Attendance rate in the Polish Cervical Cancer Screening Program in the years 2007-2009

Abstract

Material and Methods: Attendance rate in the Screening Program was evaluated for the years 2007, 2008 and 2009. The analysis included screening coverage in all voivodeships in the 12 months of the year, as well as the number of gynaecological practices participating in the Program. In addition, the place of residence of screening attenders (urban/rural area) was taken into account. For the analysis the SIMP (System of Information Monitoring in Prophylaxis) data were used. Statistical analysis was performed using Statistica 9.0 software. P-values <0.05 were considered statistically significant. Results: The target population in the years 2007-2009 was 9 727 842 women. Personal invitations were sent to 99.7% of them. Pap Smears were collected from 24.14% of the target women (in 2007 – 21.25%; in 2008 – 24.39%; in 2009 – 26.77%). We noted that the number of 1400 gynecological practices participating in the Program was the minimal value to observe a significant increase in the number of Pap smears collected (p=0.000). Polish women do not attend screening in the winter months. However, when a batch of invitations was sent in the spring or summer months, within two following months we could observe an increase in the number of Pap smears collected (p=0.000). There are significant differences in the screening uptake in particular regions of Poland (a stable trend). Compared to urban women, rural women participate in the screening more often (p=0.003). Conclusion: All Pap test results including opportunistic screening should be registered in the SIMP. In the regions where particularly low attendance rates were observed, an intensive promotional campaign should be run to encourage participation in the screening. Also, sending a repeated invitation to non-compliers should be considered. The currently unfavorable schedule of invitation sending should be changed. According to the analysis performed, invitations should be more effective if sent on a regular basis (in small but regular batches), more intensively in the summer and spring months. In the winter season it would probably be better to focus on an extensive media campaign followed by sending a large number of personal invitations.