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Factors affecting uptake of cervical and breast
cancer screening among perimenopausal women in Hong Kong
C Chan, SC Ho, SG Chan, YB
Yip, FC Wong, F Cheng
Department of Community and Family Medicine, The Chinese University
of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong
OBJECTIVES. To identify factors affecting cervical
and breast cancer screening attendance among women aged 44 to 55
years by comparing self-reported uptake of cervical smear and clinical
breast examination between patients and a population sample.
DESIGN AND SETTING. Telephone survey and audit of clinic records
to confirm patients’ self-report.
PARTICIPANTS. Two thousand and sixty-seven women identified through
random telephone dialling from the residence directory and 319 patients
ever-registered at a family practice teaching clinic.
MAIN OUTCOME MEASURES. Uptake of cervical smear and clinical breast
examination.
RESULTS. The proportion of patients undergoing cervical smear tests
and clinical breast examination in the previous 12 months were 35.4%
and 22.6%, respectively, for randomly selected women, while the
figures were 47.2% and 50.6%, respectively, for patients. Record
audit confirmed high rates of screening for patients according to
evidence-based protocols (85.1% had had a cervical smear within
3 years). For women in the random sample (mean age, 48.9 years;
standard deviation, 3.3 years), those who were older, postmenopausal,
not receiving hormone therapy, educated to primary level, and with
no chronic diseases were least likely to have had screening. For
clinic patients (mean age, 47.9 years; standard deviation, 2.8 years),
lower education level was the only variable associated with no recent
smears.
CONCLUSIONS. Healthy perimenopausal and postmenopausal women in
the community with lower educational level and not receiving hormone
therapy were more likely to be underscreened. Attendance of 44-
to 55-year-old women at a family medicine clinic that actively promotes
preventive medicine was associated with high screening uptake.
Hong Kong Med J 2002;8:334-41
Key words: Breast neoplasms; Cervix neoplasms; Female;
Mass screening; Vaginal smears
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