Center for Family Medicine Development

Do Japanese women accept having Pap smears by family physicians? *1, Sachiko Tsunekawa*2 Maki Nishimura

HeW CO-OP JAPAN

[Background] The Pap screening rate in Japan is 21% (5.6% in their twenties)#1. Governmental efforts began recently such as Pap coupon and HPV vaccination covered by public funds. Media also recommend Pap smears frequently in 2011. In Asao Clinic Pap screening test by female family physicians was started in 2008. We researched womens preference regarding physicians sex for Pap smears targeting women who had Pap smears in Asao clinic in 2010. That research showed that Almost all women prefer female physicians. Pap training in family medicine residency hasnt made progress in Japan. We should know the needs of women, not only women who had Pap smears but also women who havent had Pap smears obtained before. [Objectives] :To research barriers to obtaining Pap smears and to inform the public of the need for regular Pap smears :To research to what extent women accept Pap smears performed by family physicians in Japan [Method] Anonymous survey using questionnaire to women from 20y/o to 70y/o who visit Asao clinic where Pap screening is available or Kajiwara clinic where Pap screening is not currently available in March 2011 Sample: 150 samples at each clinic Exclusion criteria: patients with dementia, fever, or patients who cant answer the question. Answer sheets collection: collection box at the clinic, or mail depending on participants choice .
3. Preference for family physician or gynecologist
Asao Kajiwara 0% 75 25 49
p<0.001

1 Asao Clinic *2 Kajiwara Clinic

[Result] 1. Summary of the questionnaire
Asao Number of participants Collection rate Average age 133 99% 51.3 Kajiwara 121 83% 49.5 67.8%

Experience of PAP 71.4% smear

2. Knowledge of HPV

Pap coupon, HPV vaccination, Media

2010

13.1

86.9

2011 0%

44.3

55.7

know don't know

4. Acceptance of Male physician

family physician or no preference gynecologist Asao non-experiencer Kajiwara non-experiencer Asao experiencer Kajiwara experiencer 0%
40.2 35.8

50%

100%

57 53 39 33 50% 60 66

43 47

0 0 1 1 100% refuse accept prefer male

51
50%

100%

5. Reasons for having Pap smears

45 40 35 30 25 20 15 10 5 0

23.5 13.4 3.7 4.9 6.2 3.7

22.2

22.2 17.3 18.3

Asao Kajiwara

6. Reasons for not having Pap smears

P=0.094

60
51.3

Asao Kajiwara not enough knowledge about Pap anxious about Pap

50 40
33.3

30
23.1 23.5 20.5 17.6 20.5 14.7 8.8

29.4 23.5 15.4 11.8 2.6 17.6 7.7 0 2.6 15.4 14.7 8.8 10.3 14.7 7.7

20 10 0

7. Factors influencing decision to have Pap smears

80 70 60 50 40 30 20 10
2.4 40.2 38.5 35.5 32.3 29.7 24.3 21.6 18.3 12.9 8.1 7.7 2.2 12.8 7.3 2.7 0 28 40.5 41.5 66.7 62.662.2 59.5 55.9 50.5 56.4 51.4

Asao experiencer Kajiwara experiencer Asao non-experiencer Kajiwara nonexperiencer

[Conclusion] Medias influence and governmental policy are important for increasing Pap smear screening rate. Women reported a high level of acceptance of family physicians conducting Pap tests. Exposure to family physicians conducting Pap tests appeared to increase acceptance. This suggests that increasing provision of Pap tests through family practice can be an effective means for increasing screening rates. Male physicians are accepted by some women to take Pap smears, however, many Japanese women would not consider having a male physician do their Pap smears. So we need to ideally be able to give women choice of male or female physician to do their Pap smears.
[References] #1 Japanese national basic study of peoples lives 2009

location

word-of-mouth

atmosphere

wating time

female physician other health check

other gynecological check

other