International Journal of Epidemiology, Vol 28, 35-39, Copyright © 1999 by International Epidemiological Association
W Swaddiwudhipong, C Chaovakiratipong, P Nguntra, P Mahasakpan, Y Tatip and C Boonmak
BACKGROUND: We carried out a systematic screening programme using a mobile
unit with the purpose of increasing use of Papanicolaou (Pap) smear
screening among rural Thai women. The mobile unit campaign was carried out
initially between January and February 1993 and then in 1996 in all the 54
rural villages in Mae Sot District, Tak Province, northern Thailand.
METHODS: To evaluate the effect of the programme on changes in knowledge
and use of screening, we compared the results of three interview surveys of
women, 18-65 years old, in villages selected by systematic sampling for
each survey; first in 1991 (before the operation of the programme),
secondly in 1994 (one year after the first screening campaign), and last in
1997 (one year after the second campaign). This report also compares data
on Pap smears taken by the mobile unit with other existing screening
services in the study area. RESULTS: A total of 1603, 1369, and 1576 women
respectively, participated in each survey. The proportion of women reported
knowing of the Pap smear test increased from 20.8% in 1991 to 57.3% in 1994
and to 75.5% in 1997. The proportion of women who had ever had a Pap smear
increased from 19.9% in 1991 to 58.1% in 1994 and to 70.1% by 1997.
Screening by the mobile unit accounted for 85.2% of all cervical
intraepithelial neoplasia (CIN) III and all invasive cancers identified
among the Pap smears taken by screening services in the area between 1992
and 1996. The rate of CIN III was 3.5/1000 smears in this screening
programme, which was 5.2 and 2.0 times higher than the rates in the
maternal and child health/family planning clinic and the annual one-week
mass screening campaign respectively. CONCLUSIONS: The use of a mobile unit
may be an effective screening programme in rural areas where existing
screening activities cannot effectively reach the female population at
risk.
ARTICLES
A mobile unit: an effective service for cervical cancer screening among rural Thai women
Department of Community and Social Medicine, Mae Sot General Hospital, Tak, Thailand.
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