Purpose: Annual Pap smears aid in the early detection of Cervical Cancer and are vital to preventative healthcare. About 55 Million Pap smears are performed annually and 6% detect abnormalities requiring follow-up. The purpose of this study was to identify the prevalence of abnormal Pap smears and if the current ACOG recommendations for follow-up for abnormal results were being implemented. The ultimate goal of this study was to describe how well clinicians were documenting notification of abnormal results and appropriate follow-up.
Methods: This study was a retrospective cohort chart review. The outcome variables were as follows: if the patient received notification of results of their most recent abnormal Pap smear and if they patient received the appropriate follow-up. The independent variables included: patient age and ethnicity, the classification of abnormal Pap smear, and the method by which the patient was notified. After gaining IRB approval a list of patients age 18 and older from the OB/GYN clinic who had received a Pap smear over a 24 month period was generated. The researchers manually identified patients who had an abnormal Pap smear and recorded the pertinent information from these patients’ charts. Seventy-nine patient charts were eligible; however, two were excluded due to disconnected phone lines.
Results: A total of 77 charts were reviewed. Patient mean age was 29.99. Seventy-two out of 77 (93.5%) patients’ charts had documentation of notification of abnormal Pap smear results. Fifty out of the 77 abnormal Pap smear results required follow-up. Of those 50 charts requiring follow-up, 38 (76%) of patient charts had documentation that they were scheduled for a colposcopy.
Conclusions: The results revealed that patients are being notified at a satisfactory rate. However, in order to reach the ultimate goal of 100% notification, implementation of a standard method of documentation would be necessary. Another result revealed that follow-up of abnormal Pap smears was occurring at an unsatisfactory rate. A flow sheet of abnormal test results in the front of patient charts could assist clinicians in improving follow-up rates.