Papanicolaou test coverage without a cytology registry

Area of Science:

• Gynecologic Oncology
• Public Health Surveillance
• Health Services Research

Background:

• Assessing Papanicolaou (Pap) test coverage is challenging due to difficulties in tracking women over time.
• Lack of a cytology register or recall system complicates coverage assessment in many regions.

Purpose of the Study:

• To determine Papanicolaou test coverage and testing frequency in Manitoba from 1970 to 1984.
• To analyze demographic factors associated with Papanicolaou testing rates.

Main Methods:

• Utilized Manitoba's universal health insurance plan data for a 15-year period (1970-1984).
• Employed cross-sectional analysis and a probability sample of women aged 35-64 (n=17,711).

Main Results:

• Annual Papanicolaou screening was highest for women aged 25-34 (50-57%).
• Over 15 years, 91% of women aged 35-64 had at least one Pap test, and 78% had three or more.
• Untested women were more likely to be single, older, and from rural areas.

Conclusions:

• Widespread Papanicolaou testing in Manitoba indicates a functional voluntary screening system.
• High coverage rates were achieved, though some overtesting occurred.
• The study highlights the effectiveness of universal health insurance data for public health surveillance.