Impact of family physicians on cervical cancer screening: cross-sectional questionnaire-based survey in a region of southern Poland

Abstract

BackgroundDespite worldwide efforts in encouraging routine pap smears for early detection of cervical cancer, Poland’s screening rate lags behind the rest of the European Union at 20.2%. Family physicians (FPs) in Poland rarely perform pap smears, and little is known about the experiences and attitudes of Polish patients regarding pap smear screening in a primary healthcare (PHC) setting.MethodsA cross-sectional questionnaire-based survey was performed. Questionnaires were distributed among 43 FPs and 418 of their patients in one Polish region. The data from patients were associated with the doctors’ characteristics. Descriptive statistics, the χ2test and the Mann-Whitney U test were used for analysis.ResultsNearly two-thirds of patients (66%) declared willingness to undergo free pap smear screening by their FPs, with the most common reason being time saved. Among those objecting to receive pap smears from their FPs, immediate specialist care provided by gynaecologists in case of adverse results was the main concern. The factors that positively influenced the patients’ decision to undergo cervical cancer screening in PHC were: (1) living in a city with more than 100 000 inhabitants, (2) being single, (3) having a female FP or (4) a physician with specialty training in family medicine.ConclusionThere is high level of acceptance for pap smears performed in PHC offices among patients in Poland. They are more likely to comply with the screening due to easy access. Establishing a solid physician–patient relationship is also crucial in encouraging screening.

A Step towards Understanding and Tackling Health Inequalities: The Use of Secondary Prevention Services and the Need for Health Promotion in a Rural Setting

“…While mammography, FOBT, and chest Xrays rarely became out-of-pocket expenses, almost 60% of thyroid ultrasounds and nearly half of smear tests were financed this way. Our results corroborate earlier findings that a large share-in some regions up to 50%-of all smear tests performed in Poland are financed out of pocket [50,57]. Additionally, in just the first half of 2018, as many as 13% of Polish adults paid for diagnostic tests out of pocket, mostly because of shorter waiting times in the private sector [58].…”

“…For example among the female participants of our study, 75% had ever had a smear test, but only 74.3% of those had been given the test at least once every 3 years. The test could be performed in PHC offices and the acceptance for such practices among Polish patients was found to be high; unfortunately, it hardly ever happens in such settings [50]. Wielkopolskie in 2017-2018 was actually the only province in Poland with an increase in cervical cancer deaths in young women and with a relatively high death rate in the country [3].…”

Associations between the signing status of family doctor contract services and cervical cancer screening behaviors: a cross-sectional study in Shenzhen, China

“…On the other hand, the facilitating effects may be also explained by a specific service advantage that some members (general practitioners or specialized doctors) of the family doctor team usually undertake gynecological examination and cervical sampling procedures. A cross-sectional survey in Poland found that nearly two-thirds of patients were willing to undergo cervical cancer screening by their family doctors [ 32 ]. Therefore, FDCS may attract signing women to engage in screening behaviors as a result of operational accessibility.…”

Barriers and attitudes towards cervical cancer screening in primary healthcare in Poland - doctors’ perspective

“…This study is a part of a survey performed among PHC doctors and their patients. Detailed information about the study design was published elsewhere [ 14 ].…”