title: Primary care factors associated with cervical screening coverage in England.
abstract: BACKGROUND
  The National Health Service Cervical Screening Programme was established to decrease the incidence and mortality of cervical cancer in England.
  
  
  METHODS
  To identify socioeconomic and general practice factors associated with cervical screening coverage in England, a national cross-sectional study was conducted using data on 26 497 476 female patients registered with 7970 practices in 152 English primary care trusts (PCTs). The 2008-09 data on cervical screening coverage rates from the quality and outcomes framework (QOF) database were used with data on QOF indicators, staffing levels and socioeconomic status.
  
  
  RESULTS
  The mean cervical screening coverage rate was 78.5% at the PCT level and 83.5% at the practice level. At both levels, cervical screening coverage was significantly negatively associated with the index of multiple deprivation score, percentage of female patients aged 25-49 years and percentage of ethnic minority patients. Also, at the practice level, the percentage of female patients aged 50-64 years, overall QOF score and records and information score were significantly positively associated with cervical screening coverage.
  
  
  CONCLUSIONS
  Cervical screening coverage was significantly lower in PCTs and practices serving higher percentages of younger-aged women, non-Caucasian individuals and those living in socioeconomic deprivation. It is therefore important to adopt strategies to improve cervical screening coverage in these groups.
authors.affiliation: Department of Primary Care & Public Health, Imperial College London, London W6 8RP, UK. jybang@doctors.org.uk
authors.forename: Ji Young
authors.initials: JY
authors.lastname: Bang
authors.forename: Ghasem
authors.initials: G
authors.lastname: Yadegarfar
authors.forename: Michael
authors.initials: M
authors.lastname: Soljak
authors.forename: Azeem
authors.initials: A
authors.lastname: Majeed
mesh_terms: D000328:Adult; D017677:Age Distribution; D003430:Cross-Sectional Studies; D055088:Early Detection of Cancer / Q000706:statistics & numerical data* / Q000639:trends; D004739:England / Q000453:epidemiology; D005260:Female; D054625:Healthcare Disparities / Q000191:economics / Q000208:ethnology; D006801:Humans; D008875:Middle Aged; D054525:Minority Health / Q000706:statistics & numerical data / Q000639:trends; D017063:Outcome Assessment, Health Care; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data / Q000639:trends; D011320:Primary Health Care / Q000706:statistics & numerical data*; D019984:Quality Indicators, Health Care; D012044:Regression Analysis; D012052:Reimbursement, Incentive / Q000706:statistics & numerical data / Q000639:trends; D012959:Socioeconomic Factors; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis* / Q000208:ethnology / Q000517:prevention & control; D014626:Vaginal Smears / Q000706:statistics & numerical data* / Q000639:trends