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Study Shows Women Who Received Cancer Screening Invitation Letters Are More Likely to Have a Pap Test

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Key Points

  • Women who were mailed invitations were at least 1.7 times more likely to have a Pap test than those who did not receive an invitation.
  • In total, 153,617 women (13.3%) were screened within 9 months after their letters were mailed.
  • Of women who had a Pap test in the previous 3 to 5 years, approximately 26.7% were screened within 9 months of receiving a letter. Among women who had no Pap test in the previous 5 years, approximately 9.8% were screened within 9 months of receiving a letter.

Receiving an invitation to get screened for cervical cancer is associated with a greater likelihood of getting screened, according to a study published by Tavasoli et al in Preventive Medicine.

The study explored the impact of invitation and reminder letters on cervical cancer screening participation among approximately 1.15 million eligible Ontario women aged 30 to 69 years. The findings showed that women who were mailed invitations were at least 1.7 times more likely to have a 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 get screened for cervical cancer through the Ontario Cervical Screening Program.

“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. Of women who had a Pap test in the previous 3 to 5 years, approximately 26.7% were screened within 9 months of receiving a letter. Among 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 Enrolment 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 old).

“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."

The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.


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