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Br J Gen Pract. 2017 Aug;67(661):e580-e587. doi: 10.3399/bjgp17X691913. Epub 2017 Jul 17.

Impact of GP reminders on follow-up of abnormal cervical cytology: a before-after study in Danish general practice.

Author information

1
Research Unit for General Practice, and Research Centre for Cancer Diagnosis in Primary Care.
2
Department of Public Health Programs.
3
Research Unit for General Practice.
4
Department of Public Health Programs, and Department of Pathology, Randers Regional Hospital, Randers, Denmark.
5
Research Centre for Cancer Diagnosis in Primary Care, Department of Public Health, Aarhus University, Aarhus, Denmark.

Abstract

BACKGROUND:

Dysplasia may progress because of a loss to follow-up after an abnormal cervical cytology. Approximately 18% of Danish women postpone the recommended follow-up, which depends on the cytology results.

AIM:

To investigate if a reminder to the GP about missed follow-up could reduce the proportion of women who fail to act on a recommended follow-up, and to analyse the effect on sociodemographic and general practice variations.

DESIGN AND SETTING:

A national electronic GP reminder system was launched in Denmark in 2012 to target missed follow-up after screening, opportunistic testing, or surveillance indication. The authors compared follow-up proportions in a national observational before-after study.

METHOD:

From national registries, 1.5 million cervical cytologies (from 2009 to 2013) were eligible for inclusion. Approximately 10% had a recommendation for follow-up. The proportion of cervical cytologies without follow-up was calculated at different time points. Results were stratified by follow-up recommendations and sociodemographic characteristics, and changes in practice variation for follow-up were analysed.

RESULTS:

Fewer women with a recommendation for follow-up missed follow-up 6 months after a GP reminder. Follow-up improved in all investigated sociodemographic groups (age, ethnicity, education, and cohabitation status). Interaction was found for age and cohabitation status. Variation between practices in loss to follow-up was significantly reduced.

CONCLUSION:

An electronic GP reminder system showed potential to improve the quality of cervical cancer screening through reduced loss to follow-up.

KEYWORDS:

early detection of cancer; general practice; mass screening; quality of health care; uterine cervical neoplasms

PMID:
28716995
PMCID:
PMC5519130
DOI:
10.3399/bjgp17X691913
[Indexed for MEDLINE]
Free PMC Article

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