Sammanfattning
Introduction: Upon the introduction of organized screening for cervical cancer in north Jutland, a conservative strategy comprising cytological follow-up in the event of slightly abnormal smear (condyloma, excessive tissue repair, atypical metaplastic cells and atypical cells) was implemented. The present study focused on (1) compliance with the recommendations and (2) later abnormal findings. Materials and methods: A cohort of 1,072 women, of whom 88 later were excluded, presenting with a slightly abnormal smear in 1995 or 1996 was identified in the pathology database of the County of North Jutland. Results: In accordance with the recommendations, older women and women with atypical metaplastic cells or excessive tissue repair were re-examined earlier than the other groups. However, a residual group accounting for 10-20% of the women in the study was examined more than six months later than recommended. The greatest risk factor for detection of later dysplasia was atypical metaplastic cells, as the five-year estimate for developing at least mild dysplasia was 41%. In 452 women, abnormal results were later demonstrated. Of these, 186 had at least mild dysplasia. Two cases of cancer were detected. Discussion: Cytological follow-up of a slightly abnormal smear according to the recommendations presented in this study is safe. The compliance as shown in this study was suboptimal and must be improved. Findings of atypical cells warrant early follow-up, and in the case of atypical metaplastic cells, obtaining material for histological examination should be considered. Age-differentiated follow-up is not justified.