3 Results

Telephone-based recall for cervical screening commenced 1st April 2019. Table 3.1 shows interim results as of 14th November 2019. ‘n’ represents the number of patients in each sub-group. ‘CST done’ indicates that, as of 14th November 2019, a cervical screening test had been recorded within the previous two years. ‘CST overdue’ indicates that no cervical screening had been recorded during the previous two years.

‘Refugee’ is the subset of patients who have a recorded entry of ‘refugee’ or ‘asylum-seeker’ in the patient file. ‘Other’ is the remainder, who have no recorded entry of ‘refugee’ or ‘asylum-seeker’ in the patient file.

Table 3.1: Cervical screening recall results
CST overdue
CST done
n % n %
All
n 69 83.1% 14 16.9%
Phase1 26 72.2% 10 27.8%
Phase2 43 91.5% 4 8.5%
Refugee
n 34 85.0% 6 15.0%
Phase1 12 70.6% 5 29.4%
Phase2 22 95.7% 1 4.3%
Other
n 35 81.4% 8 18.6%
Phase1 14 73.7% 5 26.3%
Phase2 21 87.5% 3 12.5%

As of 14th November 19, patients aged 25 to 39 years had been contacted by telephone. A total of thirty-six (36) patients are in the sub-groups (in ‘Phase 1’) for which telephone contact had been attempted. Of these ‘Phase 1’ patients, ten (27.8%) had a recorded cervical screening test within the previous two years as of 14th November 2019.

These ‘Phase 1’ groups are compared with patients in the same age range (25 to 39 years) who are in the ‘Phase 2’ group which have not yet been contacted by telephone for cervical screening. A total of forty-seven (47) patients are in this group. Of these ‘Phase 2’ patients, four (8.5%) had a recorded screening test within the previous two years as of 14th November 2019.

Telephone-based recall for cervical screening has a positive effect on cervical screening rates for patients who are overdue for cervical screening.

The table above suggests that, although patients with a background of refugee/asylumseeker status have a very low rate of cervical screening compared to non-refugee patients (‘Refugee Phase 2’ vs. ‘Other’ Phase 2), the rate of cervical screening is similar if telephone-based recall for cervical screening is done (‘Refugee Phase 1’ vs. ‘Other’ Phase 1).

This is shown visually in the interaction plot Figure 3.1.

Table 3.2 compares a logistic regression model which includes a background of refugee/asylum-seeker status and interaction effects with telephone-based recall (‘PhaseTRUE’ in the regression table below) with a simpler logistic regression model (‘Simple model’) which just includes telephone-based recall as the predictor.

 Refugee model Simple model (Intercept) -1.946 ** -2.375 *** (0.617) (0.523) refugeeTRUE -1.145 (1.194) PhaseTRUE 0.916 1.419 * (0.808) (0.642) refugeeTRUE:PhaseTRUE 1.299 (1.407) N 83 83 logLik -34.405 -34.950 AIC 76.810 73.901 *** p < 0.001; ** p < 0.01; * p < 0.05.

The ‘refugee model’ is not superior to the ‘simple model’ according to step-wise model selection by Akaike Information Criterion (AIC). Step-wise model selection by AIC on the ‘refugee model’ yields the ‘simple model’. The ‘simple model’, with just the telephone-based recall intervention (‘Phase’, indicating ‘Phase 1’), shows that there is a significant increase in cervical screening ($$p = 0.027$$) when telephone-based recall was used.