Evaluation of follow-up colposcopy procedures after abnormal cervical screening result across a statewide study in Mississippi

• Published in: Cancer causes & control
• Main Authors: Reaves, Sydney, Hall, Katherine C, Stewart, Mary W, Wentzensen, Nicolas, Ferrell, Christina, Risley, Carolann, Wells, Jimmie, Rives, Rhonda, Bobo, Fajada, Daniels, Jon, Farrington, Kathy, Morgan, Jody C, Clarke, Megan A
• Format: Journal Article
• Language: English
• Published: Netherlands 17.08.2024
• Subjects: ASC-US; LSIL; Colposcopy; ASC-H; Cervical cancer; HSIL
• ISSN: 1573-7225; 1573-7225
• DOI: 10.1007/s10552-024-01905-0

Cervical screening is used to detect and treat precancers to prevent invasive cancers. However, successful prevention also requires adequate follow-up and treatment of individuals with abnormal screening results. The aim was to investigate demographics, clinical characteristics, and follow-up status for individuals needing colposcopy after an abnormal screening result. The STRIDES (Studying Risk to Improve DisparitiES) cohort comprises individuals undergoing cervical cancer screening and management at a Mississippi Health Department or University of Mississippi clinic. Follow-up status, demographics, and clinical data were assessed from electronic health records and, if necessary, patient navigation on individuals identified as needing a colposcopy after an abnormal screening. Of the 1,458 individuals requiring colposcopy, 43.0% had the procedure within 4 months, 16.4% had a delayed procedure, and 39.5% had no documented colposcopy follow-up, with significant predictors of follow-up identified as age and cytology diagnosis. Individuals 30 + were more likely to have follow up with a colposcopy compared to individuals < 30 years (49% and 38.7%, respectively; p < .001). Individuals with cytology diagnoses of LSIL (52.9%), ASC-H (51.4%), and HSIL (62.3%) had higher percentages of adherence to follow-up guidelines (p < .001). In total, we found that 78% of individuals had some type of follow-up, including a repeat screening visit. Despite high cervical cancer screening rates among Mississippians, a substantial proportion did not have adequate next-step intervention. However, it is encouraging that highest risk individuals were more likely to have a colposcopy. Regardless, continuing to understand the underlying causes for incomplete follow-up is crucial for timely secondary targeted interventions to reduce cervical cancer burden, promote awareness, and improve health outcomes.