Follow-up of Abnormal and Inadequate Smear-test Results
Follow-up of Abnormal and Inadequate Smear-test Results
Denmark has a higher incidence of cervical cancer than other Nordic countries, although all
 Danish women (aged 23-65) are screened regularly to identify possible cervical dysplasia or
 asymptomatic invasive cancer.

 Annually 40 000 women receives an abnormal or inadequate test result and a follow-up
 recommendation.

 However problems with delayed follow-up may threaten the effectiveness of the Danish Cervical
 Cancer Screening Program, as 20% of women are delayed and dysplasia potentially can progress
 into cancer.

 Delayed follow-up is found in situations where women either consciously or unconsciously
 postpone follow-up, or because of organizational aspects of the screening program, where
 communication regarding test results can fail either in content or with delay.This study will
 evaluate two interventions designed to increase follow-up:

 1. A letter with the test result and potential recommendation for follow up will be sent to
 the women (RCT). The intention is to ensure that all women will be notified about the
 test result, quickly, homogenously and in layman's written language, still with the
 opportunity to contact or be contacted by the general practitioner, if there is special
 needs. Furthermore, it is assumed that general practitioner consultations regarding
 delivery of normal test results will decrease, so that cost savings is a potential side
 benefit

 2. Electronic reminder to the general practitioner if women have not had the recommended
 follow up, giving the general practioner´s an opportunity to remind the women (retro
 perspective cohort study).

 The results will be of great importance to the future organisation of cervical and colorectal
 cancer screening programmes in Denmark, but will also have international interest because of
 their similar challenges.
Inclusion Criteria:

 -  woman with a pap-smear test

 Exclusion Criteria:

 -  less than 23 years