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

Sidsel S Barken, Elsebeth Lynge, Erik S Andersen, Matejka Rebolj

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    10 Citations (Scopus)

    Abstract

    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.

    Original languageEnglish
    Pages (from-to)852-7
    Number of pages6
    JournalActa Obstetricia et Gynecologica Scandinavica
    Volume92
    Issue number7
    DOIs
    Publication statusPublished - Jul 2013

    Keywords

    • Adult
    • Cervical Intraepithelial Neoplasia/diagnosis
    • 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
    • Vaginal Smears/statistics & numerical data

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