Keywords: cancer, screening, coordinated care, primary care

Background:

Breast and cervical cancer are among the leading preventable diseases in the world. In our country screening programs for these cancers are implemented in primary care within the coordination of family physicians.

Research questions:

Which factors affect the compliance of women who are registered to a Family Health Center and invited and facilitated for breast and cervical cancer screenings via phone and SMS?

Method:

All women between the ages of 30-69 registered to a Family Health Center (FHC) were included in this cross-sectional analytical study. The status of the participants having/not having breast and cervical cancer screenings was questioned. Two reminder SMSs were sent to the women at one-month intervals. 248 women participated in the study. Women with missing cancer screening tests were invited to FHC. Champion Health Belief Model (subdimensions; sensitivity, importance/seriousness, health motivation, mammography benefits, mammography barriers) and the Attitude Scale Regarding Early Diagnosis of Cervical Cancer were applied through face-to-face. The smear test was taken and women were directed to KETEM for mammography. Using the Gail Model, women's 5-year and lifetime breast cancer risk levels were calculated. The descriptive statistics were given with percentage, mean±SD, minimum and maximum. Chi-square test for categorical data and T-test in paired groups used for the comparative statistics. p<0.05 was considered statistically significant.

Results:

The mean age was 44,1±8,7. The 25.4% had mammography, 30.2% smear test in FHC. After the invitation, these were 41.5% and 66.5% respectively. The age, educational level, income level and menopausal status were the factors which were significantly different among the women who had mammography in FHC. The total and perceived sensitivity sub-dimension scores of Attitude Scale were higher who had smears in FHC than who didn't.

Conclusions:

The systematic invitation and coordination of family physicians improve the women's behaviour towards participation in breast and cervical cancer screening and increases the screening rates.

Points for discussion:

Do you have cancer screening in primary care your country?

Is there any facilitative factor that motivates the physicians or the population to apply for cancer screening tests?

What is your experience about the problems that make it difficult to use evidence based screening and coordinated care of cancer in primary care in your country?