National audit of women with abnormal cervical smears in New Zealand

Authors


: Dr Brian Cox, Hugh Adam Cancer Epidemiology Unit, Department of Preventive and Social Medicine, Otago Medical School, PO Box 913, Dunedin, New Zealand. Email: brian.cox@stonebow.otago.ac.nz

Abstract

Objective: To evaluate the follow-up of women with abnormal cervical smears identified by the National Cervical Screening Programme (NCSP) in New Zealand.

Design: Survey and clinical audit.

Setting: The study took place in New Zealand.

Population: The population included women aged 20–69 years enrolled on the NCSP with first abnormal smear recorded in 1999.

Methods: Participants were interviewed, and clinical data collected from the NCSP-register, and from clinicians.

Main outcome measures and results: The overall response rate was 57%. The proportions of women whose initial assessment, treatment or follow-up fell outside recommended times were between 17 and 35%. Of women with high-grade smears, 72% underwent a treatment procedure. Of these, 91% were excision biopsies, 6% hysterectomies and 4% ablation procedures. Approximately 10% of women had persistent or recurrent abnormalities at 6 and 12 months after treatment.

Conclusions: Overall, results were largely reassuring, but limited by the low response rate. Most women were managed within current clinical guidelines. Areas requiring improvement were identified, in particular in relation to longer than recommended waiting times for assessment and treatment.

Ancillary