Follow-up of abnormal Papanicolaou smears among women of different races

Abstract

Background: Current information about racial differences in the rate of cervical abnormalities is incomplete, and there are few data about racial differences in compliance with follow-up and treatment. The purpose of this study was to investigate the frequency and follow-up of abnormal Pap smear findings in white, black, and Southeast Asian women.

Methods: The charts of women who attended a St Paul family practice residency clinic and who had abnormal Papanicolaou (Pap) smear results between January 1, 1989, and September 1, 1992, were reviewed, and information about age, race, insurance, Pap smear findings, diagnostic studies, and treatment procedures was recorded.

Results: Of 1794 women who had Pap smears during this period, 190 (10.6%) had abnormal results, with a diagnosis of atypia, dysplasia, or carcinoma. The rate of abnormality was greater for black women (16.4%) than for Southeast Asian (6.1%) and white women (11.6%); however, the proportion of abnormal Pap smears that showed moderately severe or worse changes was greater for Southeast Asians than for whites (30.6% vs 14.3%, P < .05). Southeast Asian women with abnormal Pap smears were also less likely than whites and blacks to follow through with recommended diagnostic and treatment procedures.

Conclusions: Southeast Asian women in this study were less likely than white and black women to comply with recommended follow-up diagnostic and treatment procedures for cervical disease.