Pap Smear Usage in New South Wales ‐ Impact of Active Promotion

Abstract Less than 25 per cent of eligible Australian women have cervical (‘Pap’) smear tests in any year. Rates are particularly low (<8%) for women over 55 years, the group at highest risk of cervical cancer. A regional program, actively promoting Pap smears by widespread direct community intervention and attention to service needs, targeting women over 55 years and under 25 years, was conducted on the North Coast (population 132,000 women) immediately after a New South Wales State‐wide media campaign in February 1988. The number of Pap smears done in the region increased 119 per cent for women over 55 years and 44 per cent for 15–24 year‐olds during the promotion (63% overall) compared to New South Wales increases of 58 per cent for women over 55 years and 23 per cent for 15–24 year‐olds (31% overall). Differences between the North Coast and New South Wales were statistically significant for all age groups in March and in April for women over 55 years. Differences between New South Wales and Australia (no active promotion) were significant for women over 55 years in March and April. Records from a sample of 152 women attending clinics during the campaign showed 63 per cent had not had a smear test for three or more years, 10 per cent never. The results indicate that an intensive, low‐cost public health program, working in conjunction with general practitioners, can be effective in increasing smear rates and that well‐designed strategies will have an impact on older women, a high risk group who traditionally are poor users of Pap smear services. The combined impact of the two campaign strategies on Pap smear usage was significantly greater than media alone. A Central New South Wales cervical screening database is essential for evaluation of screening promotion.