May be influenced by practice specific factors

BMJ 1995; 310 doi: https://doi.org/10.1136/bmj.310.6985.1004b (Published 15 April 1995) Cite this as: BMJ 1995;310:1004
  1. Vivien Hollyoak
  1. Consultant in communicable disease control County Durham Health Commission, Durham DH1 5XZ

    EDITOR,—R Rudiman and colleages suggest that a financial incentive may be required to increase the participation of primary care staff in the management of breast screening.1 Data from a study undertaken in 1990-1 of part of the prevalence round of breast screening in a health district in the then Northern region support this.

    Almost 3500 women aged 50-64 who were registered with six general practices were invited for breast screening between 1 October 1990 and 31 January 1991. The overall uptake among these women was 75.8%. Decreasing age and increasing affluence, as determined by the Townsend score for ward of residence, were significantly associated with increasing uptake of the invitation (P<0.001, χ2=19.7, df=2 and P<0.001, χ2=46.8, df=3, respectively).2 Uptake varied significantly among the practices, ranging from 65.3% to 81.0% (P<0.001, χ2=22.78, df=5). The distribution of age and ward of residence of the women, however, only partly explained the differences (table).

    The uptakes of cervical cytology screening during the year ending 31 March 1991 among women aged 50-64 registered with the six practices were almost consistently higher than the uptakes of breast screening and ranged from 72.6% to 90.3%. The rank orders for the uptakes of cervical cytology and breast screening were similar from the six practices (table).

    Factors affecting uptake of breast screening and of cervical cytology screening by general practice in an English district, 1990-1. Figures are numbers (percentages) except where stated otherwise

    View this table:

    These data suggest that factors specific to the practices, such as willingness or ability to participate in population screening programmes without appropriate financial reward, in addition to population factors may have accounted for the differences in the uptake of breast screening among the practices.


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