Factors associated with the achievement of cervical smears by general practitioners

Michaël Rochoy, Thibaut Raginel, Jonathan Favre, Estelle Soueres, Nassir Messaadi, Valérie Deken, Alain Duhamel, Christophe Berkhout, Michaël Rochoy, Thibaut Raginel, Jonathan Favre, Estelle Soueres, Nassir Messaadi, Valérie Deken, Alain Duhamel, Christophe Berkhout

Abstract

Objective: Reliable data about general practitioners performing pap-tests are insufficient. A claim code for the achievement of pap-smears exists in France, but its use by general practitioners is not known. The main purpose of this study was to highlight independent factors associated with the achievement of pap-smears by the general practitioner (GP). We carried out a descriptive and analytic epidemiologic study in 347 GPs and their 244,889 patients, registered at the Health Care Insurance Fund of Flanders. The European Deprivation Index (EDI) in the area of GP's surgeries was specified. All GPs were questioned by telephone about their performance of pap-tests. The claim database of the insurance fund was analyzed to describe characteristics of GPs.

Results: The answer rate among questioned GPs was 98.8%. Pap-smears were performed in their surgeries by 182 GPs (53.1%). Among males, 45.7% performed pap-smears versus 78.4% of the female (adjusted odds-ratio = 4.5, p < 0.001). The mean rate of screened women in the target population was 44% when GPs were performing smears versus 42% when they were not (adjusted odds-ratio = 1.04, p = 0.03). Only 19.5% of GPs used the claim code. The number of patients, and the EDI were not associated with pap-smears. Trial registration ClinicalTrials.gov NCT02749110 (April 22, 2016).

Keywords: Early detection of cancer; Mass screening; Physicians; Primary care; Uterine cervical neoplasms; Vaginal smears.

References

    1. Belot A, Velten M, Grosclaude P, Bossard N, Launoy G, Remontet L, et al. Estimation nationale de l’incidence et de la mortalité par cancer en France entre 1980 et 2005. Institut de veille sanitaire Saint-Maurice (France); 2008. . Accessed 11 Feb 2011.
    1. Haute autorité de santé. Dépistage et prévention du cancer du col de l’utérus: actualisation du référentiel de pratiques de l’examen périodique de santé (EPS). Saint-Denis La Plaine: HAS; 2013. p. 55. . Accessed 30 Nov 2017.
    1. Haute autorité de santé. Etat des lieux et recommandations pour le dépistage du cancer du col de l’utérus en France. Synthèse et Recommandations. Saint-Denis La Plaine; 2010. p. 53. . Accessed 30 Nov 2017.
    1. Dache R. Le cancer du col de l’utérus. Paris: Presses universitaires de France; 2008.
    1. Institut national du cancer. Prévention et dépistage du cancer du col de l’utérus. Boulogne-Billancourt (France): INCa; 2013. . Accessed 11 Feb 2011.
    1. Beck F, Gautier A. dir. Baromètre cancer 2010. Saint-Denis: Inpes, coll. Baromètres santé; 2012. p. 272. . Accessed 30 Nov 2017.
    1. Institut national de prévention et d’éducation pour la santé (France) Beck F, Gautier A, Institut national du cancer (France) Baromètre cancer 2010. Saint-Denis: Éd. INPES; 2012.
    1. Bergeron C, Cartier I, Guldner L, Lassalle M, Savignoni A, Asselain B. Lésions précancéreuses et cancers du col de l’utérus diagnostiqués par le frottis cervical, Ile-de-France, enquête Crisap, 2002. Bull Epidemiol Hebd. 2005;2:5–6.
    1. Guillaume E, Pornet C, Dejardin O, Launay L, Lillini R, Vercelli M, et al. Development of a cross-cultural deprivation index in five European countries. J Epidemiol Community Health. 2016;70:493–499. doi: 10.1136/jech-2015-205729.
    1. Levasseur G, Bagot C, Honnorat C. The gynaecological work by GPs in Brittany. Sante Publique Vandoeuvre-Nancy Fr. 2005;17:109–119. doi: 10.3917/spub.051.0109.
    1. Weber A, Lémery B, Millot I. Prévention des cancers gynécologiques: points de vue des médecins sur les modalités de dépistage en Bourgogne. Observatoire régional de la santé de Bourgogne; 2004. . Accessed 30 Nov 2017.
    1. Bang JY, Yadegarfar G, Soljak M, Majeed A. Primary care factors associated with cervical screening coverage in England. J Public Health (Oxf Engl) 2012;34:532–538. doi: 10.1093/pubmed/fds019.
    1. Duport N, Serra D, Goulard H, Bloch J. Which factors influence screening practices for female cancer in France? Rev Dépidémiol Santé Publique. 2008;56:303–313. doi: 10.1016/j.respe.2008.07.086.
    1. Ford I, Norrie J. Pragmatic trials. N Engl J Med. 2016;375:454–463. doi: 10.1056/NEJMra1510059.
    1. Majeed FA, Cook DG, Anderson HR, Hilton S, Bunn S, Stones C. Using patient and general practice characteristics to explain variations in cervical smear uptake rates. BMJ. 1994;308:1272–1276. doi: 10.1136/bmj.308.6939.1272.
    1. Lurie N, Slater J, McGovern P, Ekstrum J, Quam L, Margolis K. Preventive care for women. Does the sex of the physician matter? N Engl J Med. 1993;329:478–482. doi: 10.1056/NEJM199308123290707.
    1. Lurie N, Margolis KL, McGovern PG, Mink PJ, Slater JS. Why do patients of female physicians have higher rates of breast and cervical cancer screening? J Gen Intern Med. 1997;12:34–43. doi: 10.1007/s11606-006-0005-3.
    1. Woodward CA, Hutchison BG, Abelson J, Norman G. Do female primary care physicians practise preventive care differently from their male colleagues? Can Fam Physician. 1996;42:2370–2379.
    1. Ahmad F, Stewart DE, Cameron JI, Hyman I. Rural physicians’ perspectives on cervical and breast cancer screening: a gender-based analysis. J Womens Health Gend Based Med. 2001;10:201–208. doi: 10.1089/152460901300039584.
    1. Webb R, Richardson J, Pickles A. A population-based study of primary care predictors of non-attendance for cervical screening. J Med Screen. 2004;11:135–140. doi: 10.1258/0969141041732166.
    1. Li G, Sajobi TT, Menon BK, Korngut L, Lowerison M, James M, et al. Registry-based randomized controlled trials- what are the advantages, challenges, and areas for future research? J Clin Epidemiol. 2016;80:16–24. doi: 10.1016/j.jclinepi.2016.08.003.

Source: PubMed

Sponsors en medewerkers

Medische omstandigheden

Geneesmiddelinterventies

3
Abonneren