Single-visit approach: 'smear-and-treat' strategy boosts follow-up.(Gynecology)

ORLANDO, FLA. -- A "smear-and-treat," single-visit approach to offering Pap smears led to better follow-up treatment in a controlled study of more than 3,000 women.

The single-visit strategy also boosted the rate of follow-up Pap smears among the women initially diagnosed with high-grade squamous intraepithelial lesion (HGSIL) or abnormal glandular cells of undetermined significance (AGUS), Dr. Wendy R. Brewster reported in a poster at the annual meeting of the American Association for Cancer Research.

The price that patients paid for the immediate follow-up that they received from single-visit testing and treatment was spending a median of 92 more minutes at the clinic, said Dr. Brewster, a gynecologic oncologist at the University of California, Irvine.

The study enrolled 3.524 women, with an average age of 43 years. The women were randomized to two management groups: 1,716 to the single-visit program, and 1,808 to a usual-care program. All women were seen at a clinic at the university's medical center. Women in the usual-care group had a Pap smear taken, and the results were sent by mail within 2-4 weeks.

Pap smear specimens taken from women in the single-visit program were sent by courier to the university's pathology department, where the specimens were immediately processed and interpreted. This STAT Pap capability was created expressly for the study. Dr. Brewster told this newspaper. The average time elapsed from taking the specimen to receiving a report was 66 minutes.

Women with smears that were diagnosed as atypical squamous cells of undetermined significance or low-grade squamous intraepithelial lesion were referred to either their primary care physicians or to the university's abnormal cytology clinic for additional evaluation.

Sixteen women in the single-visit group had Pap smears that were diagnosed as HGSIL ...