{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,16]],"date-time":"2026-05-16T01:39:24Z","timestamp":1778895564347,"version":"3.51.4"},"reference-count":17,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2014,10,23]],"date-time":"2014-10-23T00:00:00Z","timestamp":1414022400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000054","name":"National Cancer Institute","doi-asserted-by":"publisher","award":["RC2 CA148576"],"award-info":[{"award-number":["RC2 CA148576"]}],"id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancer Cytopathology"],"published-print":{"date-parts":[[2015,1]]},"abstract":"<jats:sec><jats:title>BACKGROUND<\/jats:title><jats:p>To the authors' knowledge, few studies to date have examined adherence to recommended guidelines for follow\u2010up and outcomes after an unsatisfactory Papanicolaou (Pap) test (UPT) with liquid\u2010based technologies.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS<\/jats:title><jats:p>Within 4 US health plans, the median time to follow\u2010up and the percentage of patients with follow\u2010up testing by 120 days was calculated after a UPT. Multivariable analyses evaluated the association between clinical factors and follow\u2010up testing. The authors compared the risk of a diagnosis of cervical intraepithelial neoplasia of type 2 or worse (CIN2+) after a UPT with the risk after a satisfactory Pap test while controlling for study site, test year, and other covariates.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>A total of 634,644 Pap tests performed between 2004 and 2010 were included in the current study. Of 1442 UPTs, 53.4% had follow\u2010up testing within 120 days; follow\u2010up differed across the health plans (<jats:italic>P<\/jats:italic>&lt;.001) and was found to be higher among patients aged &lt;50 years (57.2% vs 48.8%; <jats:italic>P<\/jats:italic>\u2009=\u2009.01) and those with positive human papillomavirus (HPV) results (84.6% vs 53.9; <jats:italic>P<\/jats:italic> &lt;.01). The risk of CIN2+ was similar for patients with both unsatisfactory and satisfactory Pap tests. However, after a UPT, the variables of age &lt;50 years, having no previous history of Pap testing, having a history of a previous abnormal Pap test, and positive HPV status were all found to be risk factors for CIN2+; a positive HPV test was found to be the strongest risk factor for developing CIN2+. A negative HPV test result was protective for a CIN2+ diagnosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS<\/jats:title><jats:p>Various clinical factors associated with the risk of CIN2+ appear to influence the receipt of follow\u2010up after a UPT. HPV test results in patients with UPTs might be used in follow\u2010up strategies; specifically, a negative test result might reduce the urgency for repeat Pap testing. <jats:bold><jats:italic>Cancer (Cancer Cytopathol)<\/jats:italic> 2015;123:59\u201365<\/jats:bold>. \u00a9 <jats:italic>2014 American Cancer Society<\/jats:italic>.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cncy.21490","type":"journal-article","created":{"date-parts":[[2014,10,23]],"date-time":"2014-10-23T16:46:23Z","timestamp":1414082783000},"page":"59-65","source":"Crossref","is-referenced-by-count":16,"title":["Follow\u2010up and clinical significance of unsatisfactory liquid\u2010based Papanicolaou tests"],"prefix":"10.1002","volume":"123","author":[{"given":"Christopher L.","family":"Owens","sequence":"first","affiliation":[{"name":"Meyers Primary Care Institute University of Massachusetts Medical School, Fallon Community Health Plan and Reliant Medical Group Worcester Massachusetts"},{"name":"Department of Pathology University of Massachusetts Medical School Worcester Massachusetts"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Diana S.M.","family":"Buist","sequence":"additional","affiliation":[{"name":"Group Health Research Institute Seattle Washington"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel","family":"Peterson","sequence":"additional","affiliation":[{"name":"Meyers Primary Care Institute University of Massachusetts Medical School, Fallon Community Health Plan and Reliant Medical Group Worcester Massachusetts"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aruna","family":"Kamineni","sequence":"additional","affiliation":[{"name":"Group Health Research Institute Seattle Washington"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sheila","family":"Weinmann","sequence":"additional","affiliation":[{"name":"Kaiser Permanente Center for Health Research\u2010Northwest Portland Oregon"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tyler","family":"Ross","sequence":"additional","affiliation":[{"name":"Group Health Research Institute Seattle Washington"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew E.","family":"Williams","sequence":"additional","affiliation":[{"name":"Maine Medical Research Institute Portland Maine"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Azadeh","family":"Stark","sequence":"additional","affiliation":[{"name":"Geisinger Health System Danville Pennsylvania"},{"name":"Department of Pathology Henry Ford Health System Detroit Michigan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kenneth F.","family":"Adams","sequence":"additional","affiliation":[{"name":"HealthPartners Research Foundation Minneapolis Minnesota"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chyke A.","family":"Doubeni","sequence":"additional","affiliation":[{"name":"Department of Family Medicine and Community Health Perelman School of Medicine, Center for Public Health Initiatives, University of Pennsylvania Philadelphia Pennsylvania"},{"name":"Department of Epidemiology Perelman School of Medicine, Center for Public Health Initiatives, University of Pennsylvania Philadelphia Pennsylvania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Terry S.","family":"Field","sequence":"additional","affiliation":[{"name":"Meyers Primary Care Institute University of Massachusetts Medical School, Fallon Community Health Plan and Reliant Medical Group Worcester Massachusetts"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2014,10,23]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1158\/1055-9965.EPI-04-0569"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/dji115"},{"key":"e_1_2_7_4_1","first-page":"40","article-title":"False\u2010negative 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