Open AccessLong‐term adherence to follow‐up after treatment of cervical intraepithelial neoplasia: nationwide population‐based study
Author(s) -
Barken Sidsel S.,
Lynge Elsebeth,
Andersen Erik S.,
Rebolj Matejka
Publication year - 2013
Publication title -
acta obstetricia et gynecologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.401
H-Index - 102
eISSN - 1600-0412
pISSN - 0001-6349
DOI - 10.1111/aogs.12116
Subject(s) - medicine , cervical intraepithelial neoplasia , term (time) , population , colposcopy , obstetrics , gynecology , cervical cancer , pediatrics , environmental health , cancer , physics , quantum mechanics
Objective To measure adherence to annual follow‐up among women treated for cervical intraepithelial neoplasia. Design Prospective, population‐based, register study. Setting Denmark, 1996–2007. Population All women treated for cervical intraepithelial neoplasia with conization. Methods Treated women were routinely recommended to have follow‐up with annual smears for at least 5 years. Main outcome measures Using individually linked nationwide register data on conizations and follow‐up tests (smears and biopsies), we calculated the cumulative proportion of treated women undergoing the recommended follow‐up. We measured this cumulative proportion conservatively in 15‐month intervals for 5 years. Results Adherence to annual follow‐up among 45 984 treated women decreased gradually. In total, 90% of these women obtained at least one smear in the first post‐treatment year, but only 40% obtained the recommended tests for 5 years. Five‐year adherence was substantially better outside the capital area, for example, the odds ratio for women from Jutland compared with women from the capital area was 1.70 (95% confidence interval 1.60–1.82). Conclusions Adherence to follow‐up after conization was poor in Denmark. Our findings suggest that because of this poor adherence, recommendations for long‐term annual follow‐up after treatment of cervical intraepithelial neoplasia may not be highly effective. Shorter follow‐up schedules using highly sensitive tests appear attractive.