EFFECT OF A MOBILE UNIT ON CHANGES IN KNOWLEDGE AND USE OF CERVICAL-CANCER SCREENING AMONG RURAL THAI WOMEN

Background. A large proportion of women in most developing countries, particularly in rural areas, have never had cervical cancer screening. This paper reports the effect of a cervical cancer screening programm e using a mobile unit on changes in knowledge and use of Papanicolaou (Pap) smear screening among rural Thai women. Methods. Health educatio n and collection of Pap smears were carried out by the mobile unit thr oughout the 54 rural villages in Mae Sot District, Tak Province, betwe en January and February 1993. To determine the extent of changes, we c ompared the results of two interview surveys of women 18-65 years old in the villages selected by systematic sampling for each survey, first in January 1991 and then in January 1994. Results. A total of 1603 an d 1369 women participated in each survey respectively. The proportion of women who knew of the Pap smear test increased from 20.8% in the fi rst survey sample to 57.3% in the second survey sample. The proportion of those who had ever been screened increased from 19.9% in the first survey sample to 58.1% in the second survey sample. These increases w ere observed solely among ever-married women and there were no signifi cant changes among single women, most of whom remained unscreened. Of ever-married women, the magnitude of increase was highest in the age g roup 25-34 years, and declined with increasing age. Conclusions. Great er efforts should be made to encourage the use of screening among the older women. The use of mobile units may be helpful for rapid achievem ent of higher screening coverage in rural areas, where existing screen ing services cannot effectively cover the female population at risk.