CERVICAL-CANCER SCREENING IN RURAL NSW - HEALTH-INSURANCE COMMISSION DATA COMPARED TO SELF-REPORT

There are several sources of data for estimates of community Pap test rates, including self-report, pathology laboratory records and Health Insurance Commission (HIC) data. Estimates of screening rates can vary considerably according to the sampling frame and data source. This st udy aimed to compare the self-reported estimates of cervical cancer sc reening with HIC estimates tor women in rural NSW towns. Serf-report o f a Pap test in the past two years from 2,498 women in 19 rural towns of NSW was compared to HIC-provided Pap test rates. Self-report levels were adjusted for non-HIC providers and HIC levels included data from the Victorian Cytology Register. Self-report estimates were significa ntly higher than HIC estimates in 18 of the 19 towns, with discrepanci es ranging from 13% to 29%. HIC-recorded providers accounted for betwe en 65% and 100% of Pap tests per town, according to self-report. The h ighest Pap test rate by self-report was 70.1%, the highest by HIC was 49.2%. The lowest Pap test rate by self-report was 45.2%, the lowest b y HIC was 26.1%. There was significant variation in Pap test rates bet ween towns for adjusted self-report estimates, but not for the crude s elf-report estimates. Researchers should always be aware of both the p ossible variations according to data source and the inherent biases fo r whichever data source is used. An extra caution is given to consider the public/private provider profile when exploring possible geographi cal differences in Pap test rates.