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Long-term adherence to follow-up after treatment of cervical intraepithelial neoplasia: nationwide population-based study.

AbstractOBJECTIVE:
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.
AuthorsSidsel S Barken, Elsebeth Lynge, Erik S Andersen, Matejka Rebolj
JournalActa obstetricia et gynecologica Scandinavica (Acta Obstet Gynecol Scand) Vol. 92 Issue 7 Pg. 852-7 (Jul 2013) ISSN: 1600-0412 [Electronic] United States
PMID23418941 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
Copyright© 2013 The Authors Acta Obstetricia et Gynecologica Scandinavica © 2013 Nordic Federation of Societies of Obstetrics and Gynecology.
Topics
  • Adult
  • Cervix Uteri (surgery)
  • Conization
  • Denmark
  • Early Detection of Cancer (statistics & numerical data)
  • Female
  • Follow-Up Studies
  • Humans
  • Logistic Models
  • Middle Aged
  • Odds Ratio
  • Patient Compliance (statistics & numerical data)
  • Prospective Studies
  • Registries
  • Uterine Cervical Neoplasms (diagnosis, surgery)
  • Vaginal Smears (statistics & numerical data)
  • Uterine Cervical Dysplasia (diagnosis, surgery)

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