Women who came back for PAP smear screening in rural areas in Thailand

S. Jivasak-Apimas¹, C. Leelapatanadit¹, A. Otani⁴, O. Kiriwat1, S. Wisessak³, S. Marumdee², K. Chiravacharadej¹

¹Siriraj Reproductive Health Research Center, Department of OB GYN, Facul. Med. Siriraj Hospital, Mahidol University, Bangkok, Thailand, ²Provincial Public Health Office, Suphanburi Province, Thailand, ³Provincial Public Health Office, Chaiyapoom Province, Thailand, ⁴Project HOPE, Bangkok, Thailand

Introduction Cervical cancer screening is a preventive measure to surveillance women from developing cervical cancer.. In Thailand the incidence of cervical cancer has reduced from 20.9/100,000 in 1999 to 19.5/100,000 in 2005, however, prevalence of screening and regular screening is still low country wide. Motivation for regular screening among women in remote area has been rare. An Educational Programme on cervical prevention has been implemented in 4 districts each of two provinces in 2001 with financial support from Project HOPE, Thailand to sensitise women's knowledge about the screening.

Objective The objective of this report was to look at results and characteristics of women who had regular screening in the implemented areas.

Methodology Educational materials were developed, and trainings to strengthen capacity of health and medical personnel in the two provinces were carried out. Reports about activities of the programme were reported elsewhere,China, 2002, Spain, 2003 and Malaysia 2005. Health officers who are stationed in the community health premises were standardized their Pap smear taken before starting the programme. The target population was women aged 17-72 years old. So far about 60,000 women received the tests. By December 2004 5906 screenings were done for women who came back to have their tests.

Results Ninety percent of women were 30 years old and over and with primary education or less. Most of them were engaged in farm work or casual labour work, 88% with income of less than 8000 Baht per month, (200 US$), 89%.The average living children was 2. All women had previous normal Pap smear result. 99% of women thought that yearly screening was not a burden and 33% of women would decline to accept the male provider. 93% of women recommended the test to friends. 92.% of women had normal result, and the rest had inflammation. 13 of 5906 women had abnormal results, 5 for HPV and 8 for CIN, which constituted 0.22%. 

Conclusion It is likely that experienced women would come back for the regular screening, and they are more likely to have normal or mildly serious results. Strong counselling for regular screening should be emphasized to surveillance women from developing invasive cervical cancer.