Cervical smears--an opportunity for disinvestment?

Abstract

BACKGROUND: The National Cervical Screening Programme was introduced to increase population coverage while reducing the overscreening of women at low risk. AIM: To describe the frequency with which cervical smears are unnecessarily repeated within the prescribed screening interval. METHOD: All cervical smears taken in a primary care setting in Manchester from women aged 20-64, during 1988-92, were identified. A smear was considered unscheduled if it was taken within 30 months of a preceding smear and if there was no clinical indication or laboratory recommendation for an early repeat smear. RESULTS: A total of 100 134 smears were identified from 85 594 women attending 130 general practices and 40 NHS community clinics; 12 633 women subsequently had 14 702 unscheduled smears; 50% of the unscheduled smears were taken by 18% of the general practices and 8% of the NHS community clinics. CONCLUSION: If they are replicated elsewhere, these findings suggest a substantial disinvestment opportunity.