Barriers to Follow-up of Abnormal Papanicolaou Smears in an Urban Community Health Center

Melissa D. McKee, J. Lurio, P. Marantz, W. Burton, M. Mulvihill

Research output: Contribution to journalArticlepeer-review

73 Scopus citations


Objective: To determine factors predictive of failure to return for colposcopy 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 women seen at the health center with abnormal Papanicolaou smears requiring colposcopy during 1993 to 1994. Six (2%) refused participation, and 19% could not be reached for inclusion. Subjects were mostly minority women receiving Medicaid. Main Outcome Measure: Completion of colposcopy. Results: Of the 279 selected women, 79% were inter-viewed. The rate of adherence with colposcopy was 75% for the respondents. Women who did not know the results of their smear or who incorrectly understood their results were significantly less likely to return for colposcopy (P= .001). Younger women, especially teenagers, were less likely to return (P= .02). Socioeconomic status, education, primary language, health beliefs, fear of cancer, and clinician's gender or discipline were not associated with rate of follow-up. Barriers involving transportation, child care, and insurance also did not predict follow-up. Conclusions: Effective communication of results is the most important factor related to follow-up after abnormal Papanicolaou smear in this setting. In other settings, other factors may be of greater importance.

Original languageEnglish (US)
Pages (from-to)129-134
Number of pages6
JournalArchives of family medicine
Issue number2
StatePublished - 1999

ASJC Scopus subject areas

  • General Medicine


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