FACTORS AFFECTING NONRESPONSE TO CERVICAL CYTOLOGY SCREENING IN NORFOLK, ENGLAND

A geographic information system was used to integrate information on t he uptake of cervical cytology screening for general medical practices in Norfolk with other data on the characteristics of the practices an d the population they served. Regression analysis was employed to expl ore the extent to which variations in non-response were associated wit h explanatory factors. Non-response to the earlier system of opportuni stic screening was found to be associated with the size of practice, t he presence of a female doctor, the District Health Authority in which the practice was located, the age structure of the practice populatio n, its degree of socio-economic deprivation and levels of rural remote ness. Compared with the earlier system, the new population-based call and recall system was found to be reaching a larger proportion of the population at risk. The former relationships were weaker under the new system, but non-response was still significantly associated with both social and organisational factors.