Community mobile health clinics' availability is associated with cervical cancer screening in rural and urban areas: A national cohort study in Taiwan.
Journal
Taiwanese journal of obstetrics & gynecology
Journal Volume
64
Journal Issue
6
ISSN
1875-6263
Date Issued
2025-11
Author(s)
Abstract
Despite free cervical screening in Taiwan, by 2022, less than 50 % of eligible women had undergone screening, raising concerns about spatial access to these services. Mobile health clinics (MHCs) have been implemented to improve access to primary care. This study aimed to investigate whether the MHC availability was associated with cervical cancer screening rate in rural and urban Taiwan.This retrospective cohort study used 2016-2019 National Health Insurance Research Database to identify 6,754,863 women aged ≥30 years eligible for cervical cancer screening at 2017. Each individual was followed up for three years using 2017-2019 outpatient claims to assess cervical cancer screening uptake. Primary exposure variables include residence urban/rural classification and MHC availability, categorized by place of residence. Chi-square tests and multivariable logistic regression were used to compare screening across exposure groups.In 2017, MHCs were available to 5 % of urban and 29 % of rural residents. Cervical screening rates were slightly higher in urban areas with versus without MHCs (48.24 % vs 47.99 %; p=.006), but slightly lower in rural areas with MHCs (48.09 % vs 48.32 %; p<0.001). Multivariable regression showed higher odds of screening uptake among women living in urban areas with MHCs, and among women living in rural areas regardless of MHC availability, compared to those in urban areas without MHCs.Cervical cancer screening uptake in Taiwan remained low, with the lowest screening rates in urban areas without MHCs. Expanding the reach and effectiveness of mobile health services might help improve cancer screening rates in Taiwan.
Subjects
Cervical cancer screening
Disparity
Mobile health care
Pap smear
Rural health
Type
journal article