Cervical screening in general practice - strategies for improving participation

Area of Science:

• Public Health
• Preventive Medicine
• General Practice

Background:

• National cervical screening rates have stagnated around 60%.
• Individual recruitment methods have limited effectiveness; combined strategies offer additive benefits.
• There is ongoing discussion regarding the role of nurses in performing Pap tests within general practice settings.

Purpose of the Study:

• To evaluate the impact of several interventions on cervical screening rates within a single general practice.
• To assess the effectiveness of a multi-faceted recruitment approach.

Main Methods:

• Audit of interventions including electronic record updates, proactive letter-based recruitment, and follow-up phone calls.
• Modified invitation letters to allow women to opt for 'Pap test plus other issues' or 'screening test only'.
• Offered Pap tests by a nurse for the 'screening test only' group.

Main Results:

• A 27% increase in biannual screening rates was observed over 18 months, rising from 53% to 67.5%.
• Within the last six months, 49% of women chose the 'screening only' option performed by a nurse.
• All implemented strategies proved feasible and contributed to increased screening uptake.

Conclusions:

• The study demonstrates that a combination of four distinct strategies can significantly enhance cervical screening rates.
• Patient choice is supported, with women opting for Pap tests administered by nurses in general practice.
• Each intervention's contribution to improved screening uptake appears to be independent and additive.