title: Trends in the cervical cancer screening rates in a city in Japan between the years of 2004 and 2013.
abstract: BACKGROUND
  The objective of our study was to evaluate trends in the cervical cancer screening rate in a city in Japan between the years of 2004 and 2013.
  
  
  METHODS
  The cervical cancer screening rates for all female residents 20-49 years of age living in Toyonaka City for each year between 2004 and 2013 were analyzed and the effects of reminder letters and a free coupon program for cervical cancer screening on the subjects' behavior were evaluated.
  
  
  RESULTS
  The screening rate increased on a single-year basis from 8.9 % (2004) to 12.7 % (2009) as a result of the free coupon program. From 2009 onward, the screening rate on a single-year basis remained stable. Although the free coupon program increased the rate of screening participation, it did not achieve a continuous increase in the number of subjects undergoing screening. Furthermore, despite recommendations for biennial screening, some subjects participated in consecutive screening within the last 2 years after receiving visits for a regularly scheduled residential screening program 1 year before/after the current screening program with a free coupon. There was a peak in the rate of screening participation at the end of the fiscal year among females eligible for the free coupon program.
  
  
  CONCLUSIONS
  Excessive cervical cancer screening performed unnecessarily in the young is an unexpected limitation of free coupon programs. Further efforts to improve the screening rates are required, and the various factors leading young Japanese females to have a negative attitude toward cervical cancer screening should be identified.
authors.affiliation: Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan.
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Tanaka
authors.affiliation: Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan. zvf03563@nifty.ne.jp.
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Ueda
authors.affiliation: Community Health Division, Toyonaka City Public Health Center, Toyonaka, Osaka, Japan.
authors.forename: Hisayo
authors.initials: H
authors.lastname: Kishida
authors.affiliation: Community Health Division, Toyonaka City Public Health Center, Toyonaka, Osaka, Japan.
authors.forename: Noriko
authors.initials: N
authors.lastname: Hosogai
authors.affiliation: Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan.
authors.forename: Akiko
authors.initials: A
authors.lastname: Morimoto
authors.affiliation: Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan.
authors.forename: Tomomi
authors.initials: T
authors.lastname: Egawa-Takata
authors.affiliation: Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan.
authors.forename: Shinya
authors.initials: S
authors.lastname: Matsuzaki
authors.affiliation: Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan.
authors.forename: Eiji
authors.initials: E
authors.lastname: Kobayashi
authors.affiliation: Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan.
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Yoshino
authors.affiliation: Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan.
authors.forename: Tadashi
authors.initials: T
authors.lastname: Kimura
mesh_terms: D000328:Adult; D002947:Cities; D055088:Early Detection of Cancer / Q000191:economics* / Q000639:trends*; D005249:Fees and Charges; D005260:Female; D015438:Health Behavior; D006801:Humans; D007564:Japan; D008389:Marketing of Health Services; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D017010:Reminder Systems; D019564:Unnecessary Procedures / Q000706:statistics & numerical data; D014505:Urban Population / Q000706:statistics & numerical data*; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis*; D055815:Young Adult
keywords: Cervical cancer screening; Free coupon; Participation rates; Registry data; Young females