CERVICAL-CANCER SCREENING IN WESTERN-AUSTRALIA IN 1992 - PROGRESS SINCE 1983

Objectives: To estimate the rate of cervical cancer screening in Weste rn Australia in 1992, and any variation by age, place of residence, an d socioeconomic status; and to determine the proportion of smears take n by different service providers. Design: Descriptive study; collectio n of data from Papanicolaou (Pap) smear request forms during one calen dar month. Setting: All 13 cytology laboratories in Western Australia. Participants: 15767 women in Western Australia aged 15 years and over having a cervical smear in March 1992. Main outcome measures: Rates b y age of cervical cancer screening per 1000 woman-years; age-standardi sed rate ratios for socioeconomic status and place of residence; propo rtion of smears taken by male and female service providers. Results: T he estimated rate of Pap smears at ages 15 years and over was 303 smea rs per 1 000 woman-years, an increase of 44% over a similar survey in 1983. The greatest increases were among women aged 50 years and over, but their rates were still well below that equivalent to three-yearly smears. Differences in the rate of screening by socioeconomic status ( defined by residential postcode) were not statistically significant. T he age-standardised rate ratio comparing country women with women in t he Perth metropolitan area was 0.91 (95% confidence interval 0.87-0.94 ). General practitioners took 78% of the smears, and at least 46% of a ll smears were taken by female service providers. Almost all the incre ase in the screening rate since 1983 could be attributed to an increas e in the rate of smears per 1000 woman-years taken by female general p ractitioners. Conclusion: While there have been marked improvements in the rates of cervical screening in Western Australia over the past ni ne years, there are still major deficiencies in the screening coverage of women aged 50 years and over.