Programme no. 160-P
Effects of notifications of GPs on delayed follow-up of abnormal or inadequate test results in the Danish Cervical Cancer Screening Program.
Bettina Kjær Kristiansen*1, Flemming Bro2, Berit Andersen3, Peter Vedsted4
1Aarhus University,The Research Unit for General Practice,Aarhus,Denmark, 2Aarhus University,The Research Unit for General Practice,Aarhus,Denmark, 3Department of Public Health Programs ,Randers Regional Hospital,Randers,Denmark, 4Aarhus University,The Research Unit for General Practice,Aarhus,Denmark
* = Presenting author
Objectives: The aim of this project was to evaluate if automatic notifications of GPs will shorten delays of women with a recommendation for follow-up.
Background: Denmark has a higher standardised incidence rate 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, women in Denmark have 40,000 abnormal or inadequate test results with a recommendation for follow-up. The test results are sent to the general practitioners (GPs) who convey the results to the women. However 17% of follow-ups are delayed and this may challenge the effectiveness of the Danish Cervical Cancer Screening Program, as dysplasia can potentially progress into cancer. National initiatives attempt to meet this challenge by implementing automatic GP-notifications when women postpone recommended follow-up, expecting that GPs would contact women and thereby shorten delay.
Results: All data are collected and currently the analyses are ongoing. Results will be presented at the conference.
Material/Methods: In a nationwide register-based before-after study all women with a follow-up recommendation after a cervical cytology were identified in the national Danish Pathology Data Bank. The register collects data from all regional pathology departments and private specialists in pathology, so all types of follow-up are registered here i.e. dates of a new cervical cytology or possible histology. A period before (2010-2011) was compared with a period after the implementation of GP-notifications in (2012-2013). It is analysed whether fewer women with a follow-up recommendation were delayed according to different pre-specified timeframes after the implementation of GP-notifications compared with before.
Conclusion: The findings can guide the future organisation of the Danish Cervical Cancer Screening Program and may also have international interest because of similar follow-up challenges in other countries.
Points for discussion: Will GP notifications change women’s behaviour and lead them to prioritise follow-up?