Compliance with referrals from a cancer-screening project

Family practice residents participated in a federally funded breast and uterine cancer-screening project as a part of their training experience. During the 2.5-year grant period, more than 1,800 women were screened and 12 cancers detected. Patient compliance with referral for Pap smear findings was significantly greater when there were also positive pelvic findings or when the Pap smear indicated a malignant or premalignant condition. Compliance with referral for clinical follow-up of breast findings was comparable to that for diagnostic mammography, and both were significantly greater than compliance with referral for a screening mammogram. Significant relationships were found among compliance and the self-reporting of breast symptoms, the physical findings on physician examination, and the source of payment for mammography. The health belief model provides a conceptual framework for consideration of study findings relating to patient motivation for preventive and curative care.