Gyulai Anikó, Nagy Attila, Pataki Vera, Tonté Dóra, Ádány Róza, Vokó Zoltán
Department of Public Health, Faculty of Health, University of Debrecen, Sóstói u. 2-4, Nyíregyháza, H-4400, Hungary.
Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, Kassai út 26, Debrecen, H-4028, Hungary.
BMC Fam Pract. 2018 May 19;19(1):67. doi: 10.1186/s12875-018-0755-0.
Cervical cancer is a preventable disease. Unfortunately, its mortality is high in Hungary: 9.2 deaths /100000 women/year in 2015. The Hungarian organized, nationwide cervical screening program was launched in 2003, but it could improve the coverage rate of cervical cancer screening only by a few percentage points. The vast majority of women still uses opportunistic screening and the organized screening program had little impact on participation by women who never or rarely consult their gynecologists. We assessed whether involving general practitioners in the cervical cancer screening process would increase participation.
The study consisted of two parts: 1. A questionnaire-based health survey was conducted using a representative sample of women aged 25 to 65 years from 11 Hungarian counties, in which we studied where women obtained information about cervical cancer screening. 2. Additionally, a model program and its evaluation were implemented in the practices of general practitioners in one of the 11 counties (Zala county). In this program, general practitioners were informed of their patients' participation in the cervical cancer screening program, and they motivated those who refused the invitation.
Questionnaire-based health survey: A total of 74% (95% confidence interval (CI): 70-77%) of the target population had a screening examination within the previous 3 years. The majority (58, 95% CI: 54-62%) of the target population did not ask for information about cervical cancer screening at all. Only 21% (95% CI: 17-26%) consulted their general practitioners about cancer screening. Evaluation of the model program: the general practitioners effectively motivated 24 out of 88 women (27, 95% CI: 18-38%) who initially refused to participate in the screening program.
The majority of Hungarian women are not informed about cervical cancer screening beyond the invitation letter. General practitioners could play a more important role in mobilizing the population to utilize preventive services. The involvement of general practitioners in the organization of the cervical cancer screening program could increase the participation of those women who generally refuse the services.
宫颈癌是一种可预防的疾病。不幸的是，其在匈牙利的死亡率很高：2015年为9.2例死亡/100000名女性/年。匈牙利于2003年启动了有组织的全国性宫颈癌筛查项目，但仅将宫颈癌筛查的覆盖率提高了几个百分点。绝大多数女性仍采用机会性筛查，而有组织的筛查项目对从未或很少咨询妇科医生的女性的参与率影响甚微。我们评估了让全科医生参与宫颈癌筛查过程是否会提高参与率。
该研究包括两个部分：1. 对来自匈牙利11个县的25至65岁女性的代表性样本进行了基于问卷的健康调查，我们研究了女性从何处获得宫颈癌筛查的信息。2. 此外，在11个县之一（佐洛县）的全科医生诊所实施了一个示范项目及其评估。在这个项目中，全科医生被告知其患者参与宫颈癌筛查项目的情况，并激励那些拒绝邀请的患者。
基于问卷的健康调查：共有74%（95%置信区间（CI）：70 - 77%）的目标人群在过去3年内进行了筛查检查。大多数（58%，95%CI：54 - 62%）目标人群根本没有询问过宫颈癌筛查的信息。只有21%（95%CI：17 - 26%）的人就癌症筛查咨询过他们的全科医生。示范项目评估：全科医生有效地激励了88名最初拒绝参与筛查项目的女性中的24名（27%，95%CI：18 - 38%）。
除了邀请函之外，大多数匈牙利女性对宫颈癌筛查并不了解。全科医生在动员民众利用预防服务方面可以发挥更重要的作用。全科医生参与宫颈癌筛查项目的组织工作可以提高那些通常拒绝接受服务的女性的参与率。
