The Effective Follow up System for Patient with Abnormal Cervical Cancer Screening at Sanpatong Hospital, Chiang Mai Province

Abstract

        This descriptive study and action research was to find the incidence and the reasons of loss follow up among abnormal cervical cancer screening cases and cervical cancer case treatment program. Methods: Reviewing medical records of 568 abnormal cervical cancer screening cases from private clinic, Heath care center and Sanpatong Hospital during January 2004 - December 2008. The process of this study consisted of 3 steps: 1) conducting group meeting to identify problems. 2) developing cervical cancer screening model, and 3) Evaluation. Qualitative data was analyzed by using data description and quantitative data was analyzed with descriptive statistics.

Findings: Cases who didn't come back to follow up were interviewed and separated .n 2 groups. I.) 67 cases (11.8 %) who had abnormal pap smear but didn't come back to get treatment. The reasons were 1) 37.3 % didn't get any contact. 2) 33.3 % got contact but didn't understand the information. 3) 28.6%, 21.4 % and 16.7 % didn't have time, feeling well and other reasons, respectively. These abnormal cell cytology were classified as ASC-US (58.2%), LSIL (20.9%), HSIL(13.4%), ASC-H (4.5%), and AGUS (3.0%), respectively. After repeating examination among these groups, 40.3 % were found to be early cervical cancer and 7.5% were found to be invasive cervical cancer. II.) 111 cases (19.5 %) who didn't come back to follow up after getting treatment, comprised of 1) 8.1 % of them didn't complete the treatment. 2) 19.8 % of them didn't get any appointment after treatment. 3) 72.1 % of them got the appointment but didn't come by reasons of, going to other clinics (48.7 %), feeling well, didn't have time and other reasons. Among these groups after repeating examination, 21.6 % of them were diagnosis as early cervical cancer while 1.8 % of them were invasive cervical cancer. After informing health care providers, patients together with improving the system, the follow up rate became to be 100 % at the end of the study. Recommendation: There should be the process that after cervical screening, all clients will get information of how important to comeback to get the result and treatment.