title: Cervical cytology screening and government policy.
abstract: OBJECTIVE
  To assess the coverage of cervical cytology screening in one general practice surgery according to the criteria in the new Scottish general practitioner contract and to explore the difficulties of defining performance in such screening.
  
  
  METHODS
  Review of annual analysis of uptake of screening during 1984-8.
  
  
  METHODS
  Suburban general practice surgery in Glasgow serving 3000 patients.
  
  
  METHODS
  All women aged 35-64 registered in 1984 increasing in 1988 to all women aged 20-64.
  
  
  METHODS
  Assessment of uptake of smear tests and reasons for smear not being taken and of the effect of these outcomes on the new general practitioner contract.
  
  
  RESULTS
  The numbers and percentages of women having a smear test in the previous five and three years were recorded, and the reasons why a smear was not taken were defined in the remainder (hysterectomy, test not offered, risk not known, test declined, patient moved away, and patient unaccounted for). In 1988, 85% (608/719) of the women aged 30-64 and 80% (693/870) of those aged 20-64 had had a smear test in the previous five years. An appropriate or irreducible reason for the lack of a smear test was defined in all the others.
  
  
  CONCLUSIONS
  The population studied contained a substantial number of women in whom cervical smear was unnecessary, inappropriate, or refused. These factors and the likely demographic variation in the uptake of smear tests have important implications for the setting and achieving of the government's targets for cervical cytology screening.
authors.forename: S K
authors.initials: SK
authors.lastname: Ross
mesh_terms: D000328:Adult; D005194:Family Practice; D005260:Female; D006291:Health Policy; D006801:Humans; D008403:Mass Screening / Q000706:statistics & numerical data*; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D012307:Risk Factors; D012606:Scotland; D014505:Urban Population; D002583:Uterine Cervical Neoplasms / Q000517:prevention & control*