Self-reported cervical screening practices and beliefs of women from urban, rural and remote regions

This survey aimed to explore women's perceptions of a number of issues relating to the availability and utilisation of cervical cancer screening services in the rural, remote and urban regions of New South Wales (NSW) Australia. The survey involved urban, rural and remote regions of NSW determined by the definition of the Department of Community Services and Health. This was a cross-sectional telephone survey. Of the 339 eligible urban households, 265 (78%) completed interviews; of the 286 eligible rural households, 238 (83%) completed interviews; of the 285 eligible remote households, 230 (81%) completed interviews. Telephone contact was made with randomly selected households in each region. Women in the households were asked to complete a computer-assisted telephone interview. The survey addressed a number of issues relating to cervical screening: cervical cancer risk status; provider of Pap smear service; distance travelled to have a Pap smear; perceived barriers and facilitators to cervical screening. There was no statistically significant difference in the proportions of women from urban (74%), rural (76%), and remote (71%) regions who reported having a Pap smear in the 2 years preceding the survey. General practitioners provided the majority (more than 70%) of tests irrespective of region. Compared with women from urban areas, women from rural and remote areas were almost twice as likely to have had their last Pap smear from a male general practitioner. A greater proportion of women from remote regions had to travel for 60 minutes or more to access providers of Pap smear services. Few differences in the top three reported barriers to, and facilitators for screening were evident between regions and between those women who had and had not been adequately screened. Issues of distance, isolation and access to alternative service providers are a concern to women in rural and remote regions and should be considered by those involved in the implementation of cervical cancer screening services.