Comprehensiveness of care for women with depression Association between primary care use and cervical cancer screening

Objective To explore comprehensiveness of care in patients with depression by examining associations between a diagnosis of depression, frequency of primary care visits, and Papanicolaou test completion. Design Cross-sectional retrospective survey using electronic medical record data from the Canadian Primary Care Sentinel Surveillance Network. Setting Primary care practices in Ontario. Participants Women aged 21 to 69 eligible to receive Pap tests in 2015. Main outcome measures Associations between 2 predictors (depression and number of primary care visits in 2015) and Pap test completion were measured. Results Overall, 125,258 women were included: 20.5% completed a Pap test and 16.4% had a diagnosis of depression. Having a diagnosis of depression was associated with lower likelihood of Pap test completion (adjusted odds ratio [AOR]=0.92, 95% CI 0.88 to 0.95). A greater number of primary care visits was associated with a higher likelihood of Pap test completion; this association was stronger in women with a diagnosis of depression (AOR=4.9, 95% CI 4.16 to 5.69) than in those without (AOR=3.4, 95% CI 3.25 to 3.60). Conclusion While depression was associated with fewer completed Pap tests, women with depression who saw their family doctors more often were more likely to be screened for cervical cancer. More primary care visits for depression treatment may be associated with an improved likelihood of screening for cervical cancer.

Automated summary

This study explored the comprehensiveness of care in patients with depression by examining the associations between a diagnosis of depression, frequency of primary care visits, and completion of Papanicolaou test. The results showed that having a diagnosis of depression was associated with a lower likelihood of completing the Pap test. However, women with depression who had more primary care visits were more likely to be screened for cervical cancer.