TY - JOUR
T1 - Follow-up of abnormal or inadequate cervical smears using two guidance systems
T2 - RCT on effectiveness
AU - Hermens, Rosella P.M.G.
AU - Siebers, Bert G.
AU - Hulscher, Marlies E.J.L.
AU - Braspenning, Jozé C.C.
AU - Van Doremalen, Jan H.M.
AU - Hanselaar, Antonius
AU - Grol, Richard P.T.M.
AU - Van Weel, Chris
PY - 2005/11
Y1 - 2005/11
N2 - Background. To improve follow-up compliance after an initial inadequate or abnormal cervical smear, two follow-up guidance systems were tested for effectiveness. A comprehensive system (cytopathology laboratory monitored the follow-up of all abnormal and inadequate smears) was compared to a selective system (monitoring was left to the smear taker; laboratory acted as a safety net). Methods. In an RCT on all family practices (N = 171) in the catchment areas of two cytopathology laboratories (Nijmegen region, The Netherlands, 1998-2000), practices were allocated at random to one of the follow-up guidance systems. All women included were registered at the practices, invited to the national screening program and had abnormal or inadequate smears. Measurements comprised of (1) follow-up compliance at baseline and 1 year after the initial smear and (2) diagnostic outcome of the follow-up smear. Results. During the study period, 132 practices sent their cervical smears to the laboratories. The comprehensive system covered 1226 women, the selective 1034. In the comprehensive system, the increase in follow-up compliance for initial inadequate and slightly abnormal smears was significantly higher (8.9%) than in the selective one, which implied an extra detection of eleven, more serious, abnormalities per 1000 women. Conclusion. The comprehensive system was more effective than the selective and is suitable for use on a larger scale.
AB - Background. To improve follow-up compliance after an initial inadequate or abnormal cervical smear, two follow-up guidance systems were tested for effectiveness. A comprehensive system (cytopathology laboratory monitored the follow-up of all abnormal and inadequate smears) was compared to a selective system (monitoring was left to the smear taker; laboratory acted as a safety net). Methods. In an RCT on all family practices (N = 171) in the catchment areas of two cytopathology laboratories (Nijmegen region, The Netherlands, 1998-2000), practices were allocated at random to one of the follow-up guidance systems. All women included were registered at the practices, invited to the national screening program and had abnormal or inadequate smears. Measurements comprised of (1) follow-up compliance at baseline and 1 year after the initial smear and (2) diagnostic outcome of the follow-up smear. Results. During the study period, 132 practices sent their cervical smears to the laboratories. The comprehensive system covered 1226 women, the selective 1034. In the comprehensive system, the increase in follow-up compliance for initial inadequate and slightly abnormal smears was significantly higher (8.9%) than in the selective one, which implied an extra detection of eleven, more serious, abnormalities per 1000 women. Conclusion. The comprehensive system was more effective than the selective and is suitable for use on a larger scale.
KW - Cervix neoplasms
KW - Evaluation studies
KW - Family practice
KW - Laboratory techniques and procedures
KW - Mass screening
KW - Vaginal smears
UR - http://www.scopus.com/inward/record.url?scp=28844460301&partnerID=8YFLogxK
U2 - 10.1016/j.ypmed.2005.08.002
DO - 10.1016/j.ypmed.2005.08.002
M3 - Article
SN - 0091-7435
VL - 41
SP - 809
EP - 814
JO - Preventive Medicine
JF - Preventive Medicine
IS - 5-6
ER -