dysplasia. Less than one-third of the patients in this study population followed the recommendations given to them after their colposcopic examination and treatment. Health care providers will be aware of the low percentage of patient follow-up as well as the importance of educating patients about prevention of cervical cancer and reducing risk of cervical dysplasia.
The American Cancer Society estimated that there were 9710 new cases of cervical cancer in the United States and about 3700 deaths in 2006. Despite these statistics, cervical cancer is one of the most successfully treated cancers if detected early, with a 73% 5-year survival rate in 2000 compared to a 59% 5-year survival rate in 1950. The Papanicolaou test was developed to detect precancerous lesions, and its use has significantly reduced the number of deaths related to the disease since the 1950s.
Failure to obtain regularly scheduled cancer screening has been identified as the most common reason for the development of cervical cancer among patients at risk for the disease. Therefore, improving the recruitment of women to receive the recommended Papanicolaou tests is an effective means of decreasing the incidence of cervical cancer. In the Healthy People 2010 National Health Promotion and Disease Prevention Objectives Final Review, one goal is to increase to at least 97% the proportion of women aged 18 and older who have ever received a Papanicolaou test, and to at least 90% those who received a Papanicolaou test within the preceding 1 to 3 years. In 1987, only 74% of women aged 18 years and older had had a Papanicolaou test within the preceding 3 years, and in 2000 the figure had only increased to 81%. Despite the documented importance of cancer screening and prevention programs, problems occur when patients do not initiate screening and/or do not return for follow-up care.
Effective prevention depends upon appropriate screening, the development of a care plan established between the health care provider and the patient, and adherence to the plan by the patient. Guidelines published by the American College of Obstetricians and Gynecologists (ACOG) concerning the initiation and frequency of Papanicolaou smear screening describe the standard of care for cervical cancer screening. Guidelines published by the American Society for Colposcopy and Cervical Pathology (ASCCP) describe the standard of care for treating women with abnormal Papanicolaou smears and recommendations for treatment of dysplasia. The guidelines include close follow-up and monitoring of cervical abnormalities post-colposcopy. The objective of this study was to determine whether patients followed through with the recommendation for serial cervical screening after colposcopic evaluation of the cervix, and in some cases, after treatment for cervical dysplasia.
The objective of this study was to determine compliance with follow-up serial Papanicolaou smears after the completion of colposcopic examination and treatment as required in women with abnormal Papanicolaou smears. Following a retrospective chart review, data were selected from 103 charts of women who had undergone colposcopy. Patient compliance with the treatment plan was tracked for 18 months. Compliance was defined as having at least two cervical cancer screenings performed in the year and a half following colposcopy. Thirty-two percent of the study population complied with the plan of care. Eighty-six percent of those patients who had at least one Papanicolaou smear in the 18 months following colposcopy had no progression of dysplasia. Less than one-third of the patients in this study population followed the recommendations given to them after their colposcopic examination and treatment. Health care providers will be aware of the low percentage of patient follow-up as well as the importance of educating patients about prevention of cervical cancer and reducing risk of cervical dysplasia.
The American Cancer Society estimated that there were 9710 new cases of cervical cancer in the United States and about 3700 deaths in 2006. Despite these statistics, cervical cancer is one of the most successfully treated cancers if detected early, with a 73% 5-year survival rate in 2000 compared to a 59% 5-year survival rate in 1950. The Papanicolaou test was developed to detect precancerous lesions, and its use has significantly reduced the number of deaths related to the disease since the 1950s.
Failure to obtain regularly scheduled cancer screening has been identified as the most common reason for the development of cervical cancer among patients at risk for the disease. Therefore, improving the recruitment of women to receive the recommended Papanicolaou tests is an effective means of decreasing the incidence of cervical cancer. In the Healthy People 2010 National Health Promotion and Disease Prevention Objectives Final Review, one goal is to increase to at least 97% the proportion of women aged 18 and older who have ever received a Papanicolaou test, and to at least 90% those who received a Papanicolaou test within the preceding 1 to 3 years. In 1987, only 74% of women aged 18 years and older had had a Papanicolaou test within the preceding 3 years, and in 2000 the figure had only increased to 81%. Despite the documented importance of cancer screening and prevention programs, problems occur when patients do not initiate screening and/or do not return for follow-up care.
Effective prevention depends upon appropriate screening, the development of a care plan established between the health care provider and the patient, and adherence to the plan by the patient. Guidelines published by the American College of Obstetricians and Gynecologists (ACOG) concerning the initiation and frequency of Papanicolaou smear screening describe the standard of care for cervical cancer screening. Guidelines published by the American Society for Colposcopy and Cervical Pathology (ASCCP) describe the standard of care for treating women with abnormal Papanicolaou smears and recommendations for treatment of dysplasia. The guidelines include close follow-up and monitoring of cervical abnormalities post-colposcopy. The objective of this study was to determine whether patients followed through with the recommendation for serial cervical screening after colposcopic evaluation of the cervix, and in some cases, after treatment for cervical dysplasia.
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