Women’s social conditions and their participation in Cervical Cancer Population Screening Program in Poland

Abstract

Abstract Objectives: The Aim. Early diagnosis and screening are of vital importance in Poland because of high morbidity and mortality cervical cancer statistics. Polish cervical cancer screening programme is based on personal invitations which are sent to women aged from 25 to 59 every three years. The aim of the study was to assess socioeconomic conditions of the women who decided to accept or refuse that invitation. Material and method: The data was collected from questionnaires filled in by 1625 women (age: 25-59) who sought medical help from gynecologists in Poland. The questions included: age, place of living, education, marital status, children, reaction to the invitation acceptanceand its reasons. Social profiles of women, both participating or not in screening, were characterized. Reasons for refusing the invite were analyzed. Data regarding the amount of PAP smear collected, number of practices cooperating with screening programme and invitation responses were obtained from SIMP. Statistical techniques for correspondence analyses was used in the study. Results: 1261 respondents (77.5%) had PAP smear, 894 women received a personal invitation for screening and 38% of them ignored it. In Poland 55467 women (5,5%) responded to the personal invitation (2009) and the number was independent of the number of cooperating practices (p=0.0001). Women from rural areas do not participate in the screening programme comparing to city dwellers (15,2% vs. 8%), single, unmarried and widows comparing with married and divorced (25% vs. 5%), and low-educated women in comparison to high-educated (20% vs. 6%). Lack of time (24%), dislike for seeing an unknown physician (23%) and the examination itself (15%) constitute the main reasons for the refusal. Women from villages and low-educated ones comprise the group not participating in screening. High-educated women undergo screening mainly in private medical institutions (38%). Conclusions: Personal invitations for Pap smear examination constitute an ineffective method of increasing participation. The effectiveness of cervical cancer prophylaxis depends on medical education and at random access to medical care. Information campaign should be mainly directed at rural areas and among less educated people. The screening programme management should make sure women have easy access to a gynecologist by steadily increasing the number of cooperating medical practices.