Effect of a mobile unit on changes in knowledge and use of cervical cancer screening among rural Thai women

Abstract

Background: A large proportion of women in most developing countries, particularly in rural areas, have never had cervical cancer screening. This paper reports the effect of a cervical cancer screening programme using a mobile unit on changes in knowledge and use of Papanicolaou (Pap) smear screening among rural Thai women.

Methods: Health education and collection of Pap smears were carried out by the mobile unit throughout the 54 rural villages in Mae Sot District, Tak Province, between January and February 1993. To determine the extent of changes, we compared the results of two interview surveys of women 18-65 years old in the villages selected by systematic sampling for each survey, first in January 1991 and then in January 1994.

Results: A total of 1603 and 1369 women participated in each survey respectively. The proportion of women who knew of the Pap smear test increased from 20.8% in the first survey sample to 57.3% in the second survey sample. The proportion of those who had even been screened increased from 19.9% in the first survey sample to 58.1% in the second survey sample. These increases were observed solely among ever-married women and there were no significant changes among single women, most of whom remained unscreened. Of ever-married women, the magnitude of increase was highest in the age group 25-34 years, and declined with increasing age.

Conclusions: Greater efforts should be made to encourage the use of screening among the older women. The use of mobile units may be helpful for rapid achievement of higher screening coverage in rural areas, where existing screening services cannot effectively cover the female population at risk.

PIP: A study was conducted in Mae Sot District, Tak Province, north of Bangkok. To determine knowledge and prevalence of use of the Pap smear screening, an interview survey was conducted of women 18-65 years old who had not undergone a hysterectomy in 7 villages selected from the 54 villages in January 1991. Only 333 of the 1603 women interviewed (20.8%) knew of the Pap smear test, and only 319 (19.9%) had ever been screened. To increase knowledge about the importance of the benefit of the Pap test and achieve a higher coverage, a mass screening campaign by a mobile unit was carried out between January and February 1993. Subsequently, in January 1994 an identical interview survey was conducted in 7 selected villages, which were entirely different from those in the previous survey, in order to evaluate the extent of changes of knowledge and use of the Pap smear screening among these rural women. 1369 eligible women participated in the 2nd survey. The proportion of those who knew of the Pap smear test increased from 20.8% in the 1st survey to 57.3% in the 2nd survey. The overall prevalence of screening increased from 19.9% in the 1st survey sample to 58.1% in the 2nd survey sample. Of those ever-screened women in the 2nd survey, 87.7% reported receiving a last Pap smear or = 1 year preceding the interview, compared with 52.0% in the 1st survey. Increase in screening prevalence was significantly evident in all age groups. Of ever-married women, the magnitude of increase was highest in the age group 25-34 years, and declined with increasing age. The results of the 2nd survey showed that women who reported knowing of the Pap test were more likely to receive a Pap smear (92.5%) than those who did not (12.1%). During the screening campaign by the mobile unit in 1993, 6816 out of 16,705 women 18-65 years old in the villages were screened, giving an attendance rate of 40.8%.