Effectiveness of a Case Management Protocol in Improving Follow-up and Referral of Papanicolaou Smears Indicating Cervical Intraepithelial Neoplasia

Abstract

A retrospective study of follow-up of abnormal Pap smears at the Southern Illinois University Health Service was performed between April 1980 and March 1981. Both follow-up failure and failure to refer repeated abnormal smears for gynecological evaluation were documented. A recommended protocol was devised which counselled colposcopic evaluation after two occurrences of dysplasia or a combination of dysplasia and two occurrences of inflammatory atypia. A second retrospective evaluation of smears done January 1982 to December 1983 showed significant improvement in follow-up and referral rates after the protocol was in use by health service staff. Remaining unresolved problems in the management of mildly abnormal cervical cytology are discussed.