[Analysis of the first test of ASC-US smears by general practitioners of the Maine-et-Loire in 2014]

Sante Publique. 2018 July-August;30(4):499-505. doi: 10.3917/spub.185.0499.
[Article in French]

Abstract

Introduction: During the study, the HAS (French Board of Health) recommended 3 options for the first test (C1) in case of presence of ASC-US: a smear to be carried out after 6 months, an HPV test or a colposcopy.Our main objective was to find out which C1 option was chosen. The secondary objectives were to evaluate the number of C1's carried out by general practitioners, the follow-up rate and that of adapted C1 smear reports.

Method: Retrospective descriptive study based on the data obtained from CAP Santé 49 (departmental organization of cancer screening), concerning women between the ages of 25 and 65 years old having had a smear test with a positive ASC-US result carried out by a general practitioner.

Results: Based on 397 female patients, 373 with a 94% follow-up of which 367 C1's and 6 treatments. Among the C1's: 212 smears (57.76%), 89 tests HPV (24.25%), 40 colposcopies (10.9%), 26 double techniques (7.08%). 235 representing 64.03% were carried out by general practitioners, 130 representing 35.42% by gynecologists and 2 representing 0,54% by midwives. Of the 126 normal smear reports received by general practitioners, 70.63% gave information about an ASC-US antecedent. Among them 14 representing 15.7% complied with the recommended specified time intervals.

Conclusion: This study which was carried out in 2014 demonstrates that HPV tests have doubled compared to a similar study carried out in 2011. In December 2016, the INCa (French National Cancer Institute) qualified this test as being the reference test for ASC-US checks. In January 2018, general cervical cancer screening involving general practitioners will be carried out. This study will serve as a basis on which to evaluate their practices.

MeSH terms

  • Adult
  • Aged
  • Attitude of Health Personnel*
  • Atypical Squamous Cells of the Cervix / pathology*
  • Cross-Sectional Studies
  • Female
  • France
  • General Practice*
  • Human Papillomavirus DNA Tests / statistics & numerical data*
  • Humans
  • Middle Aged
  • Papanicolaou Test / statistics & numerical data*
  • Practice Patterns, Physicians'*
  • Retrospective Studies
  • Vaginal Smears / statistics & numerical data*