An article published recently in the Journal of Public Health by Dr Ji Bang and colleagues reported wide variations in cervical screening uptake, both across primary care trusts (PCTs) and also at general practice level. Rates were lowest in general practices with high proportions of women who are young, non-white, and deprived. The study showed that the proportion of female patients aged 25-49 years, the percentage of black and ethnic minority patients, and the Index of Multiple Deprivation score were all associated with significantly lower rates of cervical screening in both PCTs and individual practices. In contrast, the percentage of female patients aged 50–64 years was associated with higher uptake of cervical screening.
Dr Ji Bang suggested that “a multifaceted approach is needed that includes patients, physicians, individual practices and policy makers,” if cervical screening uptake is to be improved. She also stated that “Performance indicators, such as cervical screening coverage, can be substantially influenced by population factors such as age, ethnicity, and socio-economic status. Using crude performance data to determine the quality of care provided by general practices and PCTs can be misleading. This is an important issue as the UK government has announced this year that the general practice performance data will be made available publicly in the near future.”
The authors concluded that the study illustrated that population and health system characteristics remain important influences on participation in preventative interventions such as cervical screening, even in a health system that offers free of charge access to universal healthcare.
The figure to the left shows the association between the percentage of women aged 50-64 and cervical screening rates in PCTs in England.