title: Evaluation of the nationwide cervical screening programme in Thailand: a case-control study.
abstract: OBJECTIVE
  To evaluate the effectiveness of the Pap smear screening programme in Thailand in the prevention of invasive cervical cancer.
  
  
  METHODS
  Four tertiary hospitals, in two provinces of north-east Thailand.
  
  
  METHODS
  A hospital-based case-control study of women aged 30-64, who were resident in north-east Thailand. A total of 130 women with a diagnosis of invasive cervical cancer were compared with two groups of controls: a) hospital controls, b) hospital patient companions. Information on risk factors for cervical cancer and history of screening by cytology (Pap smear) were collected using a structured interview.
  
  
  RESULTS
  Eighty percent of control subjects reported having had a Pap test in the past, and some two-thirds within the three years before interview. There was a significant protective effect for multiple (6+) previous screening tests as reported by 20% of controls. When women who had tests less than six months prior to the study were excluded, there was a strong, significant protective effect of the number of tests (for 1-5 tests: OR = 0.45 95% CI = 0.25 to 0.84, and for 6+ tests: OR = 0.29 95% CI = 0.11 to 0.82). Tests carried out 1-2 years and 3+ years before diagnosis were associated with an OR of 0.27 (95% CI = 0.13-0.56) and 0.42 (95% CI = 0.20-0.88), respectively.
  
  
  CONCLUSIONS
  The cervical screening programme in north-east Thailand has achieved excellent coverage and is preventing cervical cancer. Women who have been screened multiple times are at substantially lower risk than those only screened a few times suggesting that the quality of the screening could be improved.
authors: Graduate School, Khon Kaen University, Thailand.
authors: Chananya
authors: C
authors: Kasinpila
authors: Supannee
authors: S
authors: Promthet
authors: Patravoot
authors: P
authors: Vatanasapt
authors: Peter
authors: P
authors: Sasieni
authors: D Maxwell
authors: DM
authors: Parkin
mesh_terms: D000328:Adult; D002277:Carcinoma / Q000175:diagnosis* / Q000453:epidemiology / Q000473:pathology; D016022:Case-Control Studies; D002648:Child; D055088:Early Detection of Cancer / Q000379:methods / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D015994:Incidence; D008875:Middle Aged; D009035:Mothers / Q000706:statistics & numerical data; D009361:Neoplasm Invasiveness; D010298:Parity; D011247:Pregnancy; D015397:Program Evaluation; D013785:Thailand; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis* / Q000453:epidemiology / Q000473:pathology