A PILOT-STUDY OF CERVICAL SCREENING IN AN INNER-CITY AREA - LESSONS FOR A NATIONAL PROGRAM

The objectives of this study were to examine aspects of organization o f a proposed national screening programme based in general practice. T he target population of women aged 25-59 years and their general pract itioners (GPs), in a defined inner city area, was identified from a po pulation register of persons eligible for free medical services; a com puterized system was developed for invitations and record linkage of c ytology results. Smears were examined in one laboratory and follow up of women with abnormal smears was undertaken by one gynaecologist. A r andom sample of non-responders was surveyed by questionnaire. Response following two invitations was only 20%. Practices with male doctors o nly had significantly lower reponse rates (P<0.001) than those with a female doctor/nurse. A survey of non-responders showed that over 20% o f addresses were incorrect and 16% of those interviewed were ineligibl e for smear tests. A preference for a female to undertake smears was e xpressed by 67%, and 77% believed that the purpose of the cervical sme ar was to detect cancer. An accurate population register, health promo tion, support for GP practices, provision of alternative venues for sm ear tests, development of computer systems, accurate data entry and fa il-safe follow up are aspects of a cervical screening service which mu st be addressed prior to setting up a national service.