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• W2217034968 abstract "The objective of the study was to review Pap test results and follow-ups in an urban sexually transmitted disease clinic in Miami, Florida. We reviewed the results of all Pap tests conducted in the clinic during 2005. All the samples were processed by a single commercial laboratory. We attempted to contact clients with abnormal results other than inflammation to return to the clinic. Results: of the 849 samples, 622 (73.3%) were normal, 211 (24.8%) were abnormal (inflammation 76 (9.0%), ASCUS 68 (8%), and LGSIL or higher 64 (7.5%), and 16 (1.9%) were considered unsatisfactory for cytological interpretation. We were able to contact only 57% of the clients that needed to return to the clinic. The rate of abnormal cervical cytology reported in this clinic in 2005 was well above the national average. A significant fraction, 43%, of clients who had abnormal results were unable to be contacted for follow-up. Florida Public Health Review, 2008; 5, 60-63. Introduction Cervical cancer, the most commonly diagnosed malignancy in women under 35 years of age in the United States (Boring, Squires, Tong, & Montgomery, 1994) is caused by human papillomavirus (HPV) infection, the most common sexually transmitted disease (STD) (Cates, 1999; Cogliano, Baan, Straif, Grosse, Secretan, & El Ghissassi, 2005; National Toxicology Program, 2004). Cervical cytological screening using the Papanicolaou (Pap) test is widely accepted as a useful test for detection of cervical cancer and its precursors. The test has been credited as one of the factors associated with the dramatic decrease in the rates of cervical cancer in the United States. The mortality associated with cervical cancer has declined >70% since the inception of the Pap test and implementation of routine cervical cancer screening in most Western countries (National Institutes of Health, 1997). In the United States, invasive cervical cancer incidence decreased by 36% from 1973 to 1991, accompanied by a 42% reduction in the agespecific mortality rate (DiSaia & Creasman, 1993). Despite widespread availability of screening, women continue to develop cervical cancer. In the United States, 50% of cervical cancers occur in women who have never been screened, and 60% in women who have not been screened in the last 5 years (Singleton & Orr, 1995 ). STD clinics have been considered important venues for Pap smear screening both because of the association of STD with cervical neoplasia and the fact that women attending such clinics often have poor preventive health-care seeking behavior and/or limited access to health services (Engelstad et al., 2001; Kamb, 1995). Pap tests, however, are not universally available at all public STD clinics in the United States. The overall rate of an abnormal cytology reported in the United States varies from 5% to 6%. Our objective was to review Pap test results and follow-ups in an urban sexually transmitted disease clinic in Miami, Florida. Methods Setting The Miami-Dade County Health Department maintains four clinics dedicated to screening and treatment of sexually transmitted diseases. These clinics are strategically located in Miami-Dade County to meet the needs of communities most acutely in need of STD services. These clinics serve predominantly ethnic minorities and less than 25% of the clients have some type of third-party or health insurance coverage. In all these clinics Pap smear tests are routinely offered to all female patients who have not been tested for over one year. The study sample was drawn from patients of the Downtown Clinic (DTSTD), the busiest of the four clinics. Approximately 100 clients per day are seen, of which approximately 35% are women. Study Design We reviewed the results of all Pap tests performed in the DTSTD during 2005. Test results were evaluated using the 1991 revision to the" @default.
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• W2217034968 date "2008-06-01" @default.
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• W2217034968 title "Papanicolaou Test in an Urban STD Clinic: The Good and Bad News" @default.
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