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Health services and policy oral session 4—Screening
O5-S4.01 Register-based chlamydia screening: does it make a difference if the invitation is sent by GP or by Municipal Health Service?
  1. J E A M van Bergen1,
  2. R H Koekenbier2,
  3. J S A Fennema2,
  4. E E H G Brouwers3,
  5. H M Götz4,
  6. C J P A Hoebe3,
  7. E L M Op de Coul5,
  8. L L Pars1,
  9. S M van Ravensteijn6,
  10. I V F van den Broek5
  1. 1Soa Aids Nederland, Amsterdam, Netherlands
  2. 2Public Health Service, Amsterdam, Netherlands
  3. 3Public Health Service, South-Limburg, Netherlands
  4. 4Public Health Service, Rotterdam Rijnmond, Netherlands
  5. 5Centre for Infectious Disease Control RIVM, Netherlands
  6. 6Public Health Service, Rotterdam-Rijnmond, Netherlands


Background In cervical cancer screening, uptake of screening is approximately 10% higher if a woman is invited by her General Practitioner (GP) compared to invitation by Municipal Public Health Service (PHS). A large register-based selective Chlamydia Screening Programme is implemented in Amsterdam (Netherlands) since 2008 by the PHS. We wanted to evaluate whether response rates in Chlamydia screening where higher if invitational letters are sent by a persons' GP and not by PHS.

Methods Based on the municipal registers, annually all 140 000 persons in Amsterdam aged 16–29 yr are invited with a postal letter to participate. Further procedures are internet-based: requesting test-packages, obtaining results, even partner-referral, can be realised via the internet and the unique identifier provided in the personal letter. In one part of the city, the Southeast inner-city area, GP-registers of six health centre are matched with the list of invitees extracted from the municipal register. In the invitational letter these matched eligible's are personally addressed by their GP and not by the physician of the PHS. Participation rates from invitees of GP and PHS in the same geographical town area are compared in three screenings-rounds (r 3 not yet fully completed).

Results In these four town area's in each screening round annually 13 500 persons are invited, of which 35% by the GP and 65% by PHS. In screenings-round 1, the response to invitations by the GP was slightly higher than the response to invitations sent by the PHS in 3 out of 4 neighbourhoods where this was piloted (overall GPs: 16.2% [range: 15.3%–29.1%]; overall PHS: 14.9% [14.4%–21.6%], p=0.023). In round 2 and 3 the difference was not significant (GP vs MHS: r2 10.3%–10.2%; r3 9.5% vs 9.4%). (Abstract O5-S4.01 figure 1).

Abstract O5-S4.01 Figure 1

Participation rate comparing response among GP- and MHS-invitees in 4 town-areas of Amsterdam Southeast.

Conclusions In the first screening-round uptake was slightly higher among GP-invited, but this effect was lost in subsequent screening-rounds. Inviting universally via the PHS is logistically easier and yields the same response rate.

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