A call system for cervical cancer screening in the Netherlands organised on the basis of general practice

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Abstract
Objectives: Does a general practice-based call system for cervical cancer screening achieve a higher attendance of women eligible for screening, compared to the Dutch national call system? Methods: Cohort study in general practice/public health region in the eastern part of the Netherlands. Women registered in ten general practices received an invitation for cervical cancer screening from their general practitioner. A control group was invited by the Local Health Authority (national call system). The controls were group-matched on urbanisation. Subjects: 5,173 women were invited by their, general practitioner (intervention group) and 32,099 were invited by the Local Health Authority (control group). Results: The overall attendance rate in the intervention group was 55% (rural areas 56%, urban areas 54%) compared to 43% in the control group (rural areas 48%, urban areas 39%). For all age groups and during each year of the study, the attendance rate in the intervention group was higher. A reminder by the general practitioner to women not responding to the initial invitation increased the attendance rate by an additional 9%. Conclusions: The general practice-based call system for cervical cancer screening resulted in a higher attendance rate than the national call system. Therefore, a general practice-based call system is preferable to an invitation from the Local Health Authority and should be considered in organising the screening for cervical cancer. The model is a promising option for implementation in routine practice in the Netherlands and elsewhere.