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Obstetrics & Gynecology 1999;94:371-376
© 1999 by The American College of Obstetricians and Gynecologists
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ORIGINAL RESEARCH

Predicting Compliance With Follow-up Recommendations After Colposcopy Among Indigent Urban Women

L. STEWART MASSAD, MD and PETER M. MEYER, PhD

From the Division of Gynecologic Oncology, Cook County Hospital and Rush Medical College, Chicago, Illinois; and Section of Biostatistics, Department of Preventive Medicine, Rush–Presbyterian–St. Luke’s Medical Center, Chicago, Illinois.

Address reprint requests to: L. Stewart Massad, MD Department of Obstetrics and Gynecology Cook County Hospital Chicago, IL 60612 E-mail: lsmassad{at}ameritech.net

Objective: To determine correlates of compliance with follow-up recommendations after colposcopy.

Methods: Between October 1, 1992, and June 30, 1997, management recommendations were made to 451 consecutive women who attended a resident colposcopy clinic. Compliance was determined after 8–12 months. Correlates of compliance were assessed by univariate and multivariate analyses.

Results: Recommendations included repeat cytology in 6 months for 252 women, loop excision for 114, conization for 27, repeat colposcopy for 51, other for three, and not recorded for four. Rates of ever complying were 81% for loop excision, 85% for conization, 62% for repeat colposcopy, and 36% for repeat cytology. In multivariate analysis, the only significant predictors of compliance were history of genital herpes simplex infection (odds ratio [OR] 0.20; 95% confidence interval [CI] 0.05, 0.86, P = .03) and the nature of the recommendation (OR 4.73; CI 2.51,8.92 for loop excision; OR 8.72; CI 2.57,29.6 for conization; and OR 2.53; CI 1.30,4.93 for repeat colposcopy, all against observation, P < .001).

Conclusion: After colposcopy, women were more likely to comply with earlier, more intensive interventions, although the relative effect of follow-up interval and intervention could not be distinguished.




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