Cervical cancer screening in Western Australia in 1992: progress since 1983

To estimate the rate of cervical cancer screening in Western Australia in 1992, and any variation by age, place of residence, and socio-economic status; and to determine the proportion of smears taken by different service providers.

Descriptive study; collection of data from Papanicolaou (Pap) smear request forms during one calendar month.

All 13 cytology laboratories in Western Australia.

15,767 women in Western Australia aged 15 years and over having a cervical smear in March 1992.

Rates by age of cervical cancer screening per 1000 woman-years; age-standardised rate ratios for socioeconomic status and place of residence; proportion of smears taken by male and female service providers.

The estimated rate of Pap smears at ages 15 years and over was 303 smears per 1000 woman-years, an increase of 44% over a similar survey in 1983. The greatest increases were among women aged 50 years and over, but their rates were still well below that equivalent to three-yearly smears. Differences in the rate of screening by socioeconomic status (defined by residential postcode) were not statistically significant. The age-standardised rate ratio comparing country women with women in the Perth metropolitan area was 0.91 (95% confidence interval 0.87-0.94). General practitioners took 78% of the smears, and at least 46% of all smears were taken by female service providers. Almost all the increase in the screening rate since 1983 could be attributed to an increase in the rate of smears per 1000 woman-years taken by female general practitioners.

While there have been marked improvements in the rates of cervical screening in Western Australia over the past nine years, there are still major deficiencies in the screening coverage of women aged 50 years and over.