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Pilot project on improvement of cervical cancer screening coverage: efficacy of personal systematic invitation model in urban and rural areas
Date Issued |
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2019-08-05 |
ISBN 978-9955-15-620-8.
Introduction. In Lithuania, cervical cancer (CC) is the 4th cause of female cancer and 2nd cause of cancer among women aged 15 to 44 years. A well-organized CC screening at the population level every 3 to 5 years can reduce the incidence of CC by 80%. In 2004, Lithuania started a Nationwide Cervical Cancer Screening Programme with a three years screening interval, targeted at women aged 25-60 years, however, screening is more opportunistic than population-wide and its coverage is still insufficient. Research aim. To assess the efficacy of systematic personal invitation model for the cervical cancer screening coverage in the urban (Kaunas) and rural (Prienai) areas. Research methods and organization. The study was carried out in an urban (Kaunas) and a rural (Prienai) primary healthcare centres (PHCC). Before the study women in Kaunas PHCC and in Prienai PHCC were invited to participate in the CC screening by a family doctor. In the first year of the study, all women aged 25-60 not having had Pap smear test within the last 3 years in Kaunas (n=1591) and in Prienai (n=1843) received a personal invitation letter to participate in the screening. In a year, the reminder letter was sent to the non-attendees (n=1042 in Kaunas and n=929 in Prienai). Women, who did not attend for screening after two letters, received a questionnaire aimed at identifying the barriers of non-attendance. Results. Before the study, family doctors invited 35.1% of women in Kaunas PHCC and 17.7% in Prienai PHCC to participate in the CC screening. Only 9.6% of target population in Kaunas and 14.7% in Prienai attended. After the first invitation by letter, the participation rate in CC screening increased up to 24.6% in urban and 30.8% in rural areas (p<0.001). The lowest participation rate was in the youngest age group (25-34 years). The coverage after the reminder letter were also significantly higher in rural than in urban population, 22.2% and 16