Use of Pap Smear in General Practice by Case Finding or Screening Programme

Abstract

Two different organizational methods of Pap smear examination in prevention of cancer colli uteri are compared in two Danish counties. In one county the method was planned as a pure case finding model; in the other county a modified screening approach was used. Resources were measured as the number of Pap smear examinations per 1 000 women of risk age (25-54 years). They were nearly identical in the two counties. The number of sufficiently investigated women, defined as examined by a Pap smear at least once within a 3-year period, was much larger in the county using the screening model than in the other county. Furthermore the proportion of women sufficiently investigated varied greatly in the county using the case finding model. Even the most active one-fourth of the doctors in this county did not obtain the same percentage of examined women as the average in percentage of examined women in the county with a regular screening programme, even though this active group of doctors had a resource consumption about twice the average for this county. It is concluded that the Pap smear method when aiming at a maximum interval between smears in individual women of 3 years, can be conveniently carried out in general practice by using a case finding model in combination with a screening programme together with a systematized, centrally computer-surveyed procedure, in order to avoid overlapping and exclude women not examined as well as possible.