Effect of Fee on Cervical Cancer Screening Attendance--ScreenFee, a Swedish Population-Based Randomised Trial.

Attendance in the cervical cancer screening programme is one of the most important factors to lower the risk of contracting the disease. Attendance rates are often low in areas with low socioeconomic status. Charging a fee for screening might possibly decrease attendance in this population. Screenin...

Full description

Bibliographic Details
Main Authors: Emilia Alfonzo, Agneta Andersson Ellström, Szilard Nemes, Björn Strander
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2016-01-01
Series:PLoS ONE
Online Access:http://europepmc.org/articles/PMC4795635?pdf=render
_version_ 1811306040609734656
author Emilia Alfonzo
Agneta Andersson Ellström
Szilard Nemes
Björn Strander
author_facet Emilia Alfonzo
Agneta Andersson Ellström
Szilard Nemes
Björn Strander
author_sort Emilia Alfonzo
collection DOAJ
description Attendance in the cervical cancer screening programme is one of the most important factors to lower the risk of contracting the disease. Attendance rates are often low in areas with low socioeconomic status. Charging a fee for screening might possibly decrease attendance in this population. Screening programme coverage is low in low socio-economic status areas in Gothenburg, Sweden, but has increased slightly after multiple interventions in recent years. For many years, women in the region have paid a fee for screening. We studied the effect of abolishing this fee in a trial emanating from the regular cervical cancer screening programme.Individually randomised controlled trial. All 3 124 women in three low-resource areas in Gothenburg, due for screening during the study period, were randomised to receive an offer of a free test or the standard invitation stating the regular fee of 100 SEK (≈11 €). The study was conducted during the first six months of 2013. Attendance was defined as a registered Pap smear within 90 days from the date the invitation was sent out.Attendance did not differ significantly between women who were charged and those offered free screening (RR 0.93; CI 0.85-1.02). No differences were found within the districts or as an effect of age, attendance after the most recent previous invitation or previous experience of smear taking.Abolishment of a modest screening fee in socially disadvantaged urban districts with low coverage, after previous multiple systematic interventions, does not increase attendance in the short term. Other interventions might be more important for increasing attendance in low socio-economic status areas.ClinicalTrials.gov NCT02378324.
first_indexed 2024-04-13T08:37:13Z
format Article
id doaj.art-ece5784248974cffaf3a8945260887fb
institution Directory Open Access Journal
issn 1932-6203
language English
last_indexed 2024-04-13T08:37:13Z
publishDate 2016-01-01
publisher Public Library of Science (PLoS)
record_format Article
series PLoS ONE
spelling doaj.art-ece5784248974cffaf3a8945260887fb2022-12-22T02:54:04ZengPublic Library of Science (PLoS)PLoS ONE1932-62032016-01-01113e015088810.1371/journal.pone.0150888Effect of Fee on Cervical Cancer Screening Attendance--ScreenFee, a Swedish Population-Based Randomised Trial.Emilia AlfonzoAgneta Andersson EllströmSzilard NemesBjörn StranderAttendance in the cervical cancer screening programme is one of the most important factors to lower the risk of contracting the disease. Attendance rates are often low in areas with low socioeconomic status. Charging a fee for screening might possibly decrease attendance in this population. Screening programme coverage is low in low socio-economic status areas in Gothenburg, Sweden, but has increased slightly after multiple interventions in recent years. For many years, women in the region have paid a fee for screening. We studied the effect of abolishing this fee in a trial emanating from the regular cervical cancer screening programme.Individually randomised controlled trial. All 3 124 women in three low-resource areas in Gothenburg, due for screening during the study period, were randomised to receive an offer of a free test or the standard invitation stating the regular fee of 100 SEK (≈11 €). The study was conducted during the first six months of 2013. Attendance was defined as a registered Pap smear within 90 days from the date the invitation was sent out.Attendance did not differ significantly between women who were charged and those offered free screening (RR 0.93; CI 0.85-1.02). No differences were found within the districts or as an effect of age, attendance after the most recent previous invitation or previous experience of smear taking.Abolishment of a modest screening fee in socially disadvantaged urban districts with low coverage, after previous multiple systematic interventions, does not increase attendance in the short term. Other interventions might be more important for increasing attendance in low socio-economic status areas.ClinicalTrials.gov NCT02378324.http://europepmc.org/articles/PMC4795635?pdf=render
spellingShingle Emilia Alfonzo
Agneta Andersson Ellström
Szilard Nemes
Björn Strander
Effect of Fee on Cervical Cancer Screening Attendance--ScreenFee, a Swedish Population-Based Randomised Trial.
PLoS ONE
title Effect of Fee on Cervical Cancer Screening Attendance--ScreenFee, a Swedish Population-Based Randomised Trial.
title_full Effect of Fee on Cervical Cancer Screening Attendance--ScreenFee, a Swedish Population-Based Randomised Trial.
title_fullStr Effect of Fee on Cervical Cancer Screening Attendance--ScreenFee, a Swedish Population-Based Randomised Trial.
title_full_unstemmed Effect of Fee on Cervical Cancer Screening Attendance--ScreenFee, a Swedish Population-Based Randomised Trial.
title_short Effect of Fee on Cervical Cancer Screening Attendance--ScreenFee, a Swedish Population-Based Randomised Trial.
title_sort effect of fee on cervical cancer screening attendance screenfee a swedish population based randomised trial
url http://europepmc.org/articles/PMC4795635?pdf=render
work_keys_str_mv AT emiliaalfonzo effectoffeeoncervicalcancerscreeningattendancescreenfeeaswedishpopulationbasedrandomisedtrial
AT agnetaanderssonellstrom effectoffeeoncervicalcancerscreeningattendancescreenfeeaswedishpopulationbasedrandomisedtrial
AT szilardnemes effectoffeeoncervicalcancerscreeningattendancescreenfeeaswedishpopulationbasedrandomisedtrial
AT bjornstrander effectoffeeoncervicalcancerscreeningattendancescreenfeeaswedishpopulationbasedrandomisedtrial