Which women default from follow-up cervical cytology tests? A cohort study within the TOMBOLA trial

L. Sharp*, S Cotton, A. Thornton, N. Gray, D. Whynes, L. Smart, N. Waugh, I. Duncan, Maggie Cruickshank, J. Little, The TOMBOLA (Trial Of Management of Borderline and Other Low-grade Abnormal smears) Group

*Corresponding author for this work

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Objective: To identify factors associated with default from follow-up cervical cytology tests.

Methods: A cohort study was conducted involving 2166 women, aged 20–59, with recent low-grade cervical cytology taken within the NHS Cervical Screening Programmes in Scotland and England, and managed by 6-monthly cytology in primary care. For the first (6-month) and second (12-month) surveillance cytology tests separately, women were categorized as ‘on-time attendees’ (attended =6 months of test being due), ‘late attendees’ (attended greater than 6 months after test was due) or ‘non-attendees’ (failed to attend). Multivariate odds ratios (ORs) were computed for factors associated with late and non-attendance.

Results: For the first surveillance test, risk of non-attendance was significantly higher in younger women, those without post-secondary education, and non-users of prescribed contraception. Factors significantly associated with late attendance for the first test were the same as for non-attendance, plus current smoking and having children. The most important predictor of non-attendance for the second surveillance test was late attendance for the first test (OR = 9.65; 95% CI, 6.60–16.62). Non-attendance for the second test was also significantly higher among women who were younger, smokers and had negative cytology on the first surveillance test. Late attendance for the second surveillance test was higher in women who were younger, smokers, had children and attended late for the first test.

Conclusions: Women at highest risk of default from follow-up cytology tend to be young, smoke, lack post-secondary education, and have defaulted from a previous surveillance appointment. Tackling default will require development of targeted strategies to encourage attendance and research to better understand the reasons underpinning default.
Original languageEnglish
Pages (from-to)150-160
Number of pages11
JournalCytopathology
Volume23
Issue number3
Early online date2 Mar 2011
DOIs
Publication statusPublished - Jun 2012

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Cell Biology
Cohort Studies
Odds Ratio
Education
Scotland
Contraception
Smoke
England
Primary Health Care
Appointments and Schedules
Smoking
Research

Keywords

  • cytological surveillance
  • low-grade cervical cytology
  • mild dyskaryosis
  • borderline nuclear abnormalities
  • default
  • human-papillomavirus
  • randomized-trial
  • health literacy
  • management
  • abnormalities
  • smears
  • colposcopy
  • cancer
  • smoking

Cite this

Sharp, L., Cotton, S., Thornton, A., Gray, N., Whynes, D., Smart, L., ... The TOMBOLA (Trial Of Management of Borderline and Other Low-grade Abnormal smears) Group (2012). Which women default from follow-up cervical cytology tests? A cohort study within the TOMBOLA trial. Cytopathology, 23(3), 150-160. https://doi.org/10.1111/j.1365-2303.2011.00848.x

Which women default from follow-up cervical cytology tests? A cohort study within the TOMBOLA trial. / Sharp, L.; Cotton, S; Thornton, A.; Gray, N.; Whynes, D.; Smart, L.; Waugh, N.; Duncan, I.; Cruickshank, Maggie; Little, J.; The TOMBOLA (Trial Of Management of Borderline and Other Low-grade Abnormal smears) Group.

In: Cytopathology, Vol. 23, No. 3, 06.2012, p. 150-160.

Research output: Contribution to journalArticle

Sharp, L, Cotton, S, Thornton, A, Gray, N, Whynes, D, Smart, L, Waugh, N, Duncan, I, Cruickshank, M, Little, J & The TOMBOLA (Trial Of Management of Borderline and Other Low-grade Abnormal smears) Group 2012, 'Which women default from follow-up cervical cytology tests? A cohort study within the TOMBOLA trial', Cytopathology, vol. 23, no. 3, pp. 150-160. https://doi.org/10.1111/j.1365-2303.2011.00848.x
Sharp, L. ; Cotton, S ; Thornton, A. ; Gray, N. ; Whynes, D. ; Smart, L. ; Waugh, N. ; Duncan, I. ; Cruickshank, Maggie ; Little, J. ; The TOMBOLA (Trial Of Management of Borderline and Other Low-grade Abnormal smears) Group. / Which women default from follow-up cervical cytology tests? A cohort study within the TOMBOLA trial. In: Cytopathology. 2012 ; Vol. 23, No. 3. pp. 150-160.
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abstract = "Objective: To identify factors associated with default from follow-up cervical cytology tests. Methods: A cohort study was conducted involving 2166 women, aged 20–59, with recent low-grade cervical cytology taken within the NHS Cervical Screening Programmes in Scotland and England, and managed by 6-monthly cytology in primary care. For the first (6-month) and second (12-month) surveillance cytology tests separately, women were categorized as ‘on-time attendees’ (attended =6 months of test being due), ‘late attendees’ (attended greater than 6 months after test was due) or ‘non-attendees’ (failed to attend). Multivariate odds ratios (ORs) were computed for factors associated with late and non-attendance. Results: For the first surveillance test, risk of non-attendance was significantly higher in younger women, those without post-secondary education, and non-users of prescribed contraception. Factors significantly associated with late attendance for the first test were the same as for non-attendance, plus current smoking and having children. The most important predictor of non-attendance for the second surveillance test was late attendance for the first test (OR = 9.65; 95{\%} CI, 6.60–16.62). Non-attendance for the second test was also significantly higher among women who were younger, smokers and had negative cytology on the first surveillance test. Late attendance for the second surveillance test was higher in women who were younger, smokers, had children and attended late for the first test. Conclusions: Women at highest risk of default from follow-up cytology tend to be young, smoke, lack post-secondary education, and have defaulted from a previous surveillance appointment. Tackling default will require development of targeted strategies to encourage attendance and research to better understand the reasons underpinning default.",
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AU - Thornton, A.

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AU - Whynes, D.

AU - Smart, L.

AU - Waugh, N.

AU - Duncan, I.

AU - Cruickshank, Maggie

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AB - Objective: To identify factors associated with default from follow-up cervical cytology tests. Methods: A cohort study was conducted involving 2166 women, aged 20–59, with recent low-grade cervical cytology taken within the NHS Cervical Screening Programmes in Scotland and England, and managed by 6-monthly cytology in primary care. For the first (6-month) and second (12-month) surveillance cytology tests separately, women were categorized as ‘on-time attendees’ (attended =6 months of test being due), ‘late attendees’ (attended greater than 6 months after test was due) or ‘non-attendees’ (failed to attend). Multivariate odds ratios (ORs) were computed for factors associated with late and non-attendance. Results: For the first surveillance test, risk of non-attendance was significantly higher in younger women, those without post-secondary education, and non-users of prescribed contraception. Factors significantly associated with late attendance for the first test were the same as for non-attendance, plus current smoking and having children. The most important predictor of non-attendance for the second surveillance test was late attendance for the first test (OR = 9.65; 95% CI, 6.60–16.62). Non-attendance for the second test was also significantly higher among women who were younger, smokers and had negative cytology on the first surveillance test. Late attendance for the second surveillance test was higher in women who were younger, smokers, had children and attended late for the first test. Conclusions: Women at highest risk of default from follow-up cytology tend to be young, smoke, lack post-secondary education, and have defaulted from a previous surveillance appointment. Tackling default will require development of targeted strategies to encourage attendance and research to better understand the reasons underpinning default.

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KW - colposcopy

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