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 family physician on improving compliance with follow-up of abnormal smears in cervical cancer screening. Design: Observational study. Setting: Two Regional Health Authority districts in the east of The Netherlands. Study participants: Family practices with a national call system for cervical cancer screening and family practices with a family-practice-based call system. In a number of practices the family physicians had introduced a fail-safe system for follow-up. Main outcome measures: Follow-up of women who participated in the first screening round and in whom a cytological abnormality had been diagnosed in the first smear. Criteria for adequate follow-up were defined with regard to the severity of the cytological abnormality. Results: The overall compliance with follow-up in the studygroup was 88%. The study showed a strong relationship between involvement of the family physician and compliance with follow-up. The compliance in practices that had a fail-safe system for follow-up was 93% compared to 82% in the practices without a fail-safe system. The highest follow-up was found in practices involved in the family-practice-based system. © 1997 Elsevier Science Ltd.