A call recall system for cervical cancer screening : report on the pilot project in the district of Kontich (Flanders/Belgium) : 1991-1995

Purpose. To describe a call recall pilot project for cervical cancer screening in the district of Kontich (Flanders/Belgium). Methods. From October 1991 to December 1995, 36,000 women received a personal invitation from the project organization to have a Pap smear performed with their own GP. The Pap smear reports were received from the laboratories. Women who did not want to or could not participate, were given the opportunity to send back a reply card. Results. There were 10,223 women who had a Pap smear registered (28.4% of all invited women). Another 6,888 women (19.2%) sent back a reply card, leading to a total response of 47.6%, the highest response ever for a cervical screening programme in Flanders. A potential reduction of 16% in invitations for the recall could be reached. Relatively fewer older women, especially from 56-60 years on, are registered as participants in the project. On the other hand, overscreening can be observed in younger women. The percentages of women in whom epithelial changes were reported, vary from 0.9% to 1.6%, according to the laboratory. Discussion. Given the positive results of the call recall pilot project in the district of Kontich, implementation of this call recall scheme in Flanders seems to be justified. Nevertheless, a lot of work still has to be done, since several prerequisites for an efficient screening programme have not yet been met: a complete Pap smear register, a uniform training of cytopathologists, a centralized medical patient record administered by the GP and a referral system from the GP to the specialist.