Receiving an invitation to undergo screening for cervical cancer is associated with a greater likelihood of getting screened, according to a study published by Tavasoli et al in Preventive Medicine.1
The study explored the impact of invitation and reminder letters on cervical cancer screening participation among approximately 1.15 million eligible Ontario women 30 to 69 years of age. The findings showed that women who were mailed invitations were at least 1.7 times more likely to have a Papanicolaou (Pap) test than those who did not receive an invitation.
Between 2011 and 2013, 4.3 million women in Ontario were eligible for cervical cancer screening, but only 62% got screened with a Pap test. Since 2013, Cancer Care Ontario has sent direct-mail correspondence letters to reach Ontarians who are eligible for breast, colorectal, and cervical cancer screening. Women aged 30 to 69 are sent a letter inviting them to undergo screening for cervical cancer through the Ontario Cervical Screening Program (OCSP).
Linda Rabeneck, MD, MPH, FRCPC
“Increasing screening rates is critical to reducing the burden of cancer in the province,” said Linda Rabeneck, MD, MPH, FRCPC, Vice-President, Prevention and Cancer Control, Cancer Care Ontario. “This study demonstrates the importance of reaching out to Ontarians directly to invite them to get screened.”
Additional Study Findings
In total, 153,617 women (13.3%) were screened within 9 months after their letters were mailed.
Women with no Pap test in the previous 5 years were less likely to participate. Out of women who had a Pap test 3 to 5 years prior, approximately 26.7% were screened within 9 months of receiving a letter. Out of women who had no Pap test in the previous 5 years, approximately 9.8% were screened within 9 months of receiving a letter.
Age and rostering to a Patient Enrollment Physician practice were associated with having a Pap test. The women in the study receiving a Pap test after receiving an invitation letter tended to be younger (30 to 39 years of age).
Rachel Kupets, MD, MSc, FRCSC
“Although correspondence letters are widely used in other jurisdictions throughout the world and have been proven to be successful in increasing screening rates, this research provided one of the first opportunities to address the impact in a large population-based screening program,” said Rachel Kupets, MD, MSc, FRCSC, Scientific Lead, Ontario Cervical Screening Program, Cancer Care Ontario. “The findings will help inform our efforts as we look to further increase participation and remove barriers to screening.” ■
1. Tavasoli SM, Kone Pefoyo AJ, Hader J, et al: Impact of invitation and reminder letters on cervical cancer screening participation rates in an organized screening program. Prev Med 88:230-236, 2016.