Impact of family physicians on cervical cancer screening: cross-sectional questionnaire-based survey in a region of southern Poland

BMJ Open. 2019 Aug 30;9(8):e031317. doi: 10.1136/bmjopen-2019-031317.

Abstract

Background: Despite worldwide efforts in encouraging routine pap smears for early detection of cervical cancer, Poland's screening rate lags behind the rest of the European Union at 20.2%. Family physicians (FPs) in Poland rarely perform pap smears, and little is known about the experiences and attitudes of Polish patients regarding pap smear screening in a primary healthcare (PHC) setting.

Methods: A cross-sectional questionnaire-based survey was performed. Questionnaires were distributed among 43 FPs and 418 of their patients in one Polish region. The data from patients were associated with the doctors' characteristics. Descriptive statistics, the χ2 test and the Mann-Whitney U test were used for analysis.

Results: Nearly two-thirds of patients (66%) declared willingness to undergo free pap smear screening by their FPs, with the most common reason being time saved. Among those objecting to receive pap smears from their FPs, immediate specialist care provided by gynaecologists in case of adverse results was the main concern. The factors that positively influenced the patients' decision to undergo cervical cancer screening in PHC were: (1) living in a city with more than 100 000 inhabitants, (2) being single, (3) having a female FP or (4) a physician with specialty training in family medicine.

Conclusion: There is high level of acceptance for pap smears performed in PHC offices among patients in Poland. They are more likely to comply with the screening due to easy access. Establishing a solid physician-patient relationship is also crucial in encouraging screening.

Keywords: cancer; cancer epidemiology; cancer: cervix; general practice; health behaviour; preventive medicine.

MeSH terms

  • Adult
  • Cross-Sectional Studies
  • Female
  • Health Knowledge, Attitudes, Practice
  • Humans
  • Logistic Models
  • Middle Aged
  • Multivariate Analysis
  • Papanicolaou Test*
  • Patient Acceptance of Health Care / statistics & numerical data*
  • Physicians, Family
  • Poland / epidemiology
  • Primary Health Care / statistics & numerical data*
  • Surveys and Questionnaires
  • Uterine Cervical Neoplasms / diagnosis*
  • Vaginal Smears / statistics & numerical data