Objective: To determine factors predictive of failure to return for colposc
opy among women with significant abnormalities on Papanicolaou smears in a
high-risk clinical population.
Design: Telephone survey.
Setting: An urban community health center.
Participants: Two hundred seventy-nine women randomly selected from all wom
en seen at the health center with abnormal Papanicolaou smears requiring co
lposcopy during 1993 to 1944. Six (2%) refused participation, and 19% could
not be reached for inclusion. Subjects were mostly minority women receivin
g Medicaid.
Main Outcome Measure: Completion of colposcopy. Results: Of the 279 selecte
d women, 79% were interviewed. The rate of adherence with colposcopy was 75
% for the respondents. Women who did not know the re suits of their smear o
r who incorrectly understood their results were significantly less likely t
o return for colposcopy (P=.001). Younger women, especially teenagers, were
less likely to return (P=.02). Socioeconomic status, education, primary la
nguage, health beliefs, fear of cancer, and clinician's gender or disciplin
e were not associated with rate of follow-up. Barriers involving transporta
tion, child care, and insurance also did not predict follow-up.
Conclusions: Effective communication of results is the most important facto
r related to follow-up after abnormal Papanicolaou smear in this setting. I
n other settings, other factors may be of greater importance.