{
  "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. Results: Despite the organized screening programme, healthcare providers experience cervical cancer screening follow-up as a complex, fragmented, and non-standardized multi-step pathway. Delays were mainly attributed to provider- and system-level factors, including inconsistent communication, challenges in interdisciplinary responsibilities and collaboration, high workload, and poorly integrated digital systems. Patient-related factors, such as language barriers and health literacy played a secondary role. Current follow-up processes were described as relying heavily on individual provider initiative rather than on well-coordinated, system-level structures. To improve timely follow-up, healthcare providers recommended standardised and proactive communication, clearer task allocation and responsibility, better integrated digital systems, the optimisation of the existing reminder mechanism and enhanced patient education. Conclusion: Delays in follow-up primarily reflect organisational and system-level weaknesses. Standardization, integrated digital systems, and clarified roles and responsibilities are key to reducing preventable delays. A “double safety net” combining provider oversight with informed patient involvement, alongside greater primary care engagement, may further enhance the continuity and timeliness of follow-up care.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Health Promotion, CAPHRI, Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands",
    "Department of Public Health and Primary Care, Ghent University, Ghent, Belgium",
    "Department of Health Promotion, NUTRIM, Research Institute of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands"
  ],
  "article_type": "Research Article",
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  "author_total": 6,
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      "name": "Marie Hendrickx"
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      "name": "Laure-Anne Kerckhaert"
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      "name": "Sara Willems"
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    {
      "name": "Rik Crutzen"
    },
    {
      "name": "Vera Verbestel"
    },
    {
      "name": "Katrien Vanthomme"
    }
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  "bibtex": "https://research.draconitic.com/paper/b0mh02c74ewp8.bib",
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  "doi": "10.1371/journal.pone.0359860",
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  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
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  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
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  "native_subjects": [
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      "/Biology and life sciences/Microbiology/Medical microbiology/Microbial pathogens/Viral pathogens/Papillomaviruses/Human papillomavirus"
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      "/Medicine and health sciences/Oncology/Cancers and neoplasms/Gynecological tumors/Cervical cancer"
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  "pmcid": null,
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  "published": "2026-10-07",
  "publisher": "Public Library of Science",
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  "title": "Untimely follow-up after cervical cancer screening: A qualitative study among healthcare providers in Flanders (Belgium)",
  "title_text": "Untimely follow-up after cervical cancer screening: A qualitative study among healthcare providers in Flanders (Belgium)",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:17:30Z",
  "url": "https://research.draconitic.com/paper/b0mh02c74ewp8",
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