An attempt to increase compliance to cervical cancer screening through general practitioners

The authors report the results of a campaign aimed at increasing compliance to cervical cancer screening by promoting general practitioners' (GPs) cooperation. Different types of intervention were tested, namely mailing lists of non responders to the GP, visiting the GP at the office, or both. No active intervention was made in a sample of GPs who served as a control group. Overall 288 GPs assisting 75,853 women aged 25 to 59 were enrolled in the study. Compliance before and after the campaign was studied and the association between compliance and different variables such as age, residence and type of intervention was tested by univariate and multivariate analysis. The proportion of previous non responders who performed a Pap test after the campaign was 6.7%, the response being dependent on age (25-29 = 11.5%, 30-39 = 8.8%, 40-49 = 6.5%, 50-59 = 4.2%) and place of residence (urban = 7.2%, suburban = 5.9%, rural = 4.0%). Compliance was better in the case of the active campaign (list mailing = 8.3%, visit = 7.0%, list + visit = 7.2%) with respect to controls (2.9%) although no significant differences were detected between different types of active intervention. Compliance to cervical cancer screening may be increased by promoting GPs cooperation but the benefit is limited. Mailing lists of non responders was found the most cost effective policy in this study.