Estimation of Pap-test coverage in an area with an organised screening program: challenges for survey methods

Paolo Giorgi Rossi, Gennaro Esposito, Silvia Brezzi, Angela Brachini, Patrizio Raggi, Antonio Federici

Research output: Contribution to journalArticlepeer-review


BACKGROUND: The cytological screening programme of Viterbo has completed the second round of invitations to the entire target population (age 25-64). From a public health perspective, it is important to know the Pap-test coverage rate and the use of opportunistic screening. The most commonly used study design is the survey, but the validity of self-reports and the assumptions made about non respondents are often questioned.

METHODS: From the target population, 940 women were sampled, and responded to a telephone interview about Pap-test utilisation. The answers were compared with the screening program registry; comparing the dates of Pap-tests reported by both sources. Sensitivity analyses were performed for coverage over a 36-month period, according to various assumptions regarding non respondents.

RESULTS: The response rate was 68%. The coverage over 36 months was 86.4% if we assume that non respondents had the same coverage as respondents, 66% if we assume they were not covered at all, and 74.6% if we adjust for screening compliance in the non respondents. The sensitivity and specificity of the question, "have you ever had a Pap test with the screening programme" were 84.5% and 82.2% respectively. The test dates reported in the interview tended to be more recent than those reported in the registry, but 68% were within 12 months of each other.

CONCLUSION: Surveys are useful tools to understand the effectiveness of a screening programme and women's self-report was sufficiently reliable in our setting, but the coverage estimates were strongly influenced by the assumptions we made regarding non respondents.

Original languageEnglish
Pages (from-to)36
Number of pages1
JournalBMC Health Services Research
Publication statusPublished - 2006

ASJC Scopus subject areas

  • Medicine(all)


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