WHO HAS PAP SMEARS IN NEW-SOUTH-WALES - PATTERNS OF SCREENING ACROSS SOCIODEMOGRAPHIC GROUPS

The aim of this study was to determine whether Pap smear screening at adequate intervals is associated with area of residence, frequency of consultations with a general practitioner, socioeconomic status and no n-English-speaking background. A representative 10 per cent sample of women from New South Wales and the Australian Capital Territory, aged 25 to 69 years and registered with the Health Insurance Commission (Me dicare) (N = 155 281) was used to obtain age, postcode, frequency of P ap smears and frequency of consultations with general practitioners in the three-year period from February 1985 to January 1988. Census data for each postcode area were used as an indicator of other sociodemogr aphic characteristics. Age-specific screening rates did not vary betwe en Sydney, Newcastle/Wollongong, Canberra, and nonmetropolitan areas. In all age groups, having had a smear was most strongly associated wit h the frequency with which a woman consulted a general practitioner. W omen who visited a general practitioner at least four times a year on average were about twice as likely to have had a recent Pap smear as t hose who averaged less than one visit per year. Screening rates were l owest among women living in areas with the most non-English-speakers a nd the lowest socio-economic status. Sociodemographic factors and heal th service usage patterns influence the proportion of women who are cu rrently being screened. Evaluation of interventions to improve Pap sme ar screening rates should consider whether the percentage of women scr eened increases overall, and also whether the imbalances in screening rates between different groups are diminishing.