Effectiveness of a call/recall system in improving compliance with cervical cancer screening: a randomized controlled trial.
OBJECTIVE
To determine the effectiveness of a simple call/recall system in improving compliance with cervical cancer screening among women not screened in the previous 3 years.


METHODS
Prospective randomized controlled study.


METHODS
Two family medicine clinics (1 urban, 1 rural) affiliated with Memorial University of Newfoundland, St. John's.


METHODS
A sample of women aged 18-69 years who were listed as patients of the clinics but who had not had a Papanicolaou test (Pap test) within the 3 years before the start of the study. Of 9071 women listed as patients 1360 (15.0%) had not undergone screening in the previous 3 years. A random sample of 650 were selected, 209 of whom were excluded because they had had a hysterectomy, had had a recent Pap test, had moved or had records containing clerical errors. This left 441 women for the study.


METHODS
The 221 women in the intervention group were sent a letter asking them to seek a Pap test and a reminder letter 4 weeks later. The 220 in the control group were sent no letters.


METHODS
Number of women who had a Pap test within 2 months and 6 months after the first letter was sent.


RESULTS
Within 2 months, more women in the intervention group than in the control group had been screened (2.8% [5/178] and 1.9% (4/208] respectively). There was also a difference between the overall proportions at 6 months (10.7% [19/178] and 6.3% [13/208] respectively). None of the differences was statistically significant.


CONCLUSIONS
A letter of invitation is not sufficient to encourage women who have never or have infrequently undergone a Pap test to come in for cervical cancer screening. The effectiveness of added recruitment methods such as opportunistic screening by physicians, follow-up by telephone and the offer of a specific appointment should be evaluated.
Buehler
S K
SK
Faculty of Medicine, Memorial University of Newfoundland, St. John's.
Parsons
W L
WL
D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008403:Mass Screening; D008875:Middle Aged; D065006:Papanicolaou Test; D010349:Patient Compliance; D011446:Prospective Studies; D017010:Reminder Systems; D002583:Uterine Cervical Neoplasms / Q000517:prevention & control*; D014626:Vaginal Smears / Q000706:statistics & numerical data*