Predictors of Follow-up Screening in Women with Abnormal Pap Smears

ABSTRACT

PURPOSE: This descriptive study was to identify predictors of follow-up screening among Korean women with low-grade abnormal Papanicolaou smears. METHODS: This study was conducted among 158 eligible women with atypical squamous cells of undetermined significance (ASC-US) or low-grade squamous intraepithelial lesion (LSIL) on Pap smear tests from the out-patient department at an academic hospital. Data were collected on self-report questionnaires including demographics, beliefs, knowledge and psychosocial distress. Multivariate logistic regression was used to identify independent factors association with follow-up. RESULTS: Of the 158 women with abnormal Pap smear results, 60.8% completed the recommended follow-up within 6months, and 39.2% did not. In multivariate analysis, attendance of follow-up was significantly increased with good explanation from health care providers (OR=4.89, 95% CI=1.96-12.13), having intention to follow-up (OR=7.96, 95% CI=1.88-33.65), increasing perceived benefit (OR=1.91, 95% CI=1.21-2.99) and decreasing perceived barriers (OR=1.41, 95% C I=1.13-1.74). CONCLUSION: Despite increasing rates of cervical cancer screening, pervasive problems in the adherence of follow-up of abnormal findings continue. We suggest more intensive interventions including good explanations by health care providers, educational programs for follow-up care and individualized implementations depending on barriers.