Conventional cytology scheme: adherence and associated factors

Objectives

This study analyzed adherence rates to conventional cytology and associated factors in a cohort of women at a health service provider institution in Medellin, Colombia.

Study design

Observational cohort study with repeated measures.

Methods

Clinical and sociodemographic data were obtained from databases for screenings between January 2018 and December 2022. Adherence, defined as undergoing 1, 2, or 3 cytology tests according to national guidelines, was the outcome. Statistical analysis involved a Poisson model with robust errors to identify factors associated with adherence.

Results

In total, 26,445 women were included, with a median age of 25 years (IQR: 22–27). Adherence rate was 20.4%. Having just high school education (RR = 0.51; 95% CI: 0.49–0.55), a history of pregnancy (RR = 0.63; 95% CI: 0.54–0.75), and a history of sexually transmitted infections (RR = 0.88; 95% CI: 0.78–0.99) decreased adherence. Conversely, the human papillomavirus (HPV) vaccination history increased adherence (RR = 2.11; 95% CI: 1.60–2.80).

Conclusion

It is vital to monitor cytology programs to improve demand-induced and spontaneous consultations. Diligent follow-up, focusing on patients with factors linked to low adherence, along with appointment reminders, can enhance adherence to the screening protocol.