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[Participation in the Dutch national screening programme for uterine cervic cancer higher after invitation by a general practitioner, especially in groups with a traditional low level of attendance].

OBJECTIVE
To gain insight into the differences in participation in the screening programme for uterine cervix cancer between women invited by a general practitioner (GP) and women invited by the local health authority (GGD). Specific attention was given to those groups whose participation is generally below average.


DESIGN
Descriptive epidemiological study.


METHOD
In the period 2000-2003, 237,719 women (30-60 years of age) were invited to participate in the national uterine cervix cancer screening programme in the Southwest of the Netherlands; 37.1% of the women were invited by the GP and 62.9% by the GGD. Data were obtained from the Cervix Information System of the GGDs. Differences in attendance between those invited by the GP and those invited by the GGD were tested by linear regression. Participation was defined as the number of women for whom the result of a cervical smear was known, divided by the number invited.


RESULTS
Invitation by a GP led to a 7.9% (95% CI: 7.5-8.3) higher attendance rate than invitation by a GGD. This difference in attendance was higher for women born in Morocco, Turkey, Surinam and the Netherlands Antilles/Aruba (17.2%; 95% CI: 15.2-I9.2), young women (11.9%; 95% CI: 10.8-13.0), women with a low socio-economic status (11.6%; 95% CI: 10.4-12.7), and women who lived in highly urban areas (13.0%; 95% CI: 12.3-13.6). The differences were the greatest among non-western women who were also part of another low-attendance group: 19.0% (95% CI: 16.7-21.2) for women who lived in highly urban areas and 20.8% (95% CI: 16.8-24.9) for those in the youngest age group.