Low-Income Women with Cervical Abnormalities: Individual and System Factors Affecting Follow-up

Abstract

Success of cervical cancer control programs depends upon the prompt and appropriate treatment of neoplastic lesions. This study assessed whether a woman received full, partial, or no care after identification of a cervical abnormality and examined the individual and system characteristics that affected the receipt of care in a population of low-income women. The sample consisted of 674 women identified with cervical abnormalities at primary and secondary facilities in a local health department in Los Angeles County. Return for follow-up and background characteristics were obtained by reviewing hospital patient files. Results indicated that, overall, 28.5% of the women did not receive any form of follow-up care. Among those who received at least some form of follow-up, only 58.8% completed all recommended treatments. Logistic regression analysis revealed that women who did not receive any follow-up care were more likely to be non-Latino and unmarried. Among women who received at least some care, non-Latino ethnicity, single marital status, pregnancy, and the need for referral to facilities other than the one in which the abnormality was identified were characteristics associated with lack of completion of care. The information obtained from this study is important in the understanding of factors affecting follow-up care, which are essential for guiding the design of appropriate interventions.