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A Study of Women Who Appear to Default from Management of an Abnormal Pap Smear
Author(s) -
MD Heather Mitchell,
Hoy Julie,
BSc Meredith TempleSmith,
Quinn Michael
Publication year - 1992
Publication title -
australian and new zealand journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.734
H-Index - 65
eISSN - 1479-828X
pISSN - 0004-8666
DOI - 10.1111/j.1479-828x.1992.tb01901.x
Subject(s) - medicine , dysplasia , family medicine , cytology , pediatrics , gynecology , obstetrics , pathology
EDITORIAL COMMENT : Most readers of the journal will have patients who have had minor abnormalities in a Pap smear and who have passed the statutory time for repetition of cervical cytology. Is the expense of a central register of abnormal pap smears worthwhile? ‐ do the reminder letters to practitioners result in diagnosis of significant pathology when the defaulters are rounded up? (i.e. what proportion have CIN III or worse). This paper caused the reviewer to ponder that it may be better to spend our dwindling resources on encouraging never‐smeared women over the age of 30 to attend for cytology, especially those over 50 years of age ‐ should general practitioners seek to enrol these women from their practices rather than be worried about defaulters who have had a previous smear indicative of dysplasia? How many general hospitals have a policy of performing cervical cytology on all adult female patients in their medical and surgical wards? ‐ surely it would be a simple administrative matter to do this as the women were admitted to hospital. Our reviewer also made the comment, suggested by the authors in their penultimate sentence, that patients referred to a dysplasia clinic should be returned to their general practitioner for continued follow‐up after initial assessment and treatment. Summary A study of nonattendance at a Dysplasia Clinic found that 20% of women who had an appointment in 1988 failed to attend the clinic during the next 18 months. Most of the nonattendance was among women who had previously been assessed at the Dysplasia Clinic. Only 6% of the nonattending women had cytological/histological evidence of CIN which remained untreated. If all women who did not default from attendance at the Dysplasia Clinic were correctly managed, then 1% of all women who have appointments made for the Dysplasia Clinic were potentially receiving inadequate management for lesions considered to have a precancerous potential. A questionnaire to the women who failed to attend these appointments identified pregnancy and seeking management elsewhere as the most commonly stated reasons for the nonattendance.