Understanding barriers for adherence to follow-up care for abnormal pap tests?

Katherine S. Eggleston, Ann L. Coker, Irene Prabhu Das, Suzanne T. Cordray, Kathryn J. Luchok

Research output: Contribution to journalArticlepeer-review

109 Scopus citations


Objective: Approximately 4000 women annually will die from preventable and treatable cervical cancer. Failure to adhere to follow-up recommendations after an abnormal Pap test can lead to development of cervical cancer. This paper summarizes the body of literature on adherence to follow-up after an abnormal Pap test in order to facilitate development of interventions to decrease morbidity and mortality due to cervical cancer. Methods: We conducted a comprehensive search of published literature addressing risk factors for adherence or interventions to improve adherence following an abnormal Pap test as the outcome. We included peer-reviewed original research conducted in the United States from 1990 to 2005. Results: Fourteen analytical and twelve experimental studies that met our criteria were reviewed. Lesion severity and health beliefs were consistently associated with adherence rates. Communication interventions, including telephone reminders, counseling, and educational sessions, increased follow-up compliance across intervention studies. Inconsistent evidence for associations among race, income, and age were found. Conclusions: Further research is needed to reinforce current studies addressing health beliefs and social support. Interventions that focus on the interplay among psychological, educational, and communication barriers are necessary. These interventions should be adapted and applied across various racial/ethnic and socioeconomic groups to reach all women with a high-risk profile for invasive cervical cancer.

Original languageEnglish
Pages (from-to)311-330
Number of pages20
JournalJournal of Women's Health
Issue number3
StatePublished - Apr 2007

Bibliographical note

Funding Information:
We gratefully acknowledge the financial support from the National Natural Science Foundation of China (Grant No. 21503256 and No. 21373254) and the autonomous research project of SKLCC (Grant No. 2013BWZ004). The support from the State Key Laboratory of Biomass Thermal Chemistry Technology (Wuhan) (YEQT0216C1) is also appreciated.

ASJC Scopus subject areas

  • Medicine (all)


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