Cervical screening behavior of women with atypical squamous cells of undetermined significance (ASCUS)

Expectant follow-up based on early repeat Papanicolaou (Pap) smear(s) is th e most commonly recommended management of patients with atypical squamous c ells of undetermined significance (ASCUS). In a cervical cytology laborator y in northern Italy, a retrospective study of 1,087 ASCUS patients aged 25- 64 was conducted The primary aim was to assess the actual probability of ea rly repeat Pap smear and associated factors. Univariate comparisons were ba sed on the actuarial method. Multivariate associations were evaluated by Co x regression analysis. The cumulative probability of early repeat Pap smear was 0.11 at 6 mo, 0.29 at 12 mo, and 0.41 at 24 mo, with a multivariate as sociation with screening sector (relative hazard, 3.0 for public offices an d 2.8 for private offices vs, organized screening) and previous Pap smear h istory. Laboratory recommendation, patient age, place of birth, place of re sidence, marital status, and occupation exerted no independent effect. In c onclusion, the probability of early repeat Pap smear was poor and independe nt of demographic and social factors. The frequency of follow-up failures e merged as a major problem with ASCUS management. (C) 2001 Wiley-Liss, Inc.