scholarly journals Impact of GP reminders on follow-up of abnormal cervical cytology: a before–after study in Danish general practice

2017 ◽  
Vol 67 (661) ◽  
pp. e580-e587 ◽  
Author(s):  
Bettina Kjær Kristiansen ◽  
Berit Andersen ◽  
Flemming Bro ◽  
Hans Svanholm ◽  
Peter Vedsted
Keyword(s):  
General Practice ◽  
Practice Variation ◽  
Cervical Cytology ◽  
Loss To Follow Up ◽  
Reminder System ◽  
Abnormal Cervical Cytology ◽  
Status Interaction ◽  
Practice Variations ◽  
Cohabitation Status

BackgroundDysplasia may progress because of a loss to follow-up after an abnormal cervical cytology. Approximately 18% of Danish women postpone the recommended follow-up, which depends on the cytology results.AimTo investigate if a reminder to the GP about missed follow-up could reduce the proportion of women who fail to act on a recommended follow-up, and to analyse the effect on sociodemographic and general practice variations.Design and settingA national electronic GP reminder system was launched in Denmark in 2012 to target missed follow-up after screening, opportunistic testing, or surveillance indication. The authors compared follow-up proportions in a national observational before–after study.MethodFrom national registries, 1.5 million cervical cytologies (from 2009 to 2013) were eligible for inclusion. Approximately 10% had a recommendation for follow-up. The proportion of cervical cytologies without follow-up was calculated at different time points. Results were stratified by follow-up recommendations and sociodemographic characteristics, and changes in practice variation for follow-up were analysed.ResultsFewer women with a recommendation for follow-up missed follow-up 6 months after a GP reminder. Follow-up improved in all investigated sociodemographic groups (age, ethnicity, education, and cohabitation status). Interaction was found for age and cohabitation status. Variation between practices in loss to follow-up was significantly reduced.ConclusionAn electronic GP reminder system showed potential to improve the quality of cervical cancer screening through reduced loss to follow-up.

scholarly journals Feasibility study on recruitment in general practice for a low back pain online information study (part of the ADVIN Back Trial)

2020 ◽  
Vol 13 (1) ◽  
Author(s):  
Allan Riis ◽  
Michael Skovdal Rathleff ◽  
Jan Hartvigsen ◽  
Janus Laust Thomsen ◽  
Tamana Afzali ◽  
...  
Keyword(s):  
General Practice ◽  
Low Back Pain ◽  
Back Pain ◽  
Randomised Controlled Trial ◽  
Web Application ◽  
Controlled Trial ◽  
Low Back ◽  
Loss To Follow Up ◽  
Randomised Controlled

Abstract Objective In a future full-scale randomised controlled trial, we plan to compare satisfaction with a standard website versus satisfaction with a participatory driven web-application. The participatory driven web-application may facilitate the delivery of targeted evidence-based advice and information to patients with low back pain in general practice (ClinicalTrials.gov Identifier: NCT03088774). This feasibility study is intended to inform a future randomised controlled trial. The aim is to report on the lessons learned from recruitment to report on reasons for loss to follow-up. Results We recruited 12 women and 8 men from two general practices with each practice recruiting for 3 months. Full follow-up data was available in only three patients (15%). Based on the high loss to follow-up, we do not consider it feasible to conduct the full-scale confirmatory trial as planned. Modifying inclusion criteria to include only patients expressing an interest in using online health information or randomising patients directly at the general practice, supporting them in accessing the web-application, and letting patients respond with their immediate satisfaction may improve the speed of recruitment and follow-up rates. Furthermore, the participatory driven web-application can be included in a larger multi-faceted intervention, making the combined intervention seem more relevant to study participants.

scholarly journals Clinical practice variation and overtreatment risk in women with abnormal cervical cytology in the Netherlands: two-step versus see-and-treat approach

2020 ◽  
Vol 222 (4) ◽  
pp. 354.e1-354.e10
Author(s):  
Diede L. Loopik ◽  
Albert G. Siebers ◽  
Willem J.G. Melchers ◽  
Leon F.A.G. Massuger ◽  
Ruud L.M. Bekkers
Keyword(s):  
Clinical Practice ◽  
The Netherlands ◽  
Practice Variation ◽  
Cervical Cytology ◽  
Abnormal Cervical Cytology

scholarly journals Psychosocial Barriers to Follow-up Adherence After an Abnormal Cervical Cytology Test Result Among Low-Income, Inner-City Women

2014 ◽  
Vol 5 (4) ◽  
pp. 234-241 ◽  
Author(s):  
Siu-kuen Azor Hui ◽  
Suzanne M. Miller ◽  
Kuang-Yi Wen ◽  
Zhu Fang ◽  
Tianyu Li ◽  
...  
Keyword(s):  
Inner City ◽  
Low Income ◽  
Cervical Cytology ◽  
Abnormal Cervical Cytology ◽  
Psychosocial Barriers ◽  
Test Result

The Clinician's View: Role of Human Papillomavirus Testing in the American Society for Colposcopy and Cervical Pathology Guidelines for the Management of Abnormal Cervical Cytology and Cervical Cancer Precursors

2003 ◽  
Vol 127 (8) ◽  
pp. 950-958
Author(s):  
J. Thomas Cox
Keyword(s):  
Cervical Cancer ◽  
Consensus Conference ◽  
Cervical Cytology ◽  
Low Grade ◽  
Abnormal Cervical Cytology ◽  
Liquid Based Cytology ◽  
American Society ◽  
Cancer Precursors ◽  
Cytologic Abnormalities

Abstract The American Society for Colposcopy and Cervical Pathology (ASCCP) National Consensus Conference for the Management of Women With Cervical Cytological Abnormalities and Cervical Cancer Precursors was held on the National Institutes of Health campus in Bethesda, Md, September 6–8, 2001. The conference was attended by 121 representatives from 29 national organizations interested in cervical cancer screening issues. For the first time, guidelines for the management of women with abnormal cervical cytology, developed from evidence-based literature, were presented to delegates from the majority of organizations with interest in cervical cancer screening, voted on, and revised when necessary to achieve a majority two-thirds approval. This development of consensus-approved guidelines is likely to be considered one of the most important milestones to date in the management of women with abnormal cervical cytology. The timing of this Consensus Conference resulted from the convergence of many different factors, including new cytologic terminology developed at the Bethesda 2001 workshop and publication of the enrollment data from the National Cancer Institute's Atypical Squamous Cells of Undetermined Significance (ASC-US)/Low-Grade Squamous Intraepithelial Lesions (LSIL) Triage Study, otherwise known as ALTS. Additionally, new preliminary longitudinal ALTS data provided much of the information on the natural history of abnormal Papanicolaou tests and cervical intraepithelial neoplasia (CIN), as well as data on the performance of both new liquid-based cytology and human papillomavirus (HPV) DNA testing in the management of women following colposcopy. The result was a large database of new information that provided the foundation for the ASCCP Consensus Conference. This article covers only the recommendations of the ASCCP Guidelines that were based in large part on the results of the ALTS trial. Therefore, the focus is on the management of women with equivocal (ASC-US) and low-grade (LSIL) cytologic abnormalities. Management of women with these cytologic abnormalities has been particularly problematic, because individually these women are at least risk for CIN 3 and cancer, yet their sheer numerical dominance ensures that they account for the majority of high-grade CIN detected in the United States in the follow-up of abnormal cervical cytology. Data from ALTS confirmed that women with ASC-US could be safely managed by any of the conventional approaches (repeat Papanicolaou test, immediate colposcopy, or HPV testing), but that the preferred management approach for women having an ASC-US report from liquid-based cytology was to assess the patient's risk by testing for HPV. Additionally, longitudinal ALTS data determined that repeat liquid-based cytology at 6 and 12 months and an HPV test at 12 months were nearly equivalent options in the follow-up of women referred for HPV-positive ASC or LSIL, yet not found to have CIN 2+ at initial colposcopy. Therefore, all follow-up recommendations for women with CIN 1 or lower postcolposcopy findings include these 2 options. The data and the recommendations for the management of ASC-US, ASC cannot exclude high-grade squamous intraepithelial lesion, and LSIL are discussed.

scholarly journals Loss to follow-up of women with initial cervical cytology of ASC-US/LSIL in Tocantins, Brazil

2021 ◽  
Vol 10 (6) ◽  
pp. e27910615660
Author(s):  
Jucimária Dantas Galvão ◽  
Felipe Campos ◽  
Fábio Russomano
Keyword(s):  
Cervical Cancer ◽  
Record Linkage ◽  
Pap Smear ◽  
Cancer Control ◽  
Uterine Cervical Cancer ◽  
Cervical Cytology ◽  
Low Grade ◽  
Loss To Follow Up ◽  
Intraepithelial Lesion

Objective: The study aims to characterize loss to follow-up of women with initial cytological diagnosis of atypical squamous cells of undetermined significance, possibly non-neoplastic (ASC-US), or low-grade squamous intraepithelial lesion (LSIL), in Tocantins State, Brazil, from 2011 to 2013. Study Design: Cervical cytology data from the Information System on Uterine Cervical Cancer (SISCOLO) was used to identify women with initial diagnosis of ASC-US or LSIL in 2011. Nominal database record linkage was used to identify women with previous altered Pap smear results (who were excluded) and those who returned (versus failed to return) by the year 2013. Results: Record linkage identified 1,174 women with diagnoses of ASC-US (65.9%) or LSIL (34.1%) and without previous altered tests. According to the data, 55.9% and 53.5%, respectively, failed to undergo follow-up tests in the subsequent years. Conclusion: Failure to return for repeat cervical cytology suggests a missed opportunity for diagnosis and treatment of women with precursor lesions or cervical cancer not detected in the initial cytology, thus compromising the effectiveness of cervical cancer control in the State of Tocantins.

Sign in / Sign up

Export Citation Format

Share Document