Women's choice for Down's screening--a comparative experience in three district general hospitals.

Objectives: To look at women's knowledge and understanding of Down's syndrome screening at our hospital and compare the uptake of screening with two other local hospitals in the same trust.

Study Design: All women attending for their anomaly scan at 20 weeks in the three district general hospitals were given an anonymised questionnaire asking whether they had accepted Down's screening and if not, the reason for their non-acceptance. The study was continued for 6 months and then the results were analysed by an independent team. Pearson's Chi squared test was used to test the statistical significance and the data on the uptake of screening at the three different sites were analysed by logistic regression using the likelihood ratio test.

Results: 744 questionnaires were returned with a response rate of 97% and over 95% of women were satisfied with the information provided. Overall only 28% accepted screening with a significant difference between units. 20% of women at one hospital agreed to screening compared with 33% at another (p<0.05). Of those who declined the screening tests 50% gave no specific reason other than not wanting the test. One in six would not consider termination and 12% perceived themselves as low risk.

Conclusions: While most women were well informed of the screening tests available, the majority made a personal choice not to be screened. The uptake of screening in the three hospitals was significantly different despite being in the same geographical location and in all of them was much lower than has been reported in earlier studies. These results need to be taken into consideration prior to implementation of National Screening Committee recommendations.