P-15 Evaluation of management in women with Atypical Squamous Cell of the Unknown Significance (ASC-US) smear and High risk papillomavirus positive test in Martinique
Author(s):
F Najioullah , A Monthieux , M Dramé , M Jean-Laurent
Year of Presentation:
2024
Objective: According to the French guidelines, it is necessary to carry out a colposcopy in women with an ASC-US Pap smear and a positive HR-HPV test. The objectives of this study was, firstly, to evaluate the follow-up of women with ASC-US/HR-HPV positive smear in comparison to the recommendations and secondly to determine the reasons for any follow-up defects.
Methods: Women aged 25 to 65 yearsseen at the Gynae- cology department of the Martinique University Hospital, fromJanuary 1, 2018 to December 31, 2019 and having an ASC-US smear and a positive HR-HPV were included retrospectively. Specimens for cervical cytology were col- lected via ThinPrep™ Pap Test. The screening of HR-HPV were carried out using the PAPILLOCHECK™ kit. The study obtained a favorable opinion from the Institutional Review Board and the patients were informed orally. “Compliant follow-up" was defined as a colposcopy performed within 3 months after the positive ASC-US/HR-HPV smear, “Delayed follow-up” when the colposcopy was performed over 3 months and “Lost for follow-up” when no colpos- copy was performed.
Results: On the 114 women included, 64.9% underwent a colposcopy with a delay of 4.1 ± 4.2 months. Compliant follow-up was found for 45.1% of patients, 16.6% experi- enced a delayed follow-up and 35% were lost to follow-up. The main reasons cited by the women for postponed or lack- ing colposcopy were a long delay in making an appointment with a gynecologist, a complex care circuit and a lack of understanding the management of the disease and his benefits.
Conclusion: The study revealed suboptimal follow-up for ASC-US smear/HR-HPV positive women. To decrease the incidence of cervical cancer in Martinique, it is necessary to improve patient’s compliance with follow-up. Better com- munication between patient and caregiver, reduced appointments waiting time to coloposcopy and a simplified care circuit are essential.