Follow-Up and Clinical Significance of Unsatisfactory Liquid-Based Papanicolaou Tests
Owens CL, Buist DS, Peterson D, Kamineni A, Weinmann S, Ross T, Williams AE, Stark A, Adams KF, Doubeni CA, and Field TS. Follow-up and clinical significance of unsatisfactory liquid-based Papanicolaou tests. Cancer Cytopathol 2015; 123(1):59-65.
BACKGROUND: To the authors' knowledge, few studies to date have examined adherence to recommended guidelines for follow-up and outcomes after an unsatisfactory Papanicolaou (Pap) test (UPT) with liquid-based technologies.
METHODS: Within 4 US health plans, the median time to follow-up and the percentage of patients with follow-up testing by 120 days was calculated after a UPT. Multivariable analyses evaluated the association between clinical factors and follow-up testing. The authors compared the risk of a diagnosis of cervical intraepithelial neoplasia of type 2 or worse (CIN2+) after a UPT with the risk after a satisfactory Pap test while controlling for study site, test year, and other covariates.
RESULTS: A total of 634,644 Pap tests performed between 2004 and 2010 were included in the current study. Of 1442 UPTs, 53.4% had follow-up testing within 120 days; follow-up differed across the health plans (P
CONCLUSIONS: Various clinical factors associated with the risk of CIN2+ appear to influence the receipt of follow-up after a UPT. HPV test results in patients with UPTs might be used in follow-up strategies; specifically, a negative test result might reduce the urgency for repeat Pap testing.
Medical Subject Headings
Adult; Cervical Intraepithelial Neoplasia; Female; Follow-Up Studies; Humans; Middle Aged; Papanicolaou Test; Papillomaviridae; Uterine Cervical Neoplasms