PloS one
Untimely follow-up after cervical cancer screening: A qualitative study among healthcare providers in Flanders (Belgium)
By Hendrickx M, Kerckhaert LA, Willems S and 3 others.
Abstract
Background
Cervical cancer remains a global health burden despite being largely preventable through vaccination, screening, and timely treatment. Delays in follow-up after abnormal screening undermine the effectiveness of organized cervical cancer screening programmes. In Flanders (Belgium), organized screening and reminder systems exist, yet 17.7% of women do not receive adequate follow-up after an abnormal Pap smear, highlighting the need to understand multilevel factors influencing timely follow-up.
Methods
Between September and November 2025, 14 semi-structured group interviews were conducted in person with 120 general practitioners and gynaecologists responsible for cervical cancer screening in Flanders. Interviews were audio-recorded, transcribed verbatim, and analysed in MaxQDA, using iterative thematic analysis combining deductive multilevel framework coding with inductive insights. Interviews were double-coded, with discrepancies resolved through discussion. Data collection and analysis proceeded concurrently until saturation and findings were validated with stakeholders.