Cervical cytology: a general practice audit

The UK cervical cytology programme has not had a significant impact on the disease. Reasons for this are discussed, and in particular the role of the primary care physician. One method of increasing awareness and improving performance is peer group audit. Such an initiative was taken by the Vale of Trent faculty of the Royal College of General Practitioners. Of the 240 members 140 (58%) responded to a questionnaire about smear policy and organization. Seventy-six practices, which included 101 members (42%) reviewed a sample of 100 records of women aged 35-64 years. Performance was estimated by noting the number in each sample who had never had a smear taken and the number who had had a smear taken in the last five years. Wide variations in performance were found, little of which could be explained by the variables measured. Practices with an active call system produced slightly higher coverage rates. The value of such an audit is discussed and suggestions made for facilitating this approach.