The Effect of Cervical Smears Performed by General Practitioners on the Cervical Cancer Screening Rate of their Female Patients: A Claim Database Analysis and Cross-Sectional Survey

Favre, Jonathan; Rochoy, Michaël; Raginel, Thibaut; Pelletier, Marine; Messaadi, Nassir; Deken-Delannoy, V.; Duhamel, Alain; Berkhout, Christophe

doi:10.1089/jwh.2017.6656

Cited by 7 publications

(7 citation statements)

References 17 publications

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“…Our findings were in line with a study performed by Favre et al in 2018 in France, a nation where similarly GPs often do not perform pap smears 19. In their study, the participation rate in cervical cancer screening was slightly higher when a PHC physician performed smears and when the physician was female.…”

Section: Discussionsupporting

confidence: 92%

Impact of family physicians on cervical cancer screening: cross-sectional questionnaire-based survey in a region of southern Poland

et al. 2019

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BackgroundDespite worldwide efforts in encouraging routine pap smears for early detection of cervical cancer, Poland’s screening rate lags behind the rest of the European Union at 20.2%. Family physicians (FPs) in Poland rarely perform pap smears, and little is known about the experiences and attitudes of Polish patients regarding pap smear screening in a primary healthcare (PHC) setting.MethodsA cross-sectional questionnaire-based survey was performed. Questionnaires were distributed among 43 FPs and 418 of their patients in one Polish region. The data from patients were associated with the doctors’ characteristics. Descriptive statistics, the χ2test and the Mann-Whitney U test were used for analysis.ResultsNearly two-thirds of patients (66%) declared willingness to undergo free pap smear screening by their FPs, with the most common reason being time saved. Among those objecting to receive pap smears from their FPs, immediate specialist care provided by gynaecologists in case of adverse results was the main concern. The factors that positively influenced the patients’ decision to undergo cervical cancer screening in PHC were: (1) living in a city with more than 100 000 inhabitants, (2) being single, (3) having a female FP or (4) a physician with specialty training in family medicine.ConclusionThere is high level of acceptance for pap smears performed in PHC offices among patients in Poland. They are more likely to comply with the screening due to easy access. Establishing a solid physician–patient relationship is also crucial in encouraging screening.

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Section: Discussionsupporting

confidence: 92%

Impact of family physicians on cervical cancer screening: cross-sectional questionnaire-based survey in a region of southern Poland

et al. 2019

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“…Although the authors of that study did not directly evaluate the willingness of PHC physicians to perform Pap smears, their findings are in line with our own observation that no associations exist between demographic and professional characteristics of PHC physicians’ and their willingness to perform cytology screening. Moreover, Favre et al’s findings support our assertion that promoting the provision of Pap smears by PHC physicians would lead to greater coverage [ 16 ].…”

Section: Discussionsupporting

confidence: 77%

“…In a study conducted in France by Favre et al, cervical smears performed by PHC physicians led to increased screening participation rates [ 16 ]. In their evaluation of the independent PHC physicians’ characteristics that predicted participation rates in patients, multivariate analysis showed that the only significant characteristic was whether the doctor performed smears or not.…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2021

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Background Healthcare systems have adopted different strategies to reduce the burden of cervical cancer. In Poland, a population-based screening program was implemented in 2006, leading to a downward trend in cervical cancer burden. However, screening rates are still low in relation to other EU member states. In Poland, Pap smears are mainly performed by gynecologists rather than Primary Health Care (PHC) physicians. Little is known about the experiences and attitudes of the latter regarding cervical cancer screening in a PHC setting. Methods A cross-sectional questionnaire-based survey was carried out among 43 PHC physicians from the Malopolska region in Poland. Barriers and attitudes towards cytology in a PHC setting were evaluated. Results Approximately 35% of surveyed physicians reported having experience in performing cytology. Almost 75% of PHC physicians lacked the necessary equipment in their office to perform the screening. None of the studied physicians performed Pap smears in their office at the time. The reasons included: shortage of competence (78.57%) and time (69.05%), the perception of Pap smears as a task for gynecologists (69.05%), the lack of financial incentives (61.90%), and the belief that their patients would be unwilling to undergo the test in their PHC physician’s office (33.33%). More than three quarters (76.74%) declared they would be ready to perform Pap smears if the tests were additionally paid. No significant associations between PHC physicians’ characteristics and their willingness to perform cytology screening were found. Conclusion The primary barrier to perform Pap smears by PHC physicians does not lie in their personal reluctance but in the organization of the healthcare system. Provision of required training and proper funding allocation can likely improve the screening rate of cervical cancer in Poland.

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“…In our previous publications, we acknowledged as limits a follow up of only 2 years (as CCS used to be triennial in France) and no consideration of gynecology care facilities as confounding factors (8)(9)(10). These limits have been addressed in the current paper.…”

Section: Study Strengths and Limitationsmentioning

confidence: 98%

Participation rate in cervical cancer screening in general practice related to the proximity of gynecology care facilities: A 3 year follow-up cohort study

Quersin

Serman

Favre

et al. 2022

Front. Public Health

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Cervical cancer screening (CCS) by Pap tests is mainly performed by gynecologists in France, but also by general practitioners (GPs) and midwives. The screening uptake is insufficient to reduce the incidence of cervical neoplasms. Our aim was to investigate the association between screening rates in patients listed with GPs and the distance between GPs' offices and gynecology facilities. The population of 345 GPs, and their 93,918 female patients eligible for screening over 3 years (2013–2015), were derived from the Health Insurance claim database. We estimated the socioeconomic level of the geographical area of GPs' offices using the European Deprivation Index (EDI). The proximity of gynecology facilities was calculated by computing their distance from GPs' offices (in order to adjust the proximity of gynecology facilities with EDI and performance of smears by the GP). The number of gynecologists within 5 km of a GP's office was associated with the CCS rate increasing by 0.31% for every unit increase in the density of gynecologists within 5 km (p < 0.0001). The close proximity of gynecology facilities was not significantly associated with screening uptake among female patients when the office of the GP where they were registered was settled in a deprived area.

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The Effect of Cervical Smears Performed by General Practitioners on the Cervical Cancer Screening Rate of their Female Patients: A Claim Database Analysis and Cross-Sectional Survey

Abstract: Cervical smears performed by GPs led to increased screening participation rates within the recommended age group of women. However, the size of this increase is insufficient to reach the expected participation rates.

Cited by 7 publications

References 17 publications

Impact of family physicians on cervical cancer screening: cross-sectional questionnaire-based survey in a region of southern Poland

Impact of family physicians on cervical cancer screening: cross-sectional questionnaire-based survey in a region of southern Poland

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

Participation rate in cervical cancer screening in general practice related to the proximity of gynecology care facilities: A 3 year follow-up cohort study

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