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

Young Suk Park; Jeong Sook Park

doi:10.5388/aon.2014.14.2.84

Journal List > Asian Oncol Nurs > v.14(2) > 1081829

Go to TopGo to Top Go to BottomGo to Bottom

TOOLS

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

Original Article

Asian Oncology Nursing 2014; 14(2): 84-92.

Published online: 30 June 2014

DOI: https://doi.org/10.5388/aon.2014.14.2.84

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

Young Suk Park¹, Jeong Sook Park²

¹Keimyung University Dongsan Medical Center, Daegu, Korea.

²College of Nursing, Keimyung University, Daegu, Korea.

Address reprint requests to: Park, Jeong Sook. College of Nursing, Keimyung University, 1095 Shindang-dong, Dalsseo-gu, Daegu 704-701, Korea. Tel: +82-53-580-3907, Fax: +82-53-580-3907, jsp544@kmu.ac.kr

Received 9 April 2014 Accepted 20 June 2014

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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.

Keywords: Uterine Cervical Neoplasms, Uterine Cervical Dysplasia, Vaginal Smears, Early Detection of Cancer

Figures and Tables

Table 1

Characteristics of Follow-up after Abnormal Pap Results (N=158)

ASC-US=Atypical squamous cells of undetermined significance; LSIL=Low-grade squamous intraepithelial lesion.

^*Multiple response.

Table 2

Characteristics of Follow-up and Non Follow-up Group (N=158)

ES=Elementary school; MS=Middle school; HS=High school.

^*Missing value.

Table 3

Knowledge, Health Belief and Psychosocial Distress between Follow-up and Non Follow-up (N=158)

MP=Medical procedures; SR=Sexual relationship.

Table 4

Predictors of Follow-up Screening (N=158)

Notes

This article is a condensed form of the first author's master thesis from Keimyung University.

References

1. National Cancer Information Center. Cancer statistics 2013. Accessed November 13, 2013. http://www.cancer.go.kr/mbs/cancer/jsp/album/gallery.jsp.

2. Siegel R, Naishadham D, Jemal A. Cancer statistics 2013. CA Cancer J Clin. 2013; 63(1):11–30.

3. Saslow D, Solomon D, Lawson HW, Killackey M, Kukasingam SL, Cain JM, et al. American Cancer Society, American Society for Colposcopy and Cervical Pathology and American Society for clinical pathology screening guidelines for the prevention and early detection of cervical cancer. J Low Genit Tract Dis. 2012; 16(3):175–204.

4. Hong EK, Nam JH, Park MH. The Bethedsa system 2001 workshop report. Korean J Cytopathol. 2001; 12(1):1–15.

5. Apgar BS, Zoschnick L, Wright TC. The 2001 Bethesda system terminology. Am Fam Physician. 2003; 68(10):1992–1998.

6. Bentley J, Halifax NS. Colposcopic management of abnormal cervical cytology and histology. J Obstet Gynaecol Can. 2012; 34(12):1188–1202.

7. Kaplan C, Bastani R, Belin T, Marcus A, Nasseri K, Hu M. Improving follow-up after an abnormal Pap smear: results from a quasi-experimental intervention study. J Womens Health Gend Based Med. 2000; 9(7):779–790.

8. Yabroff K, Washington K, Leader A, Mandelblatt J. Is the promise of cancer-screening programs being compromised? Quality of follow-up care after abnormal screening results. Med Care Res Rev. 2003; 60(3):294–331.

9. El-Hammasi K, Samir O, Kettaneh S, Al-Fadli A, Thalib L. Use of and attitudes and knowledge about Pap smears among women in Kuwait. J Womens Health (Larchmt). 2009; 18(11):1825–1832.

10. Urritia MT. Development and testing of a questionnaire: beliefs about cervical cancer and pap test in Chilean women [dissertation]. Miami Univ.;2009.

11. Lee Mortensen G, Adeler A. Qualitative study of women's anxiety and information needs after a diagnosis of cervical dysplasia. Z Gesundh Wiss. 2010; 18(5):473–482.

12. Bertram C, Magnussen L. Informational needs and the experiences of women with abnormal papanicolaou smears. J Am Acad Nurse Pract. 2008; 20(9):455–462.

13. Percac-Lima S, Aldrich L, Gamba G, bearse A, Atlas SJ. Barriers to follow-up of abnormal pap smear in Latina women referred for colposcopy. J Gen Intern Med. 2010; 25(11):1198–1204.

14. Lee EJ, Park JS. Predictors associated withr repeated papanicolaou smear for cervical cancer screening. Asian Oncol Nurs. 2013; 13(1):28–36.

15. Cho IS, Park YS. A study on regular cervical cancer screening behavior among middle-aged women. J Korean Acad Nurs. 2004; 34(1):141–149.

16. Jeong IS, Kim SH, Kim YS. Relataed factors with cervical cancer screening and repeated screening. J Korean Soc Matern Child Health. 2004; 8(2):185–198.

17. Rojas C, Zhou MK, Khamis HJ, Amesse L. Analysis of patterns of patient compliance after an abnormal pap smear result: the Influence of demographic characteristics on patient compliance. J Low Genit Tract Dis. 2013; 17(3):298–302. [accessed on 13 May 2013].

18. Elit L, Saskin R, Raut R, Elliott L, Murphy J, Marrett L. Sociodemgraphic factors associated with cervical cancer screening coverage and follow-up of high grade abnormal results in a population-based cohort. Gynecol Oncol. 2013; 128:95–100.

19. Sharp L, Cotton S, Thornton A, Gray N, Cruickshank M, Whynes D, et al. Who defaults from colposcopy? A multi-centre, population-base prospective cohort study of predictors of non-attendance for follow-up among women with low-grade abnormal cervical cytology. Eur J Obstet Gynecol Reprod Biol. 2012; 165(2):318–325.

20. Monsonego J, Cortes J, Silva DP, Jorge AF, Klein P. Psychological impact, support and information needs for women with an abnormal pap smear: comparative results of a questionnaire in three European countries. BMC Womens Health. 2011; 11:18.

21. Lee EJ, Park JS. Knowledge about cervical cancer, health beliefs and human papillomavirus vaccination rate in female university students. J Korean Oncol Nurs. 2011; 11(1):65–73.

22. National Cancer Center. National cancer screening findings and standard recommendation. Accessed May 6, 2013. http://www.cancer.go.kr.

23. Bennetts A, lrwig L, Oldenburg B, Simpson JM, Mock P, Allison B, et al. PEAPS-Q: a questionnaire to measure the psychosocial effects of having an abnormal pap smear. J Clin Epidemiol. 1995; 48(10):1235–1243.

24. Jang JH, Kim SH, Jang SH, An TS, Won JC, Jeong GU, et al. PAP Smear: analysis of 10 years results (1992-2001). Obstet Gynecol Sci. 2003; 46(9):1714–1719.

25. Oh EJ, Lee YE, Lee SO. Cervical cancer screening behavior and related factors among married women. J Korean Soc Matern Child Health. 2010; 14(1):12–23.

26. Bednarczyk RA, Butsashvili M, Kamkamidze G, Kajaia M, McNutt LA. Attitudes and knowledge of Georgian physicians regarding cervical cancer prevention 2010. Int J Gynaecol Obstet. 2013; 121(3):224–228.

27. Oranratanaphan S, Amatyakul P, Iramaneerat K, Srithipayawan S. Knowledge, attitudes and practices about the pap smear among medical workers in Naresuan university Hospital, Thailand. Asian Pac J Cancer Prev. 2010; 11(6):1727–1730.

28. Singhal R, Rubenstein LV, Wang M, Lee M, Raza A, Holschneider CH, et al. Variations in practice guideline adherence for abnormal cervical cytology in a county healthcare system. J Gen Intern Med. 2008; 23(5):575–580.

29. Maissi E, Marteau T, Hankins M, Moss S, Legood R, Gray A. Psychological impact of human papillomavirus testing in women with borderline or mildly dyskaryotic cervical smear test results: cross-sectional questionnaire study. BMJ. 2004; 328:1293–1296.

TOOLS

Similar articles