Cervical cancer screening in the Flemish region (Belgium): measurement of the attendance rate by telephone interview.

In November and December 1995 a computer assisted telephone interview (CATI) was organized in order to measure the rate of participation in cervical cancer screening among a sample of 1,477 women between 18 and 69 years old, residing in the Flemish Region and selected by random digit dialling. Associations between screening status and a set of explanatory variables (demographic, socioeconomic determinants and exposition to primary risk factors for cervical cancer) were studied by logistic regression modelling. The screening coverage meaning the percentage of women screened less than 3 years ago, increases sharply up to 25 years and remains higher than 85% up to 40 years; from then it decreases progressively. Socioeconomically deprived groups and single women are less likely to have a smear taken. Notable regional differences exist. Over-screening (interval between Papanicolaou smears less than 3 years) is an important phenomenon among screened women especially within the younger age groups. The prevalence of risk factors (sexual intercourse at young age, multiple sex partners, contraceptive pill use, smoking) has increased over time but women at higher risk are generally better screened. This survey provides useful baseline information necessary to monitor the achievement of some main objectives, formulated by the Europe Against Cancer programme and also included in Flemish public health policy.