Factors associated with the achievement of cervical smears by general practitioners

Abstract

ObjectiveReliable data about general practitioners performing pap-tests are insufficient. A claim code for the achievement of pap-smears exists in France, but its use by general practitioners is not known. The main purpose of this study was to highlight independent factors associated with the achievement of pap-smears by the general practitioner (GP). We carried out a descriptive and analytic epidemiologic study in 347 GPs and their 244,889 patients, registered at the Health Care Insurance Fund of Flanders. The European Deprivation Index (EDI) in the area of GP’s surgeries was specified. All GPs were questioned by telephone about their performance of pap-tests. The claim database of the insurance fund was analyzed to describe characteristics of GPs.ResultsThe answer rate among questioned GPs was 98.8%. Pap-smears were performed in their surgeries by 182 GPs (53.1%). Among males, 45.7% performed pap-smears versus 78.4% of the female (adjusted odds-ratio = 4.5, p < 0.001). The mean rate of screened women in the target population was 44% when GPs were performing smears versus 42% when they were not (adjusted odds-ratio = 1.04, p = 0.03). Only 19.5% of GPs used the claim code. The number of patients, and the EDI were not associated with pap-smears. Trial registration ClinicalTrials.gov NCT02749110 (April 22, 2016)

General practitioners who never perform Pap smear: the medical offer and the socio-economic context around their office could limit their involvement in cervical cancer screening

“…Third, even if the proportion of GPs who do not perform CCS is consistent with other studies conducted in France [19, 40], it may be underestimated. For example, some GPs could be embarrassed to declare never performing the screening and may have given another reason leading to measurement bias regarding our variable of interest.…”

“…Our results could make it possible to target GPs practicing in contexts that are unfavorable to smear testing in order to raise their awareness, offer them training or provide them with lists of samplers close to their place of exercise. Finally, it should be kept in mind that in order to significantly increase the screening rate, GPs will have to carry out Pap smears but also increase their screening activity to take a larger part in the coverage [40]. The two probably go hand in hand to the extent that an unusual or occasional activity struggles to be maintained on a long-term basis.…”

"Epidemiological and Cytological Aspects of Cervical Dystrophies in Senegal Using Cervico-Uterine Smears"

“…These results are in contrast to those obtained by Diallo and his team, who showed 20 years ago that in the absence of functional urogenital signs, women rarely consulted Senegalese health facilities for early detection of cervical lesions [7]. In France, the high health authority recommends systematic screening for precancerous and cancerous cervical lesions by cervico-uterine smears every three years in women aged 25 to 65 [8]. We note that education, information and communication about cervico uterine diseases are fundamental in their prevention.…”

Barriers and attitudes towards cervical cancer screening in primary healthcare in Poland - doctors’ perspective

“…The study by Poncet et al further found that the likelihood of abstaining from cervical cancer screening was more pronounced in male PHC physicians and the youngest age group [ 19 ]. This trend was also supported in an article by Rochoy et al in 2017. published in France, which demonstrated that 78.4% of female and only 45.7% of male PHC physicians were engaged in the performance of Pap-smears [ 20 ]. As explained by one systematic review, this may also be because female physicians are generally found to screen more patients than their male counterparts [ 21 ].…”