Peter Vedsted

Direct notification of cervical cytology results to women improves follow-up in cervical cancer screening - A cluster-randomised trial

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DOI

  • Bettina Kjær Kristiansen, Research Unit for General Practice, Department of Public Health, Aarhus University, Department of Public Health, Bartholins Allé 2, Building 1260, 8000 Aarhus C, Denmark. Electronic address: mv@ph.au.dk., Department for Public Health Programmes, Randers Regional Hospital, 8930 Randers, Denmark.
  • ,
  • Berit Andersen
  • Flemming Bro
  • Hans Svanholm, Department of Pathology, Randers Regional Hospital, Østervangsvej 48, 8930, Randers NØ, Denmark.
  • ,
  • Peter Vedsted

Up to half of all women do not receive follow-up as recommended after cervical cytology testing and are thus at increased risk of dysplasia progression. Women from lower social positions are at increased risk of not receiving follow-up. Sample takers, often general practitioners, convey results to women, but communication problems constitute a challenge. We aimed to investigate the effect of direct notification of cervical cytology results on follow-up rates. In a 1:1 cluster-randomised controlled trial, we assessed if having the pathology department convey cervical cytology results directly to the investigated women improved timely follow-up, compared with conveying the results via the general practitioner as usual. All women with a cervical cytology performed in a general practice in the Central Denmark Region (2013-2014) and receiving follow-up recommendation were included (n = 11,833). The proportion of women without timely follow-up was lower in the group with direct notifications than in the control group of women receiving usual care, regardless of age, educational status, cohabitation status and ethnicity. Among the women with the most severe cervical cytology diagnoses who are recommended gynaecological follow-up within 3 months, the percentage without timely follow-up was 15.1% in the intervention group and 19.5% in the control group (prevalence difference: -0.04 (95%CI: -0.07; -0.02)). Improved timely follow-up was also observed for women with a recommendation to have follow-up performed at 3 and 12 months. Cervical cytology results conveyed directly by letter to women increased the proportion of women with timely follow-up without raising inequality in follow-up measured by social position. Trial registration: ClinicalTrials.gov (TRN: NCT02002468) 29 November 2013.

OriginalsprogEngelsk
TidsskriftPreventive Medicine Reports
Vol/bind13
Sider (fra-til)118-125
Antal sider8
ISSN2211-3355
DOI
StatusUdgivet - mar. 2019
Eksternt udgivetJa

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