THE EFFECT OF THE FAMILY PHYSICIAN ON IMPROVING FOLLOW-UP AFTER AN ABNORMAL PAP SMEAR

Objective: The aim of this study was to assess the effect of the famil y physician on improving compliance with follow-up of abnormal smears in cervical cancer screening. Design: Observational study. Setting: Tw o Regional Health Authority districts in the east of The Netherlands. Study participants: Family practices with a national call system for c ervical cancer screening and family practices with a family-practice-b ased calf system. In a number of practices the family physicians had i ntroduced a fail-safe system for follow-up. Main outcome measures: Fol low-up of women who participated in the first screening round and in w hom a cytological abnormality had been diagnosed in the first smear. C riteria for adequate follow-up were defined with regard to the severit y of the cytological abnormality. Results: The overall compliance with follow-up in the study-group was 88%. The study showed a strong relat ionship between involvement of the family physician and compliance wit h follow-up. The compliance in practices that had a fail-safe system f or follow-up was 93% compared to 82% in the practices without a fail-s afe system. The highest follow-up was found in practices involved in t he family-practice-based system, (C) 1997 Elsevier Science Ltd.