Free pap screening did not increase participation

March 21, 2016, University of Gothenburg

1,562 women were offered free gynecological pap test screening in three socioeconomically disadvantaged areas in Gothenburg, in 2013. A new study from Sahlgrenska Academy, Närhälsan and the Regional Cancer Center West now shows that these women did not participate to a greater degree than the group that was offered the screening for the usual fee.

Not participating in gynecological pap test screening is the single greatest risk factor in Sweden for acquiring and dying of cervical cancer.

1,562 women in the Gothenburg areas of Angered, Bergsjön and Biskopsgården were offered free pap test screenings in 2013, and their participation has now been compared with the same number of women that were offered the screening for the usual fee of SEK 100

Surprised by the results

The results, which were published in the American journal PLoS One, shows that 37 percent of the randomly assigned free group participated, compared to 39 percent of those who had to pay. This slight difference is not statistically significantly.

"We were actually surprised by the results. We thought that free pap would increase participation, particularly in the socioeconomically disadvantaged areas that have lower participation than the rest of the city," says Emilia Alfonzo, Gynecologist and one of the researchers behind the study.

The fee is low

Researchers also examined if there were any differences among women participating the first time, if they had previously not attended or if a woman's age was a factor; but, none of that proved significant.

"This result should not be used as an argument to raise fees or introduce fees where it has previously been free," emphasizes Björn Strander, Principal Researcher of the study.

"You have to remember that the fee is low, € 11, and a higher fee can very well be a deterrent. But the results teach us that funds that could be used to remove this low fee, could better be used elsewhere. Making it easier for women to get screening is important and there are other measures that have been proven very effective," says Björn Strander.

Other ways to increase participation

Measures that have proven effective in increasing participation are, for example, prebooked appointments that are simple to rebook, annual reminders or telephone contact by a midwife for those who do not show, as well as mailing offers for self-testing to women that have chosen not participate for a long time.

Facts on pap cell screening participation

In Gothenburg's municipality, 47 percent of the women participated within 90 days of having received an appointment (2015). In Västra Götaland Region (VGR), 67 percent participated, while the national average is 55 percent. More women occasionally participate, such as after a reminder, and the coverage of that has participated in the screening during the recommended interval (three or five years depending on age) is 89 percent in VGR, while the national average is 81 percent.

The article Effect of fee on cervical cancer screening attendance - ScreenFee, a Swedish population-based randomised trial was published in PLoS One March 17.

Explore further: What's the best test for cervical cancer? Pap, HPV or both?

More information: Emilia Alfonzo et al. Effect of Fee on Cervical Cancer Screening Attendance—ScreenFee, a Swedish Population-Based Randomised Trial, PLOS ONE (2016). DOI: 10.1371/journal.pone.0150888

Related Stories

What's the best test for cervical cancer? Pap, HPV or both?

June 9, 2014
Should U.S. women be screened for cervical cancer with Pap tests, HPV tests or both? According to researchers from Boston University School of Medicine (BUSM) and Boston Medical Center (BMC) while the merits of screening ...

Most women are unaware of new guidelines for pap test frequency, study reveals

May 11, 2015
Women know that Pap tests are a useful screening test for cervical cancer, but according to a new study led by researchers at the Perelman School of Medicine at the University of Pennsylvania, most of those surveyed are unaware ...

One in 10 US women miss cervical cancer screenings

November 5, 2014
Eight million US women have not been screened in the last five years for cervical cancer, even though regular checkups can help prevent the fatal disease, US health authorities said Wednesday.

Research makes connetion between tubal ligation and increase in cervical cancer rates

January 14, 2013
the surgical tying or severing of fallopian tubes to prohibit pregnancy – have less frequent Pap smears, which puts them at an increased risk for cervical cancer, according to research recently released by a team that included ...

Many women receive unnecessary Pap tests

October 1, 2014
As many as half to two-thirds of women who have undergone hysterectomies or are older than 65 years in the United States report receiving  Pap tests for cervical cancer. This prevalence is surprising in light of the 2003 ...

Obesity not a factor in racial/ethnic variation in cancer screening compliance

November 30, 2015
The higher rate of cancer-related deaths among racial minorities has often been attributed to disparities in cancer screening compliance, however, a new study did not find that the association between body weight/obesity, ...

Recommended for you

Students more likely to eat school breakfast when given extra time, new study finds

August 18, 2018
Primary school students are more likely to eat a nutritional breakfast when given 10 extra minutes to do so, according to a new study by researchers at Virginia Tech and Georgia Southern University.

Like shark attack and the lottery, unconscious bias influences cancer screening

August 17, 2018
What do shark attack, the lottery and ovarian cancer screening having in common? It turns out our judgments about these things are all influenced by unconscious bias.

Phantom odors: One American in 15 smells odors that aren't there, study finds

August 16, 2018
Imagine the foul smell of an ash tray or burning hair. Now imagine if these kinds of smells were present in your life, but without a source. A new study finds that 1 in 15 Americans (or 6.5 percent) over the age of 40 experiences ...

US drug overdose deaths surge amid fentanyl scourge

August 16, 2018
US drug overdose deaths surged to nearly 72,000 last year, as addicts increasingly turn to extremely powerful synthetic opioid fentanyl as the supply of prescription painkillers has tightened.

Parental life span predicts daughters living to 90 without chronic disease or disability

August 15, 2018
Researchers at the University of California San Diego School of Medicine report that women whose mothers lived to at least age 90 were more likely to also live to 90, free of serious diseases and disabilities.

Eating breakfast burns more carbs during exercise and accelerates metabolism for next meal

August 15, 2018
Eating breakfast before exercise may "prime" the body to burn carbohydrates during exercise and more rapidly digest food after working out, University of Bath researchers have found.


Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.