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Effects of an extended free‐of‐fee strategy on the rate of cervical Papanicolaou smear screening in Israel
Author(s) -
Froimovici Miron,
Sulema Vicky,
Lurie Samuel
Publication year - 2013
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1016/j.ijgo.2012.09.011
Subject(s) - medicine , pap smears , papanicolaou stain , gynecology , obstetrics , confidence interval , univariate analysis , population , multivariate analysis , demography , cervical cancer , environmental health , cancer , sociology
Objective To investigate the influence of an extended free‐of‐fee strategy on the rate of cervical Papanicolaou (Pap) smear screening in Israel. Methods A retrospective analysis was conducted of data obtained from a computer‐generated list of women aged 15–74 years who attended appointments with Clalit Health Services between January 1, 2008, and November 30, 2011, during which Pap smears were taken. The basic strategy allowed a no‐fee Pap smear once every 3 years between the ages of 35 and 54 years; the extended strategy allowed a no‐fee Pap smear once every 3 years between the ages of 25 and 54 years. Results In all, 65 565 Pap smears were taken. The mean monthly study population was 161 438 women. The mean monthly Pap smear rate for the basic strategy was 0.64% ± 0.5% (95% confidence interval [CI], 0.59–0.68) versus 0.75% ± 0.6% (95% CI, 0.70–0.79) for the extended strategy ( P = 0.004). Age group ( P < 0.001), Pap smear strategy type ( P < 0.001), and combined age group and strategy type ( P = 0.028) each predicted the monthly rate of Pap smear screening in a univariate analysis. Conclusion Implementation of the extended free‐of‐fee strategy increased the rate of Pap smear screening among Israeli women.