The potential reduction in morbidity and mortality through cancer screening cannot be realized without receipt of appropriate follow-up care for abnormalities identified via screening. In this paper, the authors critically examine the existing literature on correlates of receipt of appropriate follow-up care for screen-detected abnormalities, as well as the literature on interventions designed to increase rates of receipt of follow-up care. Lessons learned describe what is known and not known about factors that are related to or predict receipt of follow-up care.Similarly, effective interventions to increase follow-up are described and gaps identified. A conceptual model is developed that categorizes the health care system in the United States as comprising four levels: policy, practice, provider, and patient. Some patient-level factors that influence follow-up receipt are identified, but the lack of data severely limit the understanding of provider, practice, and A long the continuum from cancer screening through diagnosis, treatment, and rehabilitation, little attention has focused on intervening to assure timely, effective diagnosis once an abnormality has been identified. To achieve the goal of reducing cancer morbidity and mortality, it is imperative that patients receive timely and appropriate follow-up for detected abnormalities, as a prerequisite to appropriate treatment. Failure to obtain appropriate diagnostic services can have a significant effect on psychosocial sequelae, morbidity, and mortality, as well as cost implications for the individual and the health care system. A recent review of studies on follow-up of abnormal screening examinations reported that, in the majority of studies, fewer than 75% of patients receive adequate follow-up care. 1 The negative implications of failure to follow-up are substantial, especially at the population level.

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