Clinical Screening Strategies for Cervical Cancer, Chlamydia trachomatis Infection, and Bacterial Vaginosis in Pregnant Women in Hokkaido between 2004 and 2012: a Retrospective Study

Abstract

Background We previously conducted an anonymous survey on universal screening for uterine cervical cancer (UCC), genital Chlamydia trachomatis (CT), and bacterial vaginosis (BV) among pregnant women in Hokkaido (Japan) in 2004, and the screening rates were 87.5% (49/56), 87.5% (40/56), and 57.1% (32/56), respectively. According to the Japanese guidelines for obstetric practice published in 2008 and revised in 2011, universal screening for UCC and genital CT is recommended, but not for all asymptomatic BV patients. We investigated how the screening rates changed from 2004 to 2012. Methods The number of obstetric care facilities in Hokkaido was 113 in 2004 and 97 in 2012. We conducted an anonymous survey on universal screening for UCC, genital CT, and BV and compared the results of the 2004 and 2012 surveys. Our questionnaires in 2004 and 2012 were similar with the exception of the questions about timing of genital CT and BV screenings and diagnostic methods for BV in 2012. Results Survey response rates in 2004 and 2012 were 49.6% (56/113) and 72.9% (70/96), respectively. There were 44,020 deliveries in 2004 and 38,686 in 2012. In 2012, a total of 98.7% (69/70), 100% (70/70), and 67.1% (47/70) of facilities participated in universal screening for UCC, genital CT, and BV, respectively. Compared to 2004, screening rates significantly increased for UCC and genital CT, but did not show a significant difference for BV. However, the number of patients who participated in the screening test for BV significantly increased from 60.1% in 2004 to 75.4% in 2012 (P < 0.001). Conclusions Universal screening for UCC and genital CT followed the guidelines, but not for BV, which showed an increase when compared to the survey in 2004. Obstetricians in Hokkaido are now starting to consider the importance of BV screening and treatment in early pregnancy.