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      Timing of Colposcopy After Cervical Cytologic Abnormalities :

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          Understanding Barriers for Adherence to Follow-Up Care for Abnormal Pap Tests

          Approximately 4000 women annually will die from preventable and treatable cervical cancer. Failure to adhere to follow-up recommendations after an abnormal Pap test can lead to development of cervical cancer. This paper summarizes the body of literature on adherence to follow-up after an abnormal Pap test in order to facilitate development of interventions to decrease morbidity and mortality due to cervical cancer.
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            Is the promise of cancer-screening programs being compromised? Quality of follow-up care after abnormal screening results.

            Cancer screening has increased dramatically in the United States, yet in some populations, particularly racial minorities or the poor, advanced disease at diagnosis remains high. One potential explanation is that follow-up of abnormal tests is suboptimal, and the benefits of screening are not being realized. The authors used a conceptual model of access to care and integrated constructs from models of provider and patient health behaviors to review published literature on follow-up care. Most studies reported that fewer than 75 percent of patients received some follow-up care, indicating that the promise of screening may be compromised. They identified pervasive barriers to follow-up at the provider, patient, and health care system levels. Interventions that address these barriers appear to be effective. Improvement of data infrastructure and reporting will be important objectives for policy makers, and further use of conceptual models by researchers may improve intervention development and, ultimately, cancer control.
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              Neighborhood socioeconomic status, maternal race and preterm delivery: a case-control study.

              To explore associations between neighborhood socioeconomic context and preterm delivery, independent of maternal and family socioeconomic status, in African-American and white women. A case-control study of African-American (n = 417) and white (n = 1244) women delivering infants at the University of California, San Francisco's Moffitt Hospital, between 1980 and 1990. Neighborhood socioeconomic contexts were associated with preterm delivery but associations were non-linear and varied with race/ethnicity. For African-American women, living in a neighborhood with either high or low median household income was associated with an increased risk of spontaneous preterm delivery, as was living in a neighborhood with large increases or decreases in the proportion of African-American residents during the study decade. Residence in neighborhoods with high and low rates of male unemployment was associated with a decreased risk of preterm delivery. Among white women only large positive and negative changes in neighborhood male unemployment were associated with risk of preterm delivery. Neighborhood factors and changes in neighborhoods over time are related to preterm delivery, although the mechanisms linking local environments to maternal risk remain to be specified.
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                Author and article information

                Journal
                Obstetrics & Gynecology
                Obstetrics & Gynecology
                Ovid Technologies (Wolters Kluwer Health)
                0029-7844
                2010
                March 2010
                : 115
                : 3
                : 629-636
                Article
                10.1097/AOG.0b013e3181cec0b5
                20177296
                2cd3b189-3335-4a21-a86a-3a10fe4f3965
                © 2010
                History

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