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Which women default from follow-up cervical cytology tests ? A cohort study within the TOMBOLA trial . OBJECTIVE To identify factors associated with default from follow-up cervical cytology tests . METHODS A cohort study was conducted involving 2166 women , aged 20-59 , with recent low-grade cervical cytology taken within the NHS Cervical Screening Programmes in Scotland and England , and managed by 6-monthly cytology in primary care . For the first ( 6-month ) and second ( 12-month ) surveillance cytology tests separately , women were categorized as 'on-time attendees ' ( attended ≤6 months of test being due ) , 'late attendees ' ( attended greater than 6 months after test was due ) or 'non-attendees ' ( failed to attend ) . Multivariate odds ratios ( ORs ) were computed for factors associated with late and non-attendance . RESULTS For the first surveillance test , risk of non-attendance was significantly higher in younger women , those without post-secondary education , and non-users of prescribed contraception . Factors significantly associated with late attendance for the first test were the same as for non-attendance , plus current smoking and having children . The most important predictor of non-attendance for the second surveillance test was late attendance for the first test ( OR = 9.65 ; 95 % CI , 6.60-16.62 ) . Non-attendance for the second test was also significantly higher among women who were younger , smokers and had negative cytology on the first surveillance test . Late attendance for the second surveillance test was higher in women who were younger , smokers , had children and attended late for the first test . CONCLUSIONS Women at highest risk of default from follow-up cytology tend to be young , smoke , lack post-secondary education , and have defaulted from a previous surveillance appointment . Tackling default will require development of targeted strategies to encourage attendance and research to better understand the reasons underpinning default .
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Intervention_Educational
NHS Cervical Screening Programmes
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Outcome_Mental
follow-up cervical cytology tests