[Follow up after an abnormal pap smear: time interval acceptable, nature of follow up leaves room for improvement]

Abstract

Objective: To investigate whether the interval between an abnormal Pap smear and follow-up is too long and whether the guidelines for histological follow-up after an abnormal Pap smear are being followed.

Design: Descriptive.

Method: Data on all Pap smears of a minimum Pap class 3a (moderate dysplasia) from the national cervical-cancer screening programme in the Rotterdam area of the Netherlands were acquired from the Pathological Anatomical National Automated Archive (PALGA). The test results from each woman were arranged chronologically and the nature of the follow-up cervical examinations (cytological and histological) was recorded. The observation period was 360 days. The average interval in days between Pap smear and follow-up as well as the nature of the follow-up were analysed.

Results: In total, data on 156 women were analysed. In 93% of women follow-up was done during our observation period. The average interval was 60 days. In 80% of the women follow-up took place within 3 months and in 90% within 6 months. In 32% of women in the follow-up group the Pap smear was repeated at their first follow-up visit and in the remaining cases, a histological examination was performed according to the guidelines. In 7% of cases no cytological or histological follow-up at all took place within the year.

Conclusion: The average interval between an abnormal Pap smear and follow-up is acceptable because of the slow natural course of cervical carcinoma. Attention should be focused on the incorrect repetition of the cytological test and on the fact that in a number of cases no follow-up at all is done within 1 year.