AN EVALUATION OF CERVICAL SCREENING IN GENERAL-PRACTICE

Objectives: To identify the technical practices of general practitione rs (GPs) in relation to Papanicolaou (Pap) smear screening, and the di fferences in screening practices between male and female practitioners ; to determine the cellular content of smears taken; and to correlate screening practices and demographic variables with smear results. Desi gn: During February-May 1992, a sample of Melbourne GPs filled in a qu estionnaire concerning their screening practices, and the results were correlated retrospectively with results of Pap smears taken in March and October 1991. Setting: Melbourne metropolitan general practice. Pa rticipants: One hundred and seventy-nine GPs (72% participation rate a mong eligible practitioners) from a sample obtained from the register of the Medical Board of Victoria. Results: Female doctors took signifi cantly more smears than male doctors. An opportunistic approach to cer vical screening was most commonly practised, with the patient being as ked to ring for her results and the practice staff only contacted her if the result was abnormal. Only 43% of doctors indicated the use of a specific reminder system when rescreening was due. Endocervical cells were present in 79% of smears. The presence of endocervical cells was found to be related to the year of a doctor's graduation (with both v ery recent and older graduates [pre-1960s] having lower endocervical c ell rates), and to be positively correlated with more postgraduate tra ining. Conclusions: Our study suggests that further education and trai ning in cervical screening is needed for some GPs, in particular, male doctors, graduates of less than four or greater than 20 years, and th ose without postgraduate training.