title: Evaluation of a free-coupon program for cervical cancer screening among the young: a nationally funded program conducted by a local government in Japan.
abstract: BACKGROUND
  Finding ways to improve the cervical cancer screening rates among young women has been seen as a critical national health problem in many countries, including Japan. The aim of the present study was to evaluate the effects of a free-coupon program for cervical cancer screening conducted by a local government under financial support from the Japanese national government.
  
  
  METHODS
  The personal cervical cancer screening information was analyzed for all female residents of Toyonaka City, including any past screening history and clinical results since the year 2009, when a free-coupon program for screening was started. These results were compared to results from 2008, prior to implementation of the free-coupon screening program.
  
  
  RESULTS
  The screening rates of women eligible for the free-coupon peaked dramatically compared to women of similar age who paid for their screening; however, the rates for the ineligible-age population also increased significantly in parallel to those in the free-coupon program, possibly by indirect peer and publicity effects. In women aged 20 to 25 years, the consecutive screening rate after a free-coupon screening was significantly lower than for those women who received a regular residential screening. After a free-coupon screening, the rate for participating in consecutive screenings depended significantly on the institution where the participant received her first screening test.
  
  
  CONCLUSIONS
  These results suggest that, for a generation of young women 20-25 years of age, a free-coupon program for cervical cancer screening was effective in increasing the first-time participation rate for screening; however, the increase in first-time participation did not lead to the expected increase in consecutive screenings.
authors.affiliation: Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine.
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Ueda
authors.forename: Tomotaka
authors.initials: T
authors.lastname: Sobue
authors.forename: Akiko
authors.initials: A
authors.lastname: Morimoto
authors.forename: Tomomi
authors.initials: T
authors.lastname: Egawa-Takata
authors.forename: Chie
authors.initials: C
authors.lastname: Hashizume
authors.forename: Hisayo
authors.initials: H
authors.lastname: Kishida
authors.forename: Satomi
authors.initials: S
authors.lastname: Okamoto
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Yoshino
authors.forename: Masami
authors.initials: M
authors.lastname: Fujita
authors.forename: Takayuki
authors.initials: T
authors.lastname: Enomoto
authors.forename: Yoshimi
authors.initials: Y
authors.lastname: Tomine
authors.forename: Jun
authors.initials: J
authors.lastname: Fukuyoshi
authors.forename: Tadashi
authors.initials: T
authors.lastname: Kimura
mesh_terms: D000328:Adult; D055088:Early Detection of Cancer / Q000191:economics* / Q000706:statistics & numerical data*; D005260:Female; D005380:Financing, Government; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D007564:Japan; D009111:Local Government; D015397:Program Evaluation; D002583:Uterine Cervical Neoplasms / Q000517:prevention & control*; D055815:Young Adult