Health Organisation, Policy and Economics Group, School of Health Sciences, University of Manchester, Manchester M13 9PL, UK.
Gynaecological Oncology Research Group, Division of Cancer Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester M13 9PL, UK.
J Public Health (Oxf). 2024 Feb 23;46(1):e43-e50. doi: 10.1093/pubmed/fdad275.
Cervical cancer remains an important global public health concern. Understanding the factors contributing to a decline in screening uptake in high-income countries is fundamental to improving screening rates. We aimed to identify general practice and patient characteristics related to cervical screening coverage in England between 2013 and 2022.
We analyzed a panel of 59 271 General Practice (GP)-years from 7881 GP practices. We applied correlated random effects regression to examine the association between cervical screening uptake and a rich set of GP practice workforce, size, quality and patient characteristics.
Our results show a decline in overall screening rates from 2013/14 to 2021/22 from 77% to 72%. We find GP workforce and list size characteristics are strongly related to screening rates. An increase in 1 FTE Nurse per 1000 patients is related to a 1.94 percentage point increase in cervical screening rates. GP practices located in more deprived areas have lower screening rates.
GP workforce and patient characteristics need to be considered by decision-makers to increase screening rates. The implementation of self-sampling screening methods could help address some of the current barriers to screening, including lack of healthcare staff and facilities.
宫颈癌仍然是一个重要的全球公共卫生问题。了解导致高收入国家筛查率下降的因素对于提高筛查率至关重要。我们旨在确定英格兰 2013 年至 2022 年间与普通科医生和患者特征相关的与宫颈癌筛查覆盖率相关的因素。
我们分析了来自 7881 家普通科医生实践的 59271 个普通科医生年的面板。我们应用相关随机效应回归来研究宫颈癌筛查参与率与普通科医生实践劳动力、规模、质量和患者特征的丰富组合之间的关联。
我们的研究结果显示，从 2013/14 年到 2021/22 年，总体筛查率从 77%下降到 72%。我们发现普通科医生劳动力和名单规模特征与筛查率密切相关。每 1000 名患者增加 1 名全职护士，与宫颈癌筛查率增加 1.94 个百分点相关。位于较贫困地区的普通科医生实践的筛查率较低。
决策者需要考虑普通科医生劳动力和患者特征，以提高筛查率。自我采样筛查方法的实施可能有助于解决当前筛查的一些障碍，包括缺乏医护人员和设施。
