Abdul Rashid Rima Marhayu, Dahlui Maznah
Department of Social and Preventive Medicine, Faculty of Medicine, University Malaya, Kuala Lumpur, Malaysia E-mail :
Asian Pac J Cancer Prev. 2013;14(10):5867-70. doi: 10.7314/apjcp.2013.14.10.5867.
Cervical cancer is the second most common cancer among Malaysian women with an ASR of 17.9 and a mortality rate of 5.6 per 100,000 population in 2008 (GLOBOCAN, 2008). The 5 year prevalence was estimated to be 14.5 per 100,000 population. As the second most common cancer affecting productive females, cervical cancer imposes an impact to the socioeconomic aspect of the country. However, the poor uptake of cervical cancer screening is a major problem in detecting early pre-cancerous lesions and thus, delay in initiating treatment for cervical cancer. Realizing the urgency to increase the uptake of PAP smear, besides enhancing the promotion of PAP smear screening for women above 35 years old, the call-recall system for pap smear screening had been piloted in one of the suburban districts which aimed to improve regular participation of women for cervical and breast cancer screening. This is of public health importance as identifying the best feasible option to increase patient's respond to participate in the screening program effectively in our setting will be helpful in implementing an organized regular population based screening program tailored to our setting. The pilot program of cervical cancer screening in Klang was an opportunity to assess different options in recalling patients for a repeat pap smear to increase their participation and adherence to the program.
This was a population based randomized control trial. Women aged 20-65 years in the population that matched the inclusion and exclusion criteria were re-called for a repeat smear. There are four different intervention groups; letter, registered letters, short messages services (SMS) and phone calls where 250 subjects were recruited into each group. Samples were generated randomly from the same population in Klang into four different groups. The first group received a recall letter for a repeat smear similar to the one that has been given during the first invitation. The intervention groups were either be given a registered letter, an SMS or a phone call to re-call them. The socio-demographic data of the patients who came for uptake were collected for further analysis. All the groups were followed up after 8 weeks to assess their compliance to the recall.
The study will provide recommendations about the most effective methods for recall in a population based pap smear screening program on two outcomes: i) patients response; ii) uptake for repeat pap smear.
宫颈癌是马来西亚女性中第二常见的癌症，2008年其年龄标准化发病率为17.9，死亡率为每10万人口5.6例（全球癌症负担，2008年）。估计5年患病率为每10万人口14.5例。作为影响育龄女性的第二常见癌症，宫颈癌对该国的社会经济方面产生了影响。然而，宫颈癌筛查的接受率低是检测早期癌前病变的一个主要问题，因此导致宫颈癌治疗的延迟。意识到提高巴氏涂片检查接受率的紧迫性，除了加强对35岁以上女性巴氏涂片筛查的推广外，还在一个郊区试点了巴氏涂片筛查的电话召回系统，旨在提高女性定期参与宫颈癌和乳腺癌筛查的比例。这具有公共卫生重要性，因为确定在我们的环境中增加患者有效参与筛查计划的最佳可行选择将有助于实施适合我们环境的有组织的定期人群筛查计划。巴生的宫颈癌筛查试点项目是一个评估召回患者进行重复巴氏涂片检查的不同选项的机会，以提高他们对该计划的参与度和依从性。
这是一项基于人群的随机对照试验。对年龄在匹配纳入和排除标准的20 - 65岁人群中的女性进行召回，要求她们进行重复涂片检查。有四个不同的干预组：信件、挂号信、短信服务（SMS）和电话，每组招募250名受试者。样本从巴生的同一人群中随机分为四个不同的组。第一组收到一封类似于首次邀请时给出的重复涂片检查的召回信。干预组分别收到挂号信、短信或电话进行召回。收集前来接受检查的患者的社会人口学数据进行进一步分析。8周后对所有组进行随访，以评估他们对召回的依从性。
该研究将针对基于人群的巴氏涂片筛查计划中的召回最有效方法就两个结果提供建议：i）患者反应；ii）重复巴氏涂片检查的接受率。
